DEPARTMENT OF HEALTH SERVICES
AND HOSPITAL INSURANCE
Mental Health Branch
PROVINCE OF BRITISH COLUMBIA
ANNUAL REPORT
1971
Printed by K. M. MacDonald, Printer to the Queen's Most Excellent Majesty
in right of the Province of British Columbia.
1972
To Colonel the Honourable John R. Nicholson, P.C, O.B.E., Q.C., LL.D.,
Lieutenant-Governor of the Province of British Columbia.
May it please Your Honour:
The undersigned respectfully submits the Annual Report of the Mental Health
Branch, Department of Health Services and Hospital Insurance, for the year 1971.
RALPH R. LOFFMARK
Minister of Health Services and Hospital Insurance
Office of the Minister of Health Services and Hospital Insurance,
Victoria, British Columbia, January 20, 1972.
Department of Health Services and Hospital Insurance,
Mental Health Branch,
Victoria, British Columbia, January 20, 1972.
The Honourable Ralph R. Loffmark,
Minister of Health Services and Hospital Insurance,
Victoria, British Columbia.
Sir: I have the honour to submit the Annual Report of the Mental Health
Branch for 1971.
F. G. TUCKER, M.B, B.S., C.R.C.P., M.Sc.
Deputy Minister of Mental Health
DEPARTMENT OF HEALTH SERVICES
AND HOSPITAL INSURANCE
MENTAL HEALTH BRANCH
The Honourable Ralph R. Loffmark, Minister of Health Services and Hospital Insurance.
GENERAL ADMINISTRATION
F. G. Tucker, M.B., B.S., C.R.C.P., M.Sc,
Deputy Minister of Mental Health.
A. Porteous,
Assistant Deputy Minister of Mental
Health.
J. S. Bland, B.A., M.B., B.Chir.,
M.R.C.Psych., D.P.M.,
Co-ordinator of Mental Retardation.
H. W. Bridge, M.B., B.Ch., M.Sc,
C.R.C.P.(C),
Co-ordinator of Adult Psychiatric Services.
F. A. Matheson,
Departmental Comptroller.
Miss A. K. Carroll, B.A., M.S.W.,
Social Service Consultant.
R. H. Goodacre, B.A., M.A., C.P.H.,
Sociologist.
Miss M. M. Lonergan, B.S.N.Ed., M.N.,
Nursing Consultant.
C. B. Watson, B.A., M.A.,
Administrative Officer, Vancouver.
R. S. McInnes, B.A., B.D., M.P.H.,
Co-oidinator of Mental Health Centres.
K. Denecke, B.Com.,
Statistician.
Mrs. F. Ireland, B.A., M.S.W.,
Co-ordinator of Boarding Homes.
G. L. Tomalty, B.A., M.P.A.,
Departmental Personnel Officer.
A. Bishop, B.Ed.,
Assistant Personnel Officer.
R. H. Thompson,
Director, Information Services.
N. W. Wylie,
Administrative Officer, Victoria.
Mrs. P. A. West, R.R.L.,
Consultant in Medical Records and
Statistics.
COMMUNITY PSYCHIATRIC PROGRAMMES
P. Adrian, M.S.W.,
Administrator, Chilliwack Mental Health
Centre.
A. L. Aranas, M.D.,
Director, Victoria Mental Health Centre.
Y. Bledsoe, M.S.W.,
Administrator, Powell River Mental
Health Centre.
J. Brown, M.S.W.,
Administrator, Whalley Mental Health
Centre.
V. N. Brown, M.S.W.,
Administrator, Cranbrook Mental
Health Centre.
R. L. Cameron, R.S.W.,
Administrator, Trail Mental Health
Centre.
G. Graham Ellis, B.M., B.Ch., D.P.M.,
Director, Kamloops Mental Health Centre.
D. L. Mitchell, B.Ed., M.A.,
Administrator, Surrey Mental Health
Centre.
A. Geddes, B.S.N.,
Administrator, Prince George Mental
Health Centre.
F. J. Hannah, M.A.,
Administrator, New Westminster Mental
Health Centre.
W. C. Holt, M.D., C.R.C.P.(C),
Director, Burnaby Mental Health Centre.
J. L. Kyle, M.A.,
Administrator, Courtenay Mental Health
Centre.
W. T. Lawson, M.S.W.,
Administrator, Nanaimo Mental Health
Centre.
F. R. Linge, M.A.,
Administrator, Penticton Mental Health
Centre.
E. Little, B.S.N.,
Administrator, Fort St. John Mental Health
Centre.
S. G. Little, M.D.,
Director, Port Coquitlam Mental Health
Centre.
E. Luke, M.B., Ch.B., D.P.M., C.R.C.P.(G),
Director, Maple Ridge Mental Health
Centre.
J. A. Hutton, M.S.W.,
Administrator, Duncan Mental Health
Centre.
F. E. McNair, B.A., M.D., CM., C.R.C.P.,
Director, Kelowna Mental Health Centre.
E. J. Sopp, M.S.W.,
Administrator, Nelson Mental Health
Centre.
S. G. Travers, M.S.W.,
Administrator, Terrace Mental Health
Centre.
J. T. Wood, M.D.,
Director, Saanich Mental Health Centre.
S. Zimmerman, B.S.W.,
Administrator, Vernon Mental Health
Centre.
MENTAL HEALTH SERVICES
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.
W. W. Black, M.B., B.Sc, D.P.M.,
CR.CP.(C),
Superintendent, Geriatric Division.
J. Bower, M.D., D.P.M.,
Superintendent, The Tranquille School.
A. P. Hughes, M.D., B.Sc, C.R.C.P.,
Superintendent, The Woodlands School.
Mrs. E. Paulson, B.S.N.,
Acting Director of Nursing Education.
BRITISH COLUMBIA YOUTH DEVELOPMENT CENTRE
M. E. Campbell, R.N., B.N., M.A.,
Acting Director, Residential Unit.
D. C. Shalman, Ph.D.,
Director, Psychological Education Clinic.
A. A. Cashmore, M.D.(Lond.),
Director, Family and Children's Clinic.
GENERAL ADMINISTRATION
The Year in Review
Construction and Maintenance Review..
Personnel
Retardation and Children's Psychiatric Services..
Social Work Consultation Services
Nursing Consultation Services
Statistics and Medical Records
Special Studies and Continuing Education-
Information Services
TABLE OF CONTENTS
Page
. 11
a 14
a 19
_ 23
. 24
. 26
. 28
_ 30
_ 32
COMMUNITY MENTAL HEALTH SERVICES
Burnaby Mental Health Centre
Chilliwack Mental Health Centre
Courtenay Mental Health Centre
Cranbrook Mental Health Centre
Duncan Mental Health Centre
Fort St. John Mental Health Centre
Kamloops Mental Health Centre
Kelowna Mental Health Centre
Maple Ridge Mental Health Centre
Nanaimo Mental Health Centre
Nelson Mental Health Centre
New Westminster Mental Health Centre
Penticton Mental Health Centre
Port Coquitlam Mental Health Centre
Powell River Mental Health Centre
Prince George Mental Health Centre
Saanich Mental Health Centre
Surrey Mental Health Centre
Terrace Mental Health Centre
Trail Mental Health Centre
Vernon Mental Health Centre
Victoria Mental Health Centre
Whalley Mental Health Centre
35
37
38
39
40
40
41
41
43
44
45
45
46
46
47
47
48
49
49
50
51
52
53
IN-PATIENT SERVICES
Review, 1971
Department of Nursing Education
Riverview Hospital
Geriatric Division
The Woodlands School
The Tranquille School
British Columbia Youth Development Centre.
57
59
60
66
70
76
79
PATIENT MOVEMENT
Patient Movement Trends
Patient Movement Data
85
. _ 86
FINANCIAL STATEMENTS
89
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GENERAL ADMINISTRATION
The Year in Review
Construction and Maintenance Review
Personnel
Retardation and Children's Psychiatric
Services
Social Work Consultation Services
Nursing Consultation Services
Statistics and Medical Records
Special Studies and Continuing Education
Information Services
i4i
mental
health
branch
GENERAL
ADMINISTRATION
THE YEAR
IN REVIEW
F. G. Tucker, M.B., B.S., C.R.C.P., M.Sc.
Deputy Minister of Mental Health
During the past year the programme of the Mental Health Branch has continued to evolve in accordance with the principles approved by the Provincial
Government in 1967. While problems will always abound in the challenging and
complex field of mental health, significant advances have been made in the provision
of community services, and a number of innovative programmes have been introduced. Organization of the central office was modified to improve communication
with our major facilities, and to place an increased emphasis on planning and development of community services. The Vancouver office was closed and the
majority of staff relocated in Victoria. All in-patient facilities now report directly
to the Deputy Minister, instead of, as formerly, to the Director of Mental Health
Services. The Director's position has been reclassified to that of Co-ordinator of
Adult Psychiatric Services. In this position, Dr. H. W. Bridge will be responsible
for assisting in the initiation and co-ordination of a wide spectrum of services for
the adult mentally ill. He will be available as a consultant to Government departments, and private and public agencies who are directly responsible for providing
these services. Dr. J. S. Bland has held a similar position in the field of retardation
for the past three years, as Co-ordinator of Mental Retardation, and has made a
major contribution to the establishment of comprehensive services for the retarded
throughout the Province. Dr. Bland has also assumed the responsibilities of Coordinator of Child Psychiatric Services, pending recruitment of a suitable candidate
into this position.
We have been able to establish the following additional mental health centres
by the redistribution of existing positions:
Mental Health Centre, Whalley;
Mental Health Centre, Port Coquitlam;
Mental Health Centre, Penticton;
Mental Health Centre, Duncan (responsible to Mental Health Centre, Victoria);
Mental Health Centre, Fort St. John (responsible to Mental Health Centre,
Prince George);
Mental Health Centre, Powell River (responsible to Mental Health Centre,
Courtenay).
In spite of this expansion and the fact that we now have 23 mental health
centres established, many outlying areas of the Province are underserviced. I am
particularly concerned with the inequitable distribution of psychiatrists. Seven
centres have no psychiatrists on staff or available to them in the community, and I
am, therefore, particularly grateful to the British Columbia Medical Association
Section of Psychiatry for organizing a roster of visiting psychiatrists to the Peace
River area and the East Kootenays. Travelling expenses and sessional fees are
ll
L 12
MENTAL HEALTH BRANCH REPORT, 1971
paid by the Mental Health Branch. Unfortunately, these arrangements place heavy
demands on the public-spirited physicians who take part, and the Peace River project
was discontinued in September. I trust that the special committee established by
the British Columbia Medical Association to study this problem will make recommendations which will alleviate the situation.
Since September I have visited the majority of mental health centres in the
Province, in company with the senior consultants, in order to survey resources available to the emotionally disturbed, mentally ill, and retarded. I was encouraged and
impressed by the varied and innovative programmes that were demonstrated, by the
concern of the community leaders, and by the dedication and increasing professional
sophistication of our own staff.
I am pleased to report that the Regional Boarding-home Programme, which
was made available by the redeployment of 21 positions, is now well under way.
This will enable mentally disabled individuals requiring a boarding-home level of
care to remain in or return to their area of residence. The administration of this
programme presents many problems, but, if it is to succeed, it is imperative that
high standards of care be established and maintained. Patients must be individually
supervised and the necessary back-up services in the form of activity centres, workshops, and other programmes be readily available.
I wish particularly to draw attention to the Home Care Project initiated in
June under the general direction of Mr. R. Goodacre. We anticipate that this project
will demonstrate that the patients who would normally have been admitted to Riverview Hospital can be effectively cared for in their own homes with the assistance of
a visiting mental health team. A $30,000 research grant has been made available by
the Federal Government to evaluate this project.
The programme for retardates continues to develop satisfactorily, with The
Woodlands School and The Tranquille School providing a high level of care, in spite
of the many problems confronting them and the heavy demands made upon them.
The Tranquille School has increasingly assumed its responsibilities as a regional
resource for eastern and northern parts of the Province, although the professional
components of the programme still require strengthening. Glendale Lodge, situated
at Royal Oak, Vancouver Island, commenced operation in August, providing 300
beds for the multiple handicapped. This facility, which will serve primarily Vancouver Island, has the potential to develop an outstanding diagnostic and assessment
out-patient unit in the coming year, so essential to the effective utilization of the
resources already available in the community. I would like to take this opportunity
to express my personal appreciation to the Board of Directors of the Glendale
Lodge Society for their efforts in bringing this facility into operation, and for the
co-operation they have given the Mental Health Branch.
As the major in-patient psychiatric resource for the Province, Riverview Hospital continues to be the focus of new development. The hospital will establish an
Out-patient Department on East Broadway in Vancouver in January 1972. This
will provide for the evaluation of patients referred for admission, a limited outpatient service with particular emphasis on follow-up, and will house the Home
Care Project. I am optimistic that this will reduce unnecessary admissions to Riverview Hospital and enable better utilization of the existing service. The Riverview
Hospital does not readily lend itself architecturally or administratively to complete
regionalization of service, and yet this is essential if the hospital is to be co-ordinated
with and complement developing community-based programmes. On a trial basis,
therefore, we propose to assign professional staff to specified regions of the Province,
GENERAL ADMINISTRATION L 13
commencing with the Fraser Valley. This region, with an estimated population of
385,000, is responsible for approximately 25 per cent of admissions, and the staff
assigned will work in close co-operation with the five mental health centres serving
that area. We are currently recruiting a project manager who will be responsible
for co-ordinating this development.
The British Columbia Youth Development Centre has functioned well as the
staff gain experience, and treatment results have been satisfactory. Additional resources for children have been developed in the community in co-operation with the
Department of Rehabilitation and Social Improvement, and the programmes of existing private agencies refined and, where necessary, redirected to meet special needs.
Over-all co-ordination of children's psychiatric programmes in the Province, the
establishment and the supervision of standards, and the appropriate placement of
difficult cases continue to be matters of major concern.
The Forensic Clinic in Vancouver has remained under the aegis of the Department of Psychiatry, University of British Columbia, and out-patient forensic services
in other areas of the Province have been provided, where possible, by mental health
centre personnel. The Riverside Unit of the Riverview Hospital has been the main
in-patient assessment centre for cases on remand. Approximately 85 per cent of
those referred by the court for examination do not have a major psychiatric illness,
and the high concentration of sociopaths in our institution has, at times, led to
severe problems in security and hospital management.
No major changes have occurred in the Psychogeriatric Division, which continues to perform effectively and provide a high standard of care. I wish at this
time to pay tribute to the work of Dr. John Walsh, who retired in June after 18
years with the Mental Health Branch. During his years as Superintendent, Dr.
Walsh made a major contribution to the psychogeriatric programme of the Province
and was largely responsible for establishing pre-admission consultations and domiciliary visits and for initiating a successful rehabilitation programme. Dr. W. Black,
formerly Director of the Mental Health Centre, Boundary, succeeded Dr. Walsh as
Superintendent.
The expansion of community resources for the mentally ill and retarded has
inevitably resulted over the years in a higher proportion of severely ill and retarded
patients being admitted and retained in our hospitals and schools—and this is as it
should be. However, this change has placed a heavy burden on the nursing and
service departments. It is essential that the standards of the Mental Health Branch
institutions be at least equivalent to those available in other community facilities.
These foregoing comments will be elaborated upon in the ensuing reports.
CONSTRUCTION AND
MAINTENANCE REVIEW
MAJOR CAPITAL CONSTRUCTION
Eric Martin Institute, Victoria—Patients were moved into this new unit on
January 15, 1970. Requisitions for furniture and equipment for this unit were
approved and returned to the Department of Public Works.
Glendale Hospital, Victoria—This unit was officially opened by the Honourable W. A. C. Bennett, Prime Minister of British Columbia, on October 20, 1971.
The first transfer of patients from The Woodlands School took place on August
26, 1971, and a second transfer was made on September 23, 1971. Forty-two
patients from The Tranquille School were flown to Glendale on October 14, 1971.
Renovations to the West Lawn Building, Essondale—Phase two of this project
was nearly completed, and the Department of Public Works architects were working with Riverview officials in connection with the planning for phase three.
Fire escapes, Essondale—The Department of Public Works received tenders
for fire escapes for the Crease Unit, and was calling for tenders for fire escapes for
the East Lawn Building.
Riverview boiler-house conversion, Essondale—A contract was awarded for
the conversion of the boiler-house at Essondale from coal to gas with oil stand-by,
and work in this connection was proceeding.
Emergency power, Essondale—Plans and specifications were completed for
the installation of emergency power in the Crease Unit.
New fire-alarm system, Essondale—Part of the new fire-alarm system was installed and planning was proceeding for the remainder of the buildings.
All local building systems were connected to the new large map annunciator
at the fire hall, and the over-all site system was in operation.
Fire-alarm system, Tranquille—Work was progressing on modernization of
part of the buildings at The Tranquille School. Plans and specifications for the
balance of the buildings were proceeding.
The new site system, including the new main annunciator and coded air-blast
horn, was in operation.
New fire-alarm system, The Woodlands School, New Westminster—The new
system had been installed and was operating in three of the buildings, while installation was nearing completion in two others. Plans and specifications were being
prepared for the balance of the buildings.
Design of the over-all site system was completed, and annunciators were installed at the main gate and boiler-house.
Fire escapes, Greaves Building, Tranquille—A contract was let in the amount
of $169,950 for this project, and work was proceeding at the year-end.
Ventilation system, Cedar, Pine, Beech, and Willow Cottages, The Woodlands
School, New Westminster—The contract covering Willow Cottage was completed,
and work was proceeding on the balance of the cottages.
Industrial Therapy Building, The Woodlands School, New Westminster—Plans
and specifications for this project were out to tender in November.
14
GENERAL ADMINISTRATION L 15
Skeenaview Hospital, Terrace—A contract in the amount of $298,043 for the
renovation of the kitchens and washrooms, etc., was awarded, and work was under
way.
Riverview Hospital Out-patient Department, Vancouver—A contract in the
amount of $42,164 for alterations to the rented premises to house the Riverview
Out-patient Department was let, and work was proceeding satisfactorily.
COMMUNITY SERVICES
The following new mental health centres were opened during 1971:
Mental Health Centre, Duncan—August 1971;
Mental Health Centre, Port Coquitlam—August 1971;
Mental Health Centre, Fort St. John—September 1971;
Mental Health Centre, Penticton—October 1971;
Mental Health Centre, Whalley—December 1971.
An extension to the Vernon Mental Health Centre was completed during the
year.
INSTITUTIONS
Riverview Hospital, Essondale—A complete new cablevision set-up was installed for all buildings in the Riverview Hospital.
The isolation suite in the North Lawn Building was renovated.
Work on a new four-lane highway from the three-way interchange, west of the
Essondale grounds, past the Crease Unit to the traffic light east of the boiler-house,
was nearly completed by the year-end.
The Woodlands School, New Westminster—The Department of Public Works
made considerable improvements to the Gold Creek Camp in Garibaldi Park by
the installation of running water, stoves, lights, etc. This camp was used extensively
by the residents of The Woodlands School during the summer months. Staff and
patients from The Maples continued the caretaking duties.
The Department of Public Works appointed a permanent full-time fire officer
to The Woodlands School.
Plans for an 11-acre nature park on the grounds of The Woodlands School
were drawn up, and preliminary trails were being cleared by The Woodlands School.
Skeenaview Hospital, Terrace—During the renovations to the Skeenaview Hospital, a mobile kitchen was moved onto the grounds.
An emergency lighting plant was ordered for this institution.
Dellview Hospital, Vernon — One hundred and forty new replacement beds
were received at this institution.
The Department of Public Works painted the exterior of the hospital building.
The Tranquille School, Tranquille—Through the co-operation of the Purchasing Commission, arrangements were made to purchase clothing, not stocked in the
Stores Department, from local retail outlets, for trainees being discharged to the
community.
Mental Health Facilities, Burnaby—The construction of a new access road,
and additional parking facilities, was completed.
GENERAL
The Assessment Committee had a very active year, and there appeared to be
an increase in the number of cases submitted for assessment.
L 16
MENTAL HEALTH BRANCH REPORT, 1971
New Uniform Regulations were prepared, and became effective April 1, 1971,
in order to take advantage of the new materials on the market. It was hoped that
these new regulations would mean a considerable saving in expenditure on uniforms
and also a saving in laundry. The new uniforms would gradually be phased in as
old stock was used up.
GLENDALE
The Honourable W. A. C. Bennett, Prime Minister of the Province of British
Columbia, officially opened the new Glendale facility during special ceremonies on
Wednesday afternoon, October 20. The ceremony included a handing-over of
the key by the general contractor to the Honourable W. N. Chant, Minister of
Public Works, and concluded with the unveiling of a commemorative plaque by
the Prime Minister.
The estimated cost of construction for the entire complex, including the boiler-
house and laundry facility, was $7,170,000, of which the Provincial Government
paid approximately $7,074,000.
Glendale is located in a lovely rural setting in Saanich. The centre consists of
three interconnected buildings comprising ward wings of two stories each, and a
centre block of three stories containing operating-rooms, a dental suite, audiology
facilities, a pathology laboratory, physiotherapy, and other essential services. It
provides assessment, treatment, and training services on a residential and outpatient basis to mentally retarded persons, many with physical handicaps. It has
residential accommodation of 300 beds, plus a 20-bed infirmary for acute medical
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Glendale, a centre dedicated to the care of the handicapped and located in a lovely rural
setting in Saanich, was officially opened October 20, 1971.
GENERAL ADMINISTRATION
L 17
The laboratory complex includes this
fully equipped clinical lab. as well as bacteriology and pathology laboratories.
This six-bed dormitory has access to a
landscaped courtyard and provides each
resident with a colour-coded bedside locker
and dresser.
The two-chair dental suite has an X-ray facility and provision for general anaesthesia.
Two activity rooms, used for handicrafts
and games, also double as dining-rooms
for residents.
Modern cafeteria facilities are available for
staff requiring meal service.
L 18
MENTAL HEALTH BRANCH REPORT, 1971
services. Ambulant residents are in one unit of 150 beds, and those who are
physically handicapped and qualify for extended-care coverage are in a second
150-bed unit.
Glendale is operated by the Glendale Lodge Society, a nonprofit organization,
with funds provided by the Provincial Government and, in respect of operating costs,
in accordance with the Federal-Provincial agreements for hospital and welfare
services.
PERSONNEL
The statistics given in the following tables were based on the fiscal year April
1, 1970, to March 31, 1971. During that period the establishment of permanent
positions increased by 10, for community services.
The staff turnover for the previous fiscal year was 25.8 per cent, and for the
current fiscal year it decreased to 21.82 per cent.
The number of staff recruited during the fiscal year decreased by 384, and
separations decreased by 261. The number of student psychiatric nurses enrolled
dropped by 52 to 143 and remained at that level since April 1, 1971.
Total nursing staff on strength at the end of the fiscal year dropped by 49.
Total of all branch staff was up nine.
Sixty-one requests for classification reviews were received during 1971. Of
the 33 reviewed by Branch personnel officers, 26 were forwarded to the Civil Service Commission with recommendations for reclassification, four were turned down,
and three were under review at the year-end. The balance were in various stages
of study.
During the year, job specifications were reviewed for child care counsellors,
nursing, cooks, and X-ray technicians. The bacteriologist classification series was
changed to laboratory scientist.
Fifteen grievances were considered at the second step in 1971. Two were
settled by the Deputy Minister and the remainder went to the Chief Personnel
Officer and the Civil Service Commission for action. The Civil Service Commission's decision on two grievances concerning overtime provided the required basic
policy for a comprehensive personnel circular covering overtime.
The Personnel office was relocated to Victoria, effective October 1, 1971, with
the closure of the Vancouver offices located in the Provincial Health Building.
At the year end, two pilot projects were under way—the first to determine how
effectively an on-call system could meet the day-to-day deficiencies in nursing staff
due to illness; and the second to evaluate the supervisory requirements at the ward
level.
Branch Personnel policies and procedures were changed or issued in 25 personnel circulars in 1971.
STATISTICAL TABLES
Table A—Summary Showing Over-all Staff Totals in Relation to
Separation and Recruitment
Staff recruited, excluding students 1,221
Staff separated, transferred, etc., excluding students 1,212
Increase
Total staff, excluding students, as of March 31, 1971 4,134
Total staff, excluding students, as of March 31, 1970 4,125
Increase 9
19
l 20 mental health branch report, 1971
Table A—Summary Showing Over-all Staff Totals in Relation to
Separation and Recruitment—Continued
Quarterly staff average, excluding students, 1970/71 4,037
Quarterly staff average, excluding students, 1969/70 4,075
Decrease 3 8
Male Female Total
Student enrolment as of March 31, 1971 13 130 143
Student enrolment as of March 31, 1970 13 182 195
Change Nil -52 -52
Student quarterly average, 1970/71 169
Student quarterly average, 1969/70 201
Change — 32
Table B—Breakdown by Classification of Recruitment and Separation
Activity for the Mental Health Branch, Excluding Student Psychiatric Nurses.
Recruited Separated
Physicians 36 42
Medical interns 7 7
Registered nurses 57 75
Psychiatric nurses 271 195
Female psychiatric aides 237 291
Male psychiatric aides 40 55
Teachers 3 7
Occupational therapists 13 12
Seamstress 5 5
Recreational therapists 8 8
Psychologists 21 18
Psychiatric social workers 23 25
Dietitians 1 2
Cook's helpers 48 47
Clerks 33 31
Clerk-Stenographers 41 48
Laundry workers 50 34
Child care counsellors 23 22
Miscellaneous professional 10 16
Miscellaneous technical 27 27
Miscellaneous 267 245
Totals 1,221 1,212
Note—Tables A and B include 286 and 275 staff respectively who were employed as vacation and other
temporary relief.
GENERAL ADMINISTRATION
Table C—Summary of Staff Turnover
Nursing Staff
L 21
Classification
1969/70
1970/71
Change
Male psychiatric nurses
Female psychiatric nurses..
Registered nurses._
Per Cent
20.6
27.77
41.18
Per Cent
9.06
19.0
29.12
Per Cent
—11.54
-8.77
— 12.06
Note—Calculations made against the year-end staff totals.
By Pay Division
Pay Division
Temporary
Temporary
Relief Staff
Relief Staff
Excluded,
Excluded,
1969/70
1970/71
Per Cent
Per Cent
28.64
13.6
24.30
17.35
22.37
18.57
25.4
16.0
24.5
10.8
19.4
14.2
44.0
25.3
30.0
36.0
29.5
35.3
General administration, including community services and nurs
ing 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
25.8
21.82
Note—Calculations made against the year-end staff totals.
Table D—Comparison of Staff Totals by Unit, With Totals for the
Preceding Fiscal Year
Fiscal Year 1969/70
Fiscal Year 1970/71
Positions
in Establishment as of
March 31,
1970
Number on
Staff as of
March 31,
1970
Positions
in Establishment as of
March 31,
1971
Number on
Staff as of
March 31,
1971
61
71
55
68
61
71
137
53
62
Mental health centres and Boarding-home programme...
131
263
106
114
Subtotals , _
229 1 269 1 220
In-patient care—
1,680
924
395
449
98
74
157
1,734
960
410
469
98
76
149
1,685
924
395
449
98
74
156
1,759
955
404
482
100
77
136
3,777 3,896 3,781 3,913
4,040 4,125 4,050 4,142
325 195 325 143
Totals
4,365
4320 1 4 375
4,285
L 22
MENTAL HEALTH BRANCH REPORT, 1971
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1
RETARDATION AND
CHILDREN'S
PSYCHIATRIC SERVICES
The emphasis during the year continued on the development of community
services for the mentally retarded and for children with emotional disorders. The
increased sophistication of mental health centre staffs aided in these developments,
and there was a clearer idea of what was required in the way of services and facilities
on a regional level.
The year saw two major developments in services. The first was the opening
of Glendale facility in Victoria in October. Administered by a separate independent
Board, Glendale had over 100 patients in residence at the year-end. Many of them
were previously living in either The Woodlands or Tranquille Schools, but their
homes and families are on Vancouver Island. The others were admitted directly
from the community. This facility was already having a major impact on the
waiting-list for admission to the other two institutions. It was hoped that Glendale
would have its full complement of 300 patients by the spring of 1972. In addition
to its in-patient functions, Glendale developed an active assessment team which was
available for out-patient assessment of any mentally retarded person on Vancouver
Island. Short-term admission for such assessment was also available if indicated.
The second major development was the inauguration of the Regional Boarding-
home Programme. Apart from providing an alternative to institutional placement
for those presently in the community, it was also enabling the return to their own
region of many retarded adults who were unnecessarily living in either Woodlands
or Tranquille. This placement was not only more appropriate for these individuals,
but it also vacated much-needed training space.
Although facilities for emotionally disturbed children were improving, there
was still a lack of co-ordination and a real need for assessment, short-stay centres,
and day programmes. During the year, in conjunction with colleagues from the
Department of Rehabilitation and Social Improvement, an attempt was made to
arrange a better spectrum of resources so that the majority of children could remain
in their own areas. Centralized special centres for a few would continue to be
needed for some time, but these should be properly used and the children returned
as soon as possible for ongoing treatment and support in their home community.
With the change in the Branch administration, the Consultant in Retardation
and Children's Psychiatric Services also assumed programme responsibilities for
The Tranquille and Woodlands Schools, acted as Official Adviser to the Board of
Glendale Hospital, and was Chairman of the Board of Management of the British
Columbia Youth Development Centre.
23
SOCIAL WORK
CONSULTATION SERVICES
The year 1971 showed great progress in the definition and development of a
broad, generalized programme of mental health social services. These services,
largely family-centred, comprised work with families and children with emotional,
behavioural, and learning problems; family-life counselling; marital counselling;
services to the chronic schizophrenic and the retarded in their own homes, and in
boarding homes, as well as in sheltered workshops or in activity groups.
Such an extensive service policy demanded a well-trained social worker, one
who was skilled in community organization; in the distinction of priorities; in both
individual and group therapy. Additionally, this extensive service policy demanded
effective administrative knowledge, and above all, a commitment to personal services
and a belief in people.
During the year, all social work departments in both mental health in-patient
facilities and mental health centres were visited by the Social Work Consultant.
Social work consultative services which were rendered, related to the following:
(1) Personnel, its effective use and needs for increased establishment.
(2) The delineation and differentiation of priorities in the social service programme, related to requirements of the communities to be served.
(3) Community organization goals formed on the strengthening of co-operative
structures and procedures in the community health, welfare, education,
and recreation services.
(4) Volunteer recruitment, selection, training, and programming. The volunteer programmes in the centres were often of prime importance in the
delivery of specific services in a broad spectrum of service, for example,
(a) provision of clothing for residents in boarding homes as provided
by the Modern Service Club, White Rock;
(b) the Togetherness Centre, programmed by volunteers in Terrace;
(c) summer camping programme, picnics, hikes, and dances, offered
by a group of volunteers who were operators of boarding homes in the
Fraser Valley area;
(d) volunteer-operated activities, centres for handicapped people in
Coquitlam, which received a grant from the municipality; in Matsqui,
Sumas, and Abbotsford.
The Social Work Consultant had the great privilege of working over the last
25 years with mental health social workers who were second to none in their educational preparation, experience, professional and personal commitment to the work
of helping people. These social work staffs served with the profession of nursing,
as continuing carriers of the philosophy, traditions, purposes, and responsibilities in
this great field of effort—the prevention and treatment of mental disorder.
BOARDING-HOME PROGRAMME
The year 1971 saw the full implementation of the Regional Boarding-home
Programme agreement between the Mental Health Branch and Department of Rehabilitation and Social Improvement. In June, 14 regional boarding-home social
work positions were allocated to mental health centres in various regions of the
Province, together with seven case-aide positions provided by the Mental Health
Branch, but seconded to district offices of Department of Rehabilitation and Social
Improvement.
24
GENERAL ADMINISTRATION L 25
This expansion of the Boarding-home Programme involved the Social Work
Consultant and the Co-ordinator of Boarding Homes in meetings with Directors and
staffs of the mental health centres, public health units, and the Department of Rehabilitation and Social Improvement throughout the Province, in order to facilitate
the programme's implementation.
The regional boarding-home social workers assumed supervision of existing
case loads of mentally disordered persons resident in boarding homes; had the
responsibility of developing new boarding-home resources; accepted referrals for
boarding-home placement, developed adjunctive community services and programmes; and developed programmes and therapeutic environments within the
boarding homes.
Basing the social worker in the community for which he had responsibility
ensured a more comprehensive and immediate service both to the community and
to the client. For example, admissions to the mental hospitals may be prevented
by suitable boarding-home placement, avoiding possible traumatic and unnecessary
disruption of the lives of community residents.
The placement of the regional boarding-home social workers and case-aides
throughout the Province made it possible for many persons to leave the centralized
institutions and to return to a suitable resource in their own area of residence. As
of October 31, 1971, there were 898 persons in boarding homes being supervised
by Mental Health. Each month, an average of only 1 per cent of these persons
need readmission to a mental hospital.
For a number of years public health nurses in some regions provided services
to the Boarding-home Programme. During the year the responsibility for licensing
and standards of boarding homes, under the Community Care Facilities Licensing
Act, was placed with the Public Health Branch of Health Services and Hospital Insurance, so that even closer liaison between the Mental Health and Public Health
Branches was indicated for the future.
Many organizations and individuals provided voluntary services to the Boarding-home Programme, and, with the assistance of the Occupational Therapy Department of Riverview Hospital, groups of volunteers developed community activity
centres throughout the Lower Mainland. This community interest and service of
the volunteers was of great value to the programme.
Throughout the year, as a continuation of a programme begun in 1970, monthly
workshops with boarding-home operators were held. These workshops brought
together the operators, social workers, institutional staff, volunteers, public health,
and Department of Rehabilitation and Social Improvement personnel, and served as
a forum for the discussion of problems, the exchange of ideas, and the examination
of attitudes.
NURSING
CONSULTATION
SERVICES
During 1971, consultation visits were made to 19 mental health centres. The
purposes of the visits ranged from a review of local community resources, evaluation
of the mental health centre's programme, and the consideration of personnel matters, to a study of the nurse's contribution in the multidisciplinary team. Conferences were also held with the Acting Director of Nursing Education, Department
of Nursing Education. General visits were made to the Valleyview and Riverview
Hospitals, at Essondale, and to Skeenaview Hospital, Terrace. Consultation time
was provided on an individual basis to those members of the Branch staff, senior
nurses in the in-patient facilities, and mental health centre staff, who requested
assistance in relation to their individual activities, projects, and problems. The
Consultant provided assistance to the Civil Service Commission in its responsibility
for recruiting nurses for a great number and wide variety of services. This encompassed continuing correspondence, provision of advertising material, reviewing applications, participating on selection panels, and making special presentation when
required. Assistance was provided to the Branch Personnel office by means of
data and recommendations concerning personnel practices, administrative decisions,
and requests for transfer, among many others. An informal service through discussion of nursing problems was also afforded to a number of nursing personnel in
various psychiatric settings in the Province. Communication with nursing consultants in other branches of the Government was strengthened through a series of
informal meetings.
The responsibility of the Consultant for facilitating education opportunities
for students in a variety of nursing education programmes was fulfilled through initiating arrangements with faculties at the University of British Columbia, the British
Columbia Institute of Technology, and the Vancouver City College. In addition,
lecture-discussion sessions were held with faculty or students in nursing programmes
in these institutions. Similar meetings were held with the faculty and senior students in the Department of Nursing Education, Essondale. Orientation programmes
were arranged for newly employed mental health nurses.
Four projects were undertaken and completed during the year, with major
reports submitted to the Deputy Minister. These were
(a) a study of the nursing staff organization in one facility;
(b) a review of the roster system used by nursing throughout the service;
(c) a study of the categories of positions within the nursing establishments of
the in-patient facilities:
(d) a review of the personnel policy factors affecting the amount of nursing
time available for patient care.
In addition, further explorations were made of the current and potential functions
of the nurse on a community mental health team.
The Consultant served on a number of committees within the service and in
the general community. The latter included the Registered Nurses Association of
British Columbia Committee on Nursing Education, the British Columbia Institute
of Technology Advisory Committee to the Nursing Programme, and the Council
of Psychiatric Nurses. Several major nursing meetings were convened by the Consultant. These were concerned with nursing administration, mental health nursing,
26
GENERAL ADMINISTRATION
L 27
nursing personnel categories, and nursing liaison meetings, for which programmes
were arranged on "The Role of the Nurse Clinician," a workshop on "Counselling
the Elderly," the psychiatric programme at the Eric Martin Institute, and that at
the Surrey Memorial Hospital.
During the summer the Consultant met with two visiting nurse consultants from
the Department of National Health and Welfare, and in September was privileged
to convene a visit to the Branch office by the Professor and Director of the School
of Nursing, University of British Columbia.
STATISTICS AND
MEDICAL RECORDS
An extended programme of statistical research and routine data reporting was
carried out during the year. Major research projects included completion of a
patient cohort study on the length of stay in hospital; a time study of staff activities
in mental health centres, and preparation of the Annual Statistics. Four new mental health centres were added to the statistical reporting system, and the expansion
of the Boarding-home Programme required the training of personnel in mental health
centres.
DEVELOPMENT OF STATISTICAL FORMS
A revision of the statistical form for the mental health centres, which was started
in 1970, was completed, and use of the final revised form began in July 1971. As a
result, the data reported by mental health centres became more useful. In addition,
the revised form had provision for centre specific research data. The statistical
forms for both The Woodlands and The Tranquille Schools were also reviewed, and
appropriate changes made to enable both schools to use the same statistical form.
This resulted in the medical record-keeping and data retrieval becoming more
efficient.
Revision and improvement of the statistical forms used by other in-patient facilities was also initiated, and it was expected that upgraded statistical forms would be
implemented during 1972.
ROUTINE DATA RETRIEVAL
A monthly statistical bulletin showing patient-movement data for all mental
health centres and facilities was issued, accompanied by an annual statistical summary, current population data, and other special studies. The Annual Statistical
Report for 1970 was completed. In addition, 56 requests for statistical data were
received, to assist facilities in the planning and preparation of research studies and
reports.
ADMINISTRATIVE AND PLANNING STUDIES
A time study of mental health centre staff activities and community contacts,
similar to a study conducted in 1970, was repeated during the year. A report on
the study was prepared and made available to all participants and headquarters staff,
for review and assistance in programme development.
To assist in the selection of patients to be transferred to the Glendale Hospital,
Saanich, on Vancouver Island, both The Woodlands and The Tranquille Schools
were provided with relevant patient statistics. A report on the level of retardation
and resource utilization, prepared from a sample survey of those registered in the
Registry of Handicapped Children and Adults, was made available to the Consultant
in Retardation and Children's Psychiatric Services. To assist in the planning of
adult psychiatric services, a study on the number of beds needed, based on community and population requirements, was presented to the Planning Division.
RECORDS DEVELOPMENT AND REPORTING CONTROL
Concurrent with revision and implementation of revised statistical forms, many
consultive contacts were made with the personnel and facilities involved, to clarify,
instruct, and guide, in the application of the revised system of reporting information.
28
GENERAL ADMINISTRATION
L 29
With the opening of four mental health centres, orientation visits to this office
by senior clerks were arranged, and kits containing procedure manuals, instructions,
and initial supplies of forms, etc., were forwarded. Five senior clerks were oriented
as to their responsibilities in securing and maintaining medical records. A number
of centres were visited to train clerks in medical record-keeping. With the expansion of the Boarding-home Programme, the need for written instructions increased
in order to maintain a required standard of keeping patient records during, and after,
the transfer of patients.
SPECIAL STUDIES
AND
CONTINUING EDUCATION
PSYCHIATRIC HOME CARE RESEARCH PROJECT
A pilot study of psychiatric home treatment as an alternative to admission to a
mental hospital was started during the summer and the first patient was admitted to
the programme in August. Inauguration of this programme, which serves residents
of the City of Vancouver, was made possible by a $30,000 Public Health Research
grant from the Department of National Health and Welfare, together with $90,000
in Provincial funds to cover the service costs. The purpose of the study is to compare
domiciliary care as an alternative to mental hospital care, through a multivariate
cost-effectiveness analysis of the two methods of treatment.
Cost estimates will be based on direct costs for both hospital-days and home
treatment visits in terms of psychiatrist services as compared to nurse and social
worker visits; office versus home treatment visits; the type of visit; and the medication prescribed. In addition, as a second data category, estimates will be made to
compute indirect costs in terms of welfare expenditures, and other medical and hospital costs which may or may not be associated with the primary psychiatric illness,
as well as costs incurred through other services in the community, provided by health
and social agencies. Variables such as patient progress, patient functioning, and
family disruption, have been given operational definitions in terms of specific questionnaires, inventories, and interview questions.
Over the period of one year, 240 patients considered admissible to Riverview
will be entered into the study. One hundred and twenty will be admitted directly to
the home treatment service in lieu of hospital; 60 will be admitted to hospital, then
to home care on discharge; and 60 patients will be admitted to hospital, but not to
the home treatment service on discharge. All patients will be studied for a year
following their admission to the project. From the study it is hoped to develop a
screening instrument which will be able to predict the success of admitting a patient
to this form of treatment as opposed to hospital.
CONTINUING EDUCATION
Multidisciplinary workshops, using
Branch personnel as cc-ordinators and
teachers, formed the basis of the continuing education programme for the mental
health centres. These included workshops
on behaviour modification, learning disabilities in children, and group therapy.
In order to plan for a comprehensive and
integrated approach to in-service education on a continuing basis, three committees were established during the year to
review educational requirements on a
community mental health programme basis. These committees will look at children's services, psychogeriatrics, and retardation. Committee members were selected not only for their organizational ability, but also for their competence in
acting as teachers and discussion leaders.
30
Panelists at the Educational Seminar
in April.
GENERAL ADMINISTRATION
GENERAL PLANNING
L 31
At the year-end a series of guidelines for minimum bed and programme requirements was in the process of being developed, for adult psychiatric services, the retarded, and children's services. These guidelines will form the basis for programme-
planning discussions within each of the eight mental health planning regions.
INFORMATION
SERVICES
During 1971, Information Services continued to expand its programme of
public education, with emphasis placed on in-service requirements. The following
is a brief outline of the work undertaken by this office during the year:
The development of informational literature was continued, and a total of five
different pamphlets was printed and distributed in quantity to branch facilities and
various interested organizations. The drafting of copy for three of the pamphlets
had been completed during the previous year (i.e., The Mentally Retarded in British
Columbia, The British Columbia Youth Development Centre, and Mental Health in
British Columbia); and two pamphlets, The Tranquille School for the Mentally Retarded and Mental Health in British Columbia (revised), were developed and printed
in 1971. Three other pamphlets were in the initial planning stages.
A continuing series of monthly feature articles, with accompanying photographs, was introduced in May and the material forwarded to 31 selected newspapers. Several press releases were distributed to the news media, and special
coverage was arranged for the transfer of patients by a commercial air-line from
The Woodlands School, New Westminster, to the new Glendale centre in Victoria.
Assistance was also given in arranging for a special press tour in connection with an
Open House held by The Woodlands School in April, and at Alder Lodge in
December.
Eleven issues of the Newsletter, an in-service publication, were published in
1971. The subscription to the Information Resources Centre, Mental Health Materials, New York, was renewed, and photocopies of all relevant material were sent
to the superintendents, directors, administrators, and staff consultants. Mental
Health Branch material in the Physician's Administrative Manual was revised and
4,000 sets were printed and sent to the British Columbia Medical Association for
distribution to its members. As a member of the Planning Division, the Director
assisted in the development of institutional policy manuals and a resource manual.
Major renovations to the branch exhibit in the British Columbia Building at
the Pacific National Exhibition were completed and included displaying sheltered
workshop material from both Woodlands and Riverview. Plans for the development of a mobile display were drawn up and at the year-end the display was under
construction.
Early in the year the Director was appointed a member of the Forms Control
Committee. During the year he visited all of the institutions, and participated in a
three-day seminar at the Education Centre, Essondale. The Director also served as
a consultant to the official opening of Glendale in October, and the Port Coquitlam
Mental Health Centre in November. Other duties included the photographing of
special institutional events, the drafting of material for national publications, and the
editing and layout of this Annual Report.
At the year-end, recommendations had been developed for a further expansion
of the Information Services programme.
32
COMMUNITY MENTAL HEALTH SERVICES
A
mental
health
branch
COMMUNITY
MENTAL HEALTH
SERVICES
During 1971, with the addition of mental health centres at Duncan, Whalley,
Port Coquitlam, Penticton, Powell River, and Fort St. John, local services became
more widely available than ever. These additions brought the number of mental
health centres to 23. In addition, at the year-end, efforts were under way to
recruit a psychiatric social worker for service at Prince Rupert. Previously existing centres were located in Burnaby, Chilliwack, Courtenay, Cranbrook, Kamloops, Kelowna, Maple Ridge, Nanaimo, Nelson, New Westminster, Prince George,
Saanich, Surrey, Terrace, Trail, Vernon, and Victoria. There were nearly 6,000
admissions to service at these centres in 1971.
The standard staff complement of a mental health centre consisted of a psychiatrist, psychologist, social worker, mental health nurse, and two clerical positions.
In some of the newer centres a smaller complement of staff was established. Psychiatric time was provided for all mental health centres but, in spite of intensive recruitment efforts, there were several centres without it. In Nanaimo, Trail, and
Whalley, while without a psychiatrist in the centre, nonetheless services were available through local private practitioners, as was the case in New Westminster and
Prince George when the full-time psychiatrist left during the year. At the year-end,
psychiatric coverage was not available for Nelson or Fort St. John. In Cranbrook,
Terrace, and Prince Rupert, coverage was provided approximately once a month
by a visiting psychiatrist. During the year all centres were visited to assess community resources and local centre programmes. The year brought an emphasis
upon making centre services more effective, as well as expanding the geographic
coverage of these services.
BURNABY
MENTAL HEALTH CENTRE
The Burnaby Mental Health Centre is an out-patient community psychiatric
facility located in the approximate geographic centre of the Lower Mainland at the
junction of Willingdon Avenue and Canada Way in Burnaby. During the year,
further development of local programmes and staff reallocations caused reorganization of the Centre on a more regionalized basis, to serve primarily the Burnaby community. In 1971 the Centre consisted of child and adult out-patient teams and the
Day Hospital. With the development of the Home-treatment Team and the new
Riverview Hospital Out-patient Department, this facility no longer accepted referrals
from other than the Burnaby area, except from other mental health centres and
certain agencies and psychiatrists who, after assessment, may refer patients directly
for Day Hospital treatment.
35
L 36 MENTAL HEALTH BRANCH REPORT, 1971
During the year, functions of the Burnaby Mental Health Centre were
(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 specialized treatment resources such as Day Hospital (milieu
therapy), behaviour therapy, group and family therapies as seemed appropriate and feasible;
(3) to engage in training of health care personnel and research on emotional
illnesses and their treatment;
(4) to employ the knowledge and skills of multidisciplinary teams in developing and implementing a wide variety of community-oriented preventive
programmes in the mental health field, using the broadest possible definition of mental health and prevention.
During 1971 the assessment and treatment loads were maintained. Previous
indirect treatment services, such as the Tuesday Evening Social Club and the Centre's
involvement with the "Secure" programme for agoraphobics and the Burnaby Family
Life Institute, were continued. An additional treatment responsibility assumed
during the year was the follow-up care of Riverview boarding-home patients who
were resident in Burnaby.
A very active consultative programme to the Burnaby schools was provided
by the Children's Out-patient Team, and new groups to teach principles of behaviour
modification to teachers and parents were initiated.
The Day Hospital milieu-therapy programme continued to mature and develop.
Workshops held during the year on the programme resulted in the introduction of
several new group-therapy techniques, to provide group involvement for patients
with varying degrees of social disability, and improvements in the conferencing of
patients and the keeping of records. A major new development was the introduction
of co-operative programmes in occupational therapy with the Burnaby Parks and
Recreation Department.
At the year-end a new type of week-end social interaction programme was
being developed in co-operation with the Burnaby Parks and Recreation. This programme for teenagers and young adults provided outings to community facilities
and activities on Saturdays or Sundays.
1971 also saw efforts going forward in the Day Hospital to develop a comprehensive philosophical and theoretical foundation, in order to provide a basis for
evaluation and development of the programme. A half-day workshop on transactional analysis principles held in November was designed to introduce the staff to
the subject, and further familiarization activities were planned before a major effort
would be made to utilize this theory throughout the treatment programme.
During the year a neighborhood Information Centre was opened in southeast
Burnaby. Staffed by Opportunities Programme volunteers trained and supervised
by the local Community Services Co-ordinator, this centre provided information on
available community services, from baby-sitting to psychiatric care.
A further innovative community programme in 1971 was a four-week summer
enrichment programme operated for 30 children from deprived families who were
about to enter or had just completed Grade I. This programme was developed
largely through the efforts of the leader of the out-patient child psychiatric team and
was extremely well received by the parents and the community. In addition to providing enriching experiences for these children through group activities, games, and
outings, each child was carefully assessed so that help could be given his teacher in
COMMUNITY MENTAL HEALTH SERVICES L 37
managing problems that may arise in the regular classroom situation during the
school-year.
The Centre continued to provide educational experiences for nursing, psychology, social work, and rehabilitation medicine students. The psychiatric rotation
for second year BCIT nursing students set up last year continued to be a particular
success. Major improvements were made in orientation programmes for Riverview
and University of British Columbia student nurses. Burnaby Mental Health Centre
staff were also involved in Mental Health Branch educational programmes.
A special one-day workshop, in co-operation with the Canadian Mental Health
Association and the Pastoral Institute, on the topic of "Pastoral Counselling," was
held in May, with Dr. Ernest Bruder, of St. Elizabeth's Hospital, Washington, D.C.,
as guest speaker.
During the year a number of meetings with Burnaby General Hospital were
held, as well as consultations with Mental Health Branch staff, in attempting to
develop in an integrated and co-ordinated manner a comprehensive range of psychiatric treatment facilities for children and adults in Burnaby. Such efforts were facilitated by the work of the Centre's Director on the British Columbia Medical Association, Section of Psychiatry Committee on Planning Acute Psychiatric Facilities in
the Lower Mainland. Encouragement was received from the Lower Mainland
Regional Hospital District in this endeavour.
During 1971 the Burnaby Mental Health Centre continued to search out and
apply the latest and most effective techniques to aid the emotionally ill, to develop
community structure and institutions, to prevent emotional disorders, and to transmit this knowledge and skill to others.
CHILLIWACK
MENTAL HEALTH CENTRE
This Centre's activities, covering the communities of Chilliwack, Abbotsford,
Hope, and Agassiz, were concerned with direct patient services, indirect services,
education, and community development for mental health.
The open referral system initiated several years ago was maintained, and direct
service consisted of psychiatric assessments and follow-up (largely of cases not suitable for private psychiatric practice) rendered by two sessional psychiatrists in
Abbotsford and Chilliwack, psychological assessments, nursing and social assessments, and a variety of treatment approaches, including group therapy, marital and
family counselling, and play therapy, as well as chemotherapy. The majority of
referrals were, once again, school children requiring attention of a family service
nature.
Indirect services of a consultative and supportive nature were given priority, in
an effort to offset the demand for more time-absorbing direct services. Home and
school visits, interagency case conferences, and joint interviewing with the referring
agency characterized much of the indirect services. Steady improvement of the
schools' special services facilitated improved utilization of class-room consultation
by mental health personnel, and the use of greater discretion in making direct service
referrals to the Centre.
Education for mental health programmes was largely co-sponsored, or promoted, through another community agency or group such as the Family Life Institutes, churches, and schools. Most of the programming was preventive in nature
and was directed to the public at large, with the general focus on a greater under-
L 38 MENTAL HEALTH BRANCH REPORT, 1971
standing of human relationships, effective child guidance, and a broader understanding of social and emotional problems of living. During the year these programmes gained in popularity and increased participation, and appeared to hold
considerable potential for further development.
A sheltered workshop for the handicapped became operational during the year,
and provided a valuable resource for a number of the Centre's patients. The regionalization of the boarding-home programme, with the establishment of a boarding-
home social worker at this Centre, also generated further interest in community care
facilities, with a number of inquiries and applications for boarding-home or foster-
home care being made. Members of the team continued to participate on special
project committees, co-ordinating and social planning councils, and other special
interest groups related to mental health concerns.
COURTENAY
MENTAL HEALTH CENTRE
With a full complement of staff at the year-end, including a sessional psychiatrist and a part-time pharmacist, this Centre was in a position to provide a wider
range of mental health services to the communities in the Upper Island area.
Difficulty was still experienced in meeting the needs and expectations of the
communities in the outlying areas. Travelling clinic sessions were held regularly;
however, the Centre could not provide the ongoing services (in terms of direct
patient care and community-agency consultations) that these communities requested.
Through the combined use of tape recordings and selected psychometrics, the Centre
was attempting to bridge the gap between visits. This technique was being utilized
primarily by the family doctors and special school counsellers for marital counselling
and learning disabilities.
The travelling sessions were expanded due to the fact that Powell River was
reassigned to this Centre. A social worker will function there on a full-time basis,
and travelling sessions conducted by the rest of the staff will be on a monthly basis.
The Centre was active in the area of indirect community services, and staff
members served as consultants or advisers to approximately 20 community groups
of various natures. Centre staff also regularly provided consultative services to the
four school districts, the Department of Rehabilitation and Social Improvement,
probation officers, and public health.
During the year the staff conducted a series of training seminars on selected
mental health topics. Participants in these sessions included the family doctors,
Bevan Lodge staff, school counsellors, foster parents, and NOW volunteers. In-staff
training sessions were also conducted.
NOW, a volunteer crisis phone line operated by students, was in operation
throughout the year and performed a very necessary function within the community,
particularly the adolescent community. The community in general also recognized
the value of this group and was beginning to come forth with offers of support. As
an adjunct to the telephone services, the volunteers and the mental health staff
published a Counselling Newsletter which was distributed throughout most of the
secondary schools in the area during the spring.
At the year-end, staff members were involved in developing a number of new
programmes to benefit the communities. They were exploring the idea of sheltered
workshops or activity programmes for boarding-home residents and were hopeful
COMMUNITY MENTAL HEALTH SERVICES
L 39
that one of the local volunteer groups would develop this idea into their special
project. The Centre would also like to see a chapter of the Canadian Mental Health
Association established in the north Island area, and was planning to lay the groundwork for this development in the near future. Other ideas for serving the isolated
areas included newspaper columns, more volunteer groups which could conduct
superficial counselling, and the development of a neuropsychological assessment
programme for the northern school district. The Centre was asked to participate
in the training and orientation programme for the Department of Indian Affairs
case-aides.
1971 was a year of increasing emphasis placed on indirect community services,
and it was hoped that the Centre's participation in these areas would lead to a better
awareness of sound mental health concepts and earlier recognition of potential
mental health problems.
CRANBROOK
MENTAL HEALTH CENTRE
During the year, staff members participated in the meeting and screening of
personnel for a Crisis Centre in Kimberley. In addition, both the psychologist and
mental health nurse were consultants to a programme in sex education which the
doctors in Kimberley initiated. Staff from the Department of Rehabilitation and
Social Improvement, as well as the school psychologist in Kimberley, advised the
Centre regarding the creation of adequate group homes for moderately disturbed
children.
The Centre's psychologist spoke at a number of schools in the area and
provided assessment and consultative services in Creston, Kimberley, Cranbrook,
Invermere, and Fernie. Future plans call for him to provide similar services to the
schools at Riondel and Crawford Bay.
A highlight of the year was the visit of the Deputy Minister and staff. Besides
planning with Centre staff, Dr. Tucker met with representatives of the medical
and educational community. Press coverage was excellent and beneficial to the
Centre's programme.
The services of a psychiatrist for a day and a half every month were established
in 1971. Private referrals from physicians were increasing. It appeared that perhaps these referrals would require the full time of the visiting psychiatrist.
The year 1971 was characterized by staff changes, but the high quality of the
service continued. Mr. J. S. Brown, Social Work Administrator, was transferred to
the Whalley Centre, and was replaced by Mr. Virgil Brown.
Referrals continued to be heavy in areas of disturbed children, marriage counselling, and supportive services to the chronically mentally ill.
The number of disturbed children who needed care in settings other than their
own homes was very large. Services such as probation and parole were in need of
homes for adolescents, and the Department of Rehabilitation and Social Improvement had the same need, as well as a need for homes for younger children. The
Centre found an increasing number of younger children in need of therapeutic
environments outside the home.
L 40 MENTAL HEALTH BRANCH REPORT, 1971
DUNCAN
MENTAL HEALTH CENTRE
The Duncan Mental Health Centre commenced operation on August 2, 1971.
Mr. J. A. Hutton, M.S.W., Administrator, completed a brief orientation period at
Riverview and the Victoria Mental Health Centre from July 15 to July 30, 1971.
As this office is under the supervision of the Victoria Mental Health Centre,
Dr. A. Aranas provided consultative services to Centre staff on a weekly basis.
Psychiatric services were provided by Dr. Frances Wood on a sessional basis—four
sessions per week. The Centre also had the services of the psychologists of the
Victoria Mental Health Centre.
The Centre was able to maintain a wide range of services during the year.
In terms of direct service to this area, the Centre provided medication to mental
health patients through the dispensing services of the Cowichan District Hospital.
With the approval of the Mental Health Branch and BCHIS and with the cooperation of the board of administrators of the hospital, the Centre entered into an
arrangement with the hospital pharmacist to dispense medication to Centre patients,
effective October 1, 1971.
The case load at the year-end was approximately one hundred. In terms of
psychological testing and evaluation, the team from Victoria assessed 12 children,
conferenced five of these with school personnel, and had a waiting-list of approximately 20 children to be seen for testing. Most of these children had been referred
by the Special School Counsellors and appeared to have learning and emotional
problems.
In response to requests from various community groups, the Administrator
attended several open meetings to discuss the Centre's programme and explain its
potential role in the community.
Another major community concern was related to the provision of a Crisis
Centre, and it was anticipated that an association of interested persons would attempt
to launch such a service in the near future. To assist with information in this area,
Dr. Aranas, Director of the Victoria Mental Health Centre, provided three lectures,
covering depression, suicide, and preventive services, and the use of psychotropic
medication. An average of 40 persons attended the lectures.
FORT ST. JOHN
MENTAL HEALTH CENTRE
The Fort St. John Mental Health Centre opened on September 23, 1971, with
offices located in the Sister's residence, at the Providence Hospital. Activities of the
Centre consisted of surveying the community to determine resources and needs,
establishing relationships with local agencies and organizations, and the provision of
some direct treatment. Co-operation from the community was excellent. At the
year-end a psychologist was being recruited for the Centre staff.
COMMUNITY MENTAL HEALTH SERVICES L 41
KAMLOOPS
MENTAL HEALTH CENTRE
The first half of the year was one of expansion, with the emphasis on direct
service. In January the psychologist joined the team, and school services rapidly
accelerated, both at direct service and at professional consultative levels. There
was a greatly increased work load resulting from the arrival of the Co-ordinator of
Boarding Homes in June. From July, when the social worker was appointed, the
Centre had a full team.
The second half of the year was one of consolidation and allowed an increase
in emphasis on indirect service. Direct referrals fell off, partly because of the psychologist's consultation programme with school referral sources and of the social
worker's similar programme with social agencies, and partly because physicians were
tending to refer to the increased private psychiatric facilities in the area.
The Director was involved in considerable direct and indirect service on the
psychiatry ward at the Royal Inland Hospital. The net results were a greatly increased in-service education programme for the ward staff, in which other Mental
Health personnel participated, and the formation of a psychiatric subcommittee of
psychiatrists on the hospital staff.
Travelling clinics were established on a regular schedule to four smaller centres.
Close co-operation with local branches of the Health Unit enabled a reasonably
comprehensive service to be given.
In Kamloops, the psychologist, Dr. M. Bendick, arranged training programmes
for social workers attached to the home for unmarried mothers, and for the Family
Life Association counsellors. She increased consultation with the public health
nurses and the school counsellors, and gave educational talks to a wide spectrum of
local organizations. Research projects were discussed with the Health Unit.
Mr. P. Wheatley, the social worker, rapidly established a warm relationship
with his colleagues in welfare and probation and was able to move directly to consultation without a direct service overload developing. He enabled the Centre to
see emergency referrals immediately and made several home visits.
Mrs. E. Lovett, the mental health nurse, steadily increased her load of chronic
patients. Extensive use of I.M. Fluphenazine permitted better control of many
patients. The Director rigorously controlled the dispensing of mental health medications.
The Boarding-home Programme imposed a particularly high patient load on
this Centre, consisting of people placed locally by The Tranquille School over several years. Fortunately, Mrs. D. Osborne, the new Co-ordinator, merely continued
in the role she had filled in Tranquille and the transition was most efficient. It was
hoped that in 1972 there would be an increasing emphasis on boarding homes for
chronic psychotic patients.
The Centre staff attended courses during the year, and were visited on several
occasions by members of the Victoria office.
KELOWNA
MENTAL HEALTH CENTRE
There was considerable growth of population and secondary industry in the
Central Okanagan during the year, as well as expansion of the tertiary education
L 42 MENTAL HEALTH BRANCH REPORT, 1971
programme, with the drawing-together of the Okanagan Regional College, whose
main centre is in Kelowna, with the Kelowna Vocational School. The new modern
addition to the Kelowna General Hospital was opened. More doctors came into
the area and there was increasing participation by the doctors in mental health problems. In psychiatry, in particular, Dr. Victor Mollerup commenced practice in Penticton, in January, and Dr. Larry Anderson in Penticton, in February. In April,
Dr. Kenneth J. Davies commenced practice in Kelowna, and in September Dr. David
Wheelwright, specializing in child psychiatry, took up residence in Kelowna.
Mental health centres, in general, benefited from the Branch's development of
a community policy for the centres, which included the establishment of standards
of practice, while still leaving room for individuality of programme according to
local needs and the particular professional skills of the local staff. The multidisciplinary approach, made possible through the public service, broadened and enriched
the scope of mental health resources available in every community. The Boarding-
home Programme for the chronically ill was launched in this community with the
appointment of an additional staff social worker.
The Medical School at the University of British Columbia, in co-operation with
the local medical societies and regional hospitals, provided an option for fourth-year
medical students to be clinical clerks at accredited hospitals for a three-month period
in the final year of their training. The centre received encouragement from the university's Department of Psychiatry with regard to establishing a psychiatric residency
programme in Kelowna. The training of the specialists in psychiatry must include
participation in community programmes, if recruitment for the smaller centres is to
be improved.
Community resources in this region continued to develop. In Penticton the
Psychiatric Ward at the General Hospital was opened, and the Human Resources
Society, which develops programmes for emotionally troubled children, continued
to be effective. The Community Board of Mental Health, a volunteer citizens' committee, took an active part in mental health developments in Penticton and the surrounding area. The additional personnel requested by this Centre for expanded
mental health services at the south of the Okanagan Valley were approved, and a
large measure of autonomy was being granted the psychiatrists and citizen group
in establishing a mental health centre in the Penticton-Similkameen area.
Both in Penticton and Kelowna the arrival of additional psychiatrists meant
that many service needs to patients were now covered through medical insurance and
could be met in private offices. It was to be expected there would be some modification in the mental health centre programmes.
During the year the centre undertook two research surveys—one on suicide,
the other on therapeutic abortion—and received good co-operation in their development. The Centre was a participant in an ongoing programme to assure the follow-up of attempted suicides.
Centre staff participated with the Central Okanagan Social Planning Council,
and the Citizens Committee to the Family Court, to develop a Family Life Education Programme, with a health educator financed in the first instance through the
Vancouver Foundation. The Centre was glad to see the establishment of the FISH
24-hour crisis line, to deal with social emergencies, and served as one of the referral
resources for them. The community continued to give constructive thought to prevent the alienation of youth, through upgrading programmes at the Vocational
School, and the appointment of young persons to such city advisory committees as
the Social Planning Council, the Social and Recreational Advisory Committee, and
the Family Court Committee. The summer youth hostel at the Catholic Church
COMMUNITY MENTAL HEALTH SERVICES L 43
was successful. There continued to be a mild problem of drug abuse in the community, and staff members participated in various drug education programmes.
Dr. Keith Barnes continued to be consultant to the Pupil Personnel Department at
School District No. 23, and special classes for behaviour modification were developed. The following ongoing research projects under Dr. Barnes' leadership were
also worthy of mention: The D.D.S.T.: A Normative Study; T-Group Techniques
for High School Students: An Evaluation; and Attempted Suicides in the Community: An Exploratory Study.
MAPLE RIDGE
MENTAL HEALTH CENTRE
Individual assessment and treatment played a prominent role in the activity of
the Centre during 1971.
A very close and valuable liaison was maintained with the school system.
The psychologist tested two children each week, and other disturbed children were
seen. A full assessment of the children's medical, neurological, emotional, and
social difficulties was undertaken, with the Centre members working as a team.
The required therapy was then provided. In addition to individual therapy, family
therapy and play therapy were also given. The management of the child in the
classroom, in the home, and in various aspects of behaviour, were all part of an
over-all programme tailored to meet individual need.
Marital counselling and individual assessment of adults were also undertaken
and, in the case of acute psychotics, often on an emergency basis.
At the year-end the psychologist, Mrs. A. Palvesky, was planning to organize
a programme for mothers of pre-school children who were having difficulties in child
management. During the summer, regular group-therapy sessions for disturbed
children were held. Twelve children were sent on summer camp, the Centre being
represented on the executive of the organizing committee.
The psychologist attended interagency meetings in Mission once weekly, and
saw patients there for ongoing therapy. The Social Worker Consultant, Mr. D.
Meiners, performed a similar function in Langley.
The Centre provided a consultant function to the homes for the retarded. The
Director served on the Advisory Board of the Local Association for the Retarded.
The Centre was involved in the evaluation of a new programme for the rehabilitation of recovering alcoholics, taking place at the Half-Way House in Maple Ridge,
which originally functioned mainly as a sheltered environment for recovering alcoholics. With the aid of a Government grant, the Half-Way House was reorientating
its therapy toward providing a treatment facility, with the emphasis on short-term
intensive treatment, with greater emphasis on counselling and group therapy.
At the year-end, Community Services Council was being organized in Maple
Ridge, with the ultimate object of co-ordinating the social and volunteer agencies.
The two most urgent items on its agenda were a Homemaker Service and "Meals
on Wheels."
In addition to this broad over-all look at community needs, the Centre met
with representatives of welfare, public health, probation, and the schools, once a
month, at an interagency conference where individual patients and interests common
to these organizations were discussed.
Centre staff helped to instigate the formation of the local Association of Children with Learning Disabilities (ACLD). When it became an autonomous body,
L 44 MENTAL HEALTH BRANCH REPORT, 1971
the Centre acted in an advisory, consultative, and educational capacity. This is a
vigorous organization, which has helped, by education and group support, the
parents of those children who are afflicted with learning disabilities.
The regionalization of the Boarding-home Programme became effective as of
June 1, 1971. The social worker visited 11 boarding homes in the Haney-Mission
area and had a case load of 175 patients. More boarding-home beds were expected
to be available in the area early in the new year.
The CMHA volunteers in Haney continued to do valuable work, putting on
their bimonthly socials for the seven boarding homes in the area. The Centre worked
in close association with them, occasionally attending their meeting.
Drugs were being supplied by the Centre instead of Riverview Hospital, and
the Centre was fortunate in securing the services of a part-time pharmacist who
came one day a week.
The boarding-home operators were adjusting to the change-over from supervision by Riverview, and were making more use of the community resources. The
Centre's Director and boarding-home social worker held a monthly meeting with the
operators in the area, in order to improve communication and discuss common
problems.
NANAIMO
MENTAL HEALTH CENTRE
With the establishment of a new mental health centre in Duncan in July 1971,
the territory covered by this Centre was reduced considerably. It served a population of approximately 80,000, in an area extending from Ladysmith north to Bowser,
and including the Alberni Valley and the west coast of the Island, where regular
travelling clinics to Ucluelet and Tofino were being conducted. The Centre staff
consisted of a clinical psychologist, mental health nurse, a stenographer, a part-time
pharmacist, and a part-time receptionist, with a social worker as administrator.
The Centre worked very closely with the local health units, and in particular with
the public health nurses.
The Centre's main emphasis was on community organization and public education. A good deal of time was spent working with school personnel, and providing
consultative services to a wide variety of community groups and agencies. Time
spent in working with individual cases was sharply reduced over the year. In part
this was possible because of new community agencies—Family Guidance Associations in Port Alberni and Parksville as well as in Nanaimo, and an active Crisis
Centre in Nanaimo. In addition, at the year-end there were three psychiatrists
practising full time in Nanaimo and one part time in Port Alberni.
Over one-third of the Centre's active case load was made up of elementary
school children referred because of behaviour problems or learning disabilities.
After an initial assessment, the Centre staff concentrated on working with parents
and teachers. More than one hundred school conferences were held over the year,
as well as group meetings with teachers and counsellors, and innumerable school
consultations. In a number of cases staff members went into classrooms to help
set up specialized teaching programmes. The psychologist conducted workshops
for teachers on the topic of learning disabilities, and the Centre held a number of
public meetings with parents and teachers to discuss the use of the behaviour modification approach at home and in the classroom. The Centre saw a few selected
COMMUNITY MENTAL HEALTH SERVICES L 45
children for play therapy, and operated a number of treatment groups, including
a weekly remedial group for children with learning disabilities.
In 1971, for the first time in its existence, the Vancouver Island School Camp
for Special Children was operated independently of the Centre.
NELSON
MENTAL HEALTH CENTRE
The Centre was officially opened June 1970, and by the beginning of 1971
had acquired most of its professional and clerical staff and moved into adequate
quarters. The Centre handled a continuous and rapidly increasing number of
patient cases on a direct-treatment basis, involving a wide range of problems from
school-learning disabilities to drugs, marriage counselling, and innumerable psycho-
pathologies.
The Nelson and District Mental Health Professional Advisory Board, which
held its first meeting in 1970, was the outstanding community mental health development in 1971. Senior representatives from all social and health agencies were drawn
together through the initiative of the Nelson Mental Health Centre to set up an
autonomous Advisory Board. This Board created an amazing variety of research
projects, new services, and the co-ordination of activities, during its relatively short
period of existence.
Virtually all social medical activities in the community were under the purview
of the Mental Health Professional Advisory Board, and the Nelson Mental Health
Centre was a very active member, having one or more of its staff on all committees
and functions. Through the Board, study and implementation proceeded on the
following: In-service education, the Boarding-home Programme, a Central Registry,
drug habituation study, educational workshops, group therapy, consultation to
schools, the Nelson and District Community Centre, psychiatric treatment policy,
community clinics, the provision of psychotropic medication, and the Nelson Hostel.
The year was characterized by a growing together and a working effectively of
the staff as a team. Outstanding efforts were made by Mr. Kosof, psychologist, in
the school and university programmes, and Miss Carvell, mental health nurse, in
community mental health conceptualization and organization.
NEW WESTMINSTER
MENTAL HEALTH CENTRE
In the first half of 1971, direct services continued as in previous years. However, with the resignation of the psychiatrist, and the reduction of the Centre's catchment area, the emphasis shifted from direct services to greater community involvement. Centre staff were involved in the planning and (or) organization of various
community services, including the Togetherness Society Crisis Centre, group homes
for boys, Family Life Education Survey, and correlation of youth resources. The
Centre stimulated greater interest in co-ordinating community services. Direct service included individual, family, group, and behaviour modification approaches.
Since October the Centre operated under a flexible intake system, with referrals
coming from a variety of community sources, in addition to self-referral.
L 46 MENTAL HEALTH BRANCH REPORT, 1971
PENTICTON
MENTAL HEALTH CENTRE
The population covered by this Centre, which started in the fall of 1971, was
over 30,000 and included the larger centres of Penticton, Summerland, Oliver,
Osoyoos, and Princeton. The residents showed a very ready acceptance for programmes initiated by the Centre and much credit was due a very dedicated, informed
group of lay people who formed the Okanagan Similkameen Society for Community
Mental Health, and who were given official recognition under the Societies Act.
Centre staff were involved on their professional advisory boards.
Staff members were increasingly called upon to offer consultative services, and
a considerable amount of time was spent at evening lectures, seminars, and workshops.
At the year-end a total of 29 cases had been activated. The referral system
was as simple as possible, even to the extent of promoting a drop-in policy.
Centre staff were actively engaged in some individual therapy, family therapy,
and were organizing group therapy, with a special emphasis on those having problems with drug abuse.
Staff members were also involved in psychiatric consultation at the Penticton
Hospital. A brief presented by the Centre to the Hospital Board for the establishment of a Day Hospital was approved and would be operative in 1972. The Day
Hospital will provide an urgently needed service to this community.
A considerable amount of time was also spent with the schools on a consultative basis, and staff spoke with school counsellors and teachers about specific cases.
The school counsellors were also interested in workshops and in-service training
programmes.
The Centre spent a great deal of time in dealing with simple preventive mental
health measures, such as prenatal and postnatal educational services, programmes
fostering child/parent relationship, and were involved in establishing healthier communications within families and in programmes sponsored by the Department of
Rehabilitation and Social Improvement, the Canadian Mental Health Association,
retirement centres, and so on.
The Centre was also involved in the development of a comprehensive follow-up
programme for those patients released from either the local hospital or from Centre
Lawn, recognizing the fact that this is a preventive measure in its own right.
PORT COQUITLAM
MENTAL HEALTH CENTRE
This Centre opened August 1, 1971, and served a population of approximately
75,000 in School District No. 43, including Coquitlam, Port Coquitlam, Port Moody,
and loco. The official opening took place Wednesday, November 24, 1971, with
Mr. G. Mussallem, M.L.A., officiating.
The Centre's initial objective was to survey the community in order to determine its needs, and to become acquainted with the agencies already dealing with
COMMUNITY HEALTH SERVICES L 47
these needs. Educational talks were given to various groups in the community.
Staff provided direct service as well as consultation on specific cases, and assessed
an average of 25 cases per month. In the brief time the Centre was in operation it
received excellent co-operation from the community, and met with the Canadian
Mental Health Association to propose development of a summer camp and a sheltered workshop.
The Centre had a full professional staff complement, including the boarding-
home worker. The Centre was involved in the Boarding-home Programme for patients discharged from Riverview and Woodlands, and staff reviewed patients for
their medication and treatment and the organization of a comprehensive programme.
Clinics were held two days a week in the Health Unit at Poirier Street for the
people in the Coquitlam area.
POWELL RIVER
MENTAL HEALTH CENTRE
The extension of mental health services into Powell River was started in December with the appointment of a psychiatric social worker. The operation of the
office came under the Courtenay Mental Health Centre.
Initial activities included a survey of community needs in terms of mental
health requirements. Psychiatric consultation was being provided by Dr. J. R.
Robertsen, on the sessional staff of the Courtenay Centre.
PRINCE GEORGE
MENTAL HEALTH CENTRE
During the year there were some major changes in the activities of this Centre.
From May until September there was the planning and developing of mental health
services located in Fort St. John, and in August, Dr. J. A. Steedman, the psychiatrist
on the Centre's staff, moved to Australia. These changes resulted in a revision of
the Centre's programme.
A report on the centre's serving areas follows:
The north—The visits by private psychiatrists from Vancouver, arranged
through the Psychiatric Section of the British Columbia Medical Association, were
discontinued in April. However, one psychiatrist consulted to the agencies and
doctors in the Dawson Creek area until June.
Centre services were established in September in Fort St. John, and the staff
consisted of a mental health nurse and a psychologist.
The south—The Centre's team travelled to Williams Lake and Quesnel
monthly, staying one day in each community. The service included assessing individual cases for various agencies and family doctors. An education programme for
the staff of the Public Health Unit and the Department of Rehabilitation and Social
Improvement was instituted on the subject of family therapy techniques.
Prince George area—In March, monthly consultative visits to Vanderhoof and
Burns Lake were started, and most of each day was spent assessing school children
and interviewing parents. Some direction was provided the school teachers or public
health nurses in case conferences, and consulting with the teacher in the classroom
was being tried.
L 48 MENTAL HEALTH BRANCH REPORT, 1971
The Centre had been primarily involved with direct treatment, and there had
been little time available to develop and institute public education or preventive
programmes. At the year-end the Centre's emphasis was changing and efforts were
being directed in the area of prevention.
At the end of the year the statistics were being reviewed, and those cases not
active were being closed. By January 1972 it was hoped to have a more accurate
statistical table of active and inactive cases. It was also planned to review some
closed cases and determine the effectiveness of the treatment programme.
SAANICH
MENTAL HEALTH CENTRE
Toward the end of 1971 the Saanich Mental Health Centre had been in operation for almost two years at Royal Oak. It is located at the hub of important
crossroads, close to the demographic centre of the region it serves. It worked in
close collaboration with all other public and private agencies serving the people of
Saanich, Central Saanich, North Saanich, Sidney, and the Gulf Islands. Major
activities included community psychiatric consultation service and direct help for
patients via diagnostic assessment and treatment.
Community services were made available to agencies and individuals in an
effort to reduce the incidence or morbidity of emotional illness. These efforts were
directed into educative programmes to reduce anxiety, tension, and fears in specific
situations. The centre worked in the conjoint development of these projects with
one or more of the following agencies: School Districts Nos. 61, 63, 64; public
health nurses; representatives of Family Court and the Probation Department; the
John Howard Society; Department of Rehabilitation and Social Improvement;
Family and Children's Service; Canadian Mental Health Association; and Citizen's
Counselling Centre. Projects with the last two agencies deserve special mention,
since these were services dedicated to the use of volunteers in helping others meet
their needs. The Victoria Branch of the Canadian Mental Health Association was
involved in many resocialization and rehabilitation projects, and in exploring the
needs of the community for additional mental health services. The centre was represented on their Education Committee. The Citizen's Counselling Centre is a local
nonprofit society formed by family doctors, clergymen, and social workers. It sponsored training programmes to help laymen acquire some basic counselling skills and
attitudes, and placed particular emphasis on the training of volunteer marriage
counsellors. The Centre was represented on the Executive Board, and provided
assistance in developing educational programmes.
In addition to consultative help, the Centre provided the Citizen's Counselling
Centre counsellors with prompt supportive psychiatric and social work service when
problems arose or crises developed. At the year-end it was assisting in the development of several satellite projects that were being initiated by local groups and
included some members of Citizen's Counselling Centre. The Cordova Bay Volunteers explored the needs and assets of their area and consulted with school principals,
ministers, social workers, mental health workers, boarding-home operators, and
youth workers, as well as with members of other volunteer groups. Their initial
undertaking was a volunteer transportation service to enable persons to get to then
medical or treatment appointments. Continuing exploration of community needs
would decide the choice of future projects. In Sidney a group of Kinettes aided by
COMMUNITY MENTAL HEALTH SERVICES L 49
public health nurses, mental health workers, rehabilitation and social improvement
workers, and school and library staff, developed an educational and group process
programme for the mothers of pre-school children. The object of the programme
was to improve communication among the mothers of pre-schoolers, and to reduce
anxieties, separation fears, and related problems. The initial programme was so
enthusiastically received that it was being repeated.
Through the joint efforts of the Department of Nursing Education of the Royal
Jubilee Hospital, and the mental health nurse of the Saanich Mental Health Centre,
a programme was developed to better serve the needs of student nurses during then
time of training on the psychiatric wards at the Eric Martin Institute of Psychiatry.
The purposes of this programme were to facilitate communication between the
nurses and student nurses, to reduce the anxiety of the student nurses, and to enable
them to find the service profitable to themselves and useful to the patient. These
group meetings were entitled "Human Relations Laboratories" and were, in part,
designed by Mrs. D. Appleton, of Saanich Mental Health Centre.
SURREY
MENTAL HEALTH CENTRE
The Surrey Mental Health Centre operated under an open referral system,
accepting referrals from all community agencies, self-referrals, and those directly
from the medical practitioners.
The latter half of the year was a difficult transitional period for this centre. By
late summer the former professional team had all transferred to other positions, and
had been replaced by new personnel who were faced with the immediate task of
providing treatment continuity. This direct service commitment absorbed most of
the new team's time and energy.
Despite these difficulties, the Surrey Mental Health Centre staff had, by December 1971, developed co-operative and effective working relationships with school
district personnel, and all other agencies with whom the Centre shared a concern
and responsibility for mental health. An effort would be made in the new year to
preserve and expand indirect services.
TERRACE
MENTAL HEALTH CENTRE
During 1971 the Terrace Mental Health Centre completed its first full year of
service. The geographical area covered by this Centre included Queen Charlotte
Islands in the west, Houston in the east, south to Ocean Falls, and north to Stewart.
The population of the area served was approximately 58,728, according to the 1969
statistics.
The staff of this Centre included a psychologist, a psychiatric social worker, a
boarding-home social worker, and a stenographer. Psychological and psychiatric
consultation were provided by Dr. A. L. Aranas, of the Victoria Mental Health
Centre; Dr. A. A. Cashmore, the British Columbia Youth Development Centre; and
R. Wilson, Ph.D.
The Centre operated an extensive travelling clinic which visited Hazelton,
Smithers, Houston, Kitimat, and Prince Rupert on a regular basis. Other areas,
L 50 MENTAL HEALTH BRANCH REPORT, 1971
such as the Queen Charlottes, Ocean Falls, Nass Camp, Kispiox Village, and
Kemano, also received visits. The northwestern portion of this Province is continually expanding due to economic developments. This naturally adds to the above-
average rate of psychopathology, which created an enormous demand for psychiatric
services in remote areas.
As of November 12, the Centre had an active patient count of 200.
The creation and upgrading of resources was seen as a priority. In the schools,
the Centre was involved in the promotion of special services, the creation of a hostel
for the retarded children of school-age, a survey of the number of retarded children
in the Indian villages, and the upgrading of counselling services. This Centre also
provided in-service training for general hospital nurses in the area of mental health,
and workshops for the ministry regarding family and marital counselling. Evaluation of the resources and identification of the unmet community mental health needs
were discussed with various community agencies and organizations. This was an
ongoing process that was readily accepted and encouraged by the communities
served.
TRAIL
MENTAL HEALTH CENTRE
The year 1971 reflected a continuing effort by Centre staff to utilize consultation and education as a means of increasing prevention, treatment, and follow-up
services to individuals, families, and groups throughout the region. Administration
responsibilities increased significantly with the addition of the Regional Boarding-
home Programme, and the gradual development of additional porgrammes undertaken by the Centre.
The Centre's priorities in direct treatment continued to be the following: Parent,
family, and marital counselling; preventive follow-up of persons discharged from
acute treatment units; and individual and group therapy for adolescents and young
adults. In connection with the last, a group for delinquent boys was supplemented
with a group for their parents and the utilization of lay volunteers. Interagency
co-operation continued to be one of the primary reasons for improved services to
children and their families. The Youth Liaison Committee was the major body
through which the Centre offered consultation to teachers. A second Community
Agency Workshop was held in early December with the focus on interprofessional
communication and effectiveness in counselling.
Two major additions to the Centre programme during 1971 were: Travelling
clinic services to the Grand Forks-Greenwood area and the initiation of the Regional
Boarding-home Programme. The first was fully utilized by physicians, the schools,
and other agencies, and provided an opportunity to give consultation to these agencies, along with a limited amount of direct treatment by Centre staff. Effective coordination by public health nurses was the most important factor in making the programme work well.
The Regional Boarding-home Programme began in July with considerable and
able assistance by the Branch's Social Work Consultant and the Provincial Co-ordinator of Boarding Homes. As a relatively underdeveloped area in terms of available
boarding care for the adult mentally disordered, it was recognized that considerable
education and aggressive "reaching out" would have to be effected before actual re-
COMMUNITY MENTAL HEALTH SERVICES L 51
sources were realized. The fact that at the year-end the programme was beginning
to show concrete results illustrated the value of this policy.
The Centre psychologist, Mr. S. Horvath, carried out two major programmes
during the year, in addition to his regular team assessment and treatment responsibilities. The first was a comprehensive survey of admissions to the Trail Regional
Hospital Columbia Unit during its first year of operation. The results of this survey
indicated three major areas of need—improvement in the community's capacity to
deal with psychiatric emergencies, creation of day-care facilities to relieve burdening
the acute-care unit, and co-ordinated, intensive follow-up services during the first
three months following discharge from hospital. The second programme began in
September and involved the structuring of a programme for training senior high
school students as mental health volunteers. The actual training began in November
with the expectation that these volunteers would be prepared to work in the immediate Trail area by early 1972.
Centre staff continued to be involved as advisers to such groups as the Canadian Mental Health Association, the Association for Community Planning, Youth
Information Centre, and the Kootenay Aid to the Handicapped Committee, as well
as several other volunteer groups and organizations. New developments included
a much-closer working relationship with the local Associations for the Mentally
Retarded, the RCMP, the Union Board of Health, staffs of medical clinics, and high
school counsellors.
All staff members were active in speaking to groups on a variety of topics related to mental health. The purpose was primarily one of education with a view to
continued community awareness as to the mental health problems and needs of the
region. For the second time since opening, the Centre provided a student field
placement from the University of British Columbia for a public health nurse. An
expanded consultative and training programme, for mental health volunteers and the
volunteer co-ordinator, was well received.
VERNON
MENTAL HEALTH CENTRE
The region served by the Vernon Mental Health Centre in 1971 coincided with
the Health Region of the North Okanagan, and also included Golden. The area's
population was approximately 57,000. Dr. Bennee, who was the Centre's Director
and psychiatrist, resigned in August and the psychiatric social worker was appointed
as Administrator. Dr. David Wheelwright provided the Centre with excellent
psychiatric consultation since September.
There continued to be increasing requests for direct and consultative services,
and the Centre averaged about 35 new cases per month. Usually the emphasis was
on reality-oriented brief service, with the technique of marriage or family therapy
being used whenever possible. Transactional analysis was used, with satisfying
results. When necessary, long-term psychotherapy or sustaining service was undertaken by some members of the team. The Centre's psychologist was used a great
deal by the schools, with the assessment of possible learning difficulties.
No referral procedures were required for direct services, and patients could
telephone and ask for an appointment, and any agency that wished to refer could
also do so. This approach brought the Centre far closer to the other community
agencies, both professional and volunteer. In addition, there was no waiting-list.
New referrals were seen as soon as possible, often the same week, and emergencies
were usually dealt with the same day.
L 52 MENTAL HEALTH BRANCH REPORT, 1971
The Centre expanded its connection with other professionals to the extent that
the staff interviewed couples, or families, together with the family physician, school
counsellors, social workers from the Department of Rehabilitation and Social Improvement, and others. This proved to be an effective way of enhancing communication between professionals and the patients needing the Centre's help.
In addition the Centre provided frequent consultation to such professional
agencies as the Department of Rehabilitation and Social Improvement, public health,
schools, private physicians, probation, etc. The staff were either members or on
the advisory board of many of the volunteer organizations.
Requests for the staff to provide education to both lay and professional people
increased during the year. A staff member was very much involved with the Health
Branch prenatal programme and the Homemakers Society. The mental health
nurse regularly attended the monthly meetings of the Aid to the Handicapped Committee at both Vernon and Salmon Arm.
Mrs. Janice Christman was appointed to the staff in September as the boarding-
home social worker. The staff met with the social workers and the head nurse at
The Tranquille School, and worked out a programme that was suitable for both
Tranquille and this Centre to provide boarding-home care for those discharged from
Tranquille to the area. The Boarding-home Programme also provided services for
other psychiatric disabilities.
Service was provided to Salmon Arm and Revelstoke on a biweekly basis, and
patients from Golden were seen in Revelstoke.
Arrangements were completed with the hospital pharmacist to work for the
Centre up to eight hours per week, so that he can dispense all the psychotropic medication to those who would otherwise be denied this help because of cost.
VICTORIA
MENTAL HEALTH CENTRE
The Victoria Mental Health Centre continued to meet the needs of the community it served.
The appointment of Andrew S. Kerr, Ed.D., as full-time psychologist to this
Centre added a significant discipline to the professional staff. His expertise in educational psychology opened the doors to many schools in School Districts Nos. 61
to 66, inclusive, for children having special learning problems.
The Neuropsychology Unit of this Centre was very busy during the year, as
the practising neurologists in Victoria became aware of its services.
In the early part of this year the Centre started a staff development programme
for the counsellors of Canada Manpower Centre, and provided services in terms of
assessment, consultation, and treatment of criminal offenders to the Vancouver Island
Regional Correctional Centre.
Mental health education was a vital aspect of the community mental health
programme. Members of the professional staff gave lectures, talks, and consultations
to various community organizations; the University of Victoria, Department of
Psychology; and the two schools of nursing in this area. This being a preventive
aspect of community psychiatry, it played a significant role in the services of the
Victoria Mental Health Centre.
COMMUNITY MENTAL HEALTH SERVICES L 53
The Centre continued to be a practicum placement facility for the University
of Victoria's Department of Psychology and the University of British Columbia's
School of Public Health Nursing. During the year the centre had one master of
psychology candidate from the University of British Columbia Department of
Psychology, Mrs. Johanna Cartwright. Her paper on "The Use of Cognitive Modelling and Self-instructional Training for the Reduction of Perseveration and Im-
pulsivity in the Mentally Retarded: A Case Study" was selected and presented at
the British Columbia Psychological Student Research Award Conference on October
29, 1971.
The Boarding-home Programme progressed during the year.
The opening of the Glendale Hospital maximized the work of Mrs. Bridget
Moncrieff and Mrs. Betty Bryant, social workers for the Mental Retardation Programme.
A significant event was the opening of the Duncan Mental Health Centre in
August 1971. Mr. Jack Hutton, M.S.W., was appointed the Administrator. Dr.
Frances Wood, psychiatrist, provided four sessions a week in the assessment, treatment, and consultation of patients referred to the Centre. The Centre was under
the clinical direction of Dr. Arturo L. Aranas, Director of the Victoria Mental Health
Centre.
WHALLEY
MENTAL HEALTH CENTRE
This community mental health centre began operation in the early fall of 1971
with the appointment of a psychiatric social worker as Administrator, and a mental
health nurse. It was expected that a psychologist would join the team in mid-
December, and negotiations were also under way for the appointment of a sessional
psychiatrist.
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 positions.
The Whalley Mental Health Centre, in its first four months of operation, introduced itself to the community and was able to offer a limited treatment and consultative service.
IN-PATIENT SERVICES
Review of In-patient Services, 1971
Department of Nursing Education
Riverview Hospital
Geriatric Division
The Woodlands School
The Tranquille School
British Columbia Youth Development Centre,
The Maples, Burnaby
jtv
mental
health
branch
IN-PATIENT
SERVICES
REVIEW, 1971
During 1971 the most conspicuous development in the area of mental health
services was the continuation at an increasing pace in the change of relationship
between the in-patient institutions and the total Branch structure. While the inpatient facilities continued their traditional programmes, they concentrated particularly on attempts to upgrade their standards of patient care and to establish
identifiable levels below which the standard of care should not be permitted to fall.
Meanwhile, all other aspects of mental health care in the Province were growing and
developing, with the result that the in-patient facilities moved in a relatively short
period of time from the position of being almost the only resource for most of the
population to finding themselves in increasing communication with a variety of
agencies in the community. Increasing activity in growing numbers of mental health
centres; increase in residential centres, group homes, and other agency operated services for children and adolescents; and an expanding programme of resources for the
retarded brought about a situation in which the in-patient facility could concentrate
on delivering only that element of the total service which was appropriately delivered
on an institutional basis.
In the light of these changed relationships, a changed Branch organizational
structure was discussed in detail early in the year, and was implemented on October
1, 1971. The work of the institutions during the year was oriented toward accommodating this change, which gave official recognition to a trend which was already
developing.
The traditional function of the Director of Mental Health Services was terminated at the end of September 1971. The few statutory obligations of the Director
were assumed at that time by the Deputy Minister, and the Mental Health Branch
operation ceased to be broken down into in-patient services and community-based
services, and instead was organized into programmes, the chief of which are the
programmes of mental retardation, adult psychiatry, child and adolescent psychiatry,
and boarding-home care. All of these first-line programme services are seen as
having various components and all are backed up by the consultative services of the
Deputy Minister's consultant staff.
In Riverview Hospital a great deal of attention was given to the developing
Regional Boarding-home Programme, and the preparation of patients leaving the
institutions for this programme. Work was actively proceeding toward the concentration of the out-patient services in a building on Broadway in Vancouver, which
was being renovated and expected to open early in 1972.
Throughout the early part of the year a great deal of work was done by the
Regionalization Committee toward the introduction of a pilot regionalization project
for the Fraser Valley, as was described in the Annual Report of 1970. This work
was completed, and it was anticipated that the regional project could be placed in
operation by the year-end.
The Geriatric Division was very energetic during 1971, and the appointment of
a new Superintendent, Dr. W. W. Black, resulted in an ongoing review of policies
57
L 58 MENTAL HEALTH BRANCH REPORT, 1971
and objectives. The Dellview Hospital in Vernon provided a useful service locally,
as well as augmenting the general programme of the Valleyview Hospital. Skeenaview Hospital underwent considerable renovations to the physical plant, and was
continuing its traditional operation as an adjunct to the Valleyview Hospital. At the
year-end its function was under review because of its isolated situation, and the
absence of any substantial need for this type of programme for the local population.
The possibility of using the Skeenaview Hospital for treatment programmes more
appropriate to the residents of the area was under study.
The retardation services were endeavouring to provide an ever more seriously
handicapped over-all level of population with adequate service. They succeeded in
bringing about a considerable reduction in the waiting-list, and, during 1971, with
the opening of the Glendale Hospital in Saanich and the probability of at least one
more residential centre, there was a real prospect that the waiting-lists could be
eliminated during 1972. The Tranquille School practicaUy eliminated a waiting-list
which amounted to approximately 140 in October 1969, reduced to less than 20
within a 24-month period.
The British Columbia Youth Development Centre in Burnaby was continuing
its programme, with two residential cottages and one cottage utilized for a day-care
programme. The residential and day-care programme provided treatment for 45 to
50 adolescents, and the Psychological Education Clinic and Family and Children's
Clinic were active with larger numbers of children.
The Department of Nursing Education continued its programme in psychiatric
nursing throughout the year, and, with the abolition of the office of Director of
Mental Health Services, the Department head reported to Miss M. M. Lonergan,
Consultant in Nursing for the Branch.
Throughout, the work of volunteers continued to provide a valuable service.
It was hoped with the changed organizational emphasis in the Mental Health Branch
that the value of volunteers, and the participation of patients' f amilies and other concerned community members, would not be lost sight of but would be utilized to an
even greater extent. One of the prime justifications for maintenance of psychiatric
programmes in the community is because of the necessary and desirable involvement
of patients' families and community members in the treatment and rehabilitation
process.
DEPARTMENT OF
NURSING EDUCATION
During the year, 79 students enrolled in the psychiatric nursing programme.
With the exception of one student who was deficient in one subject, all students had
achieved high school standing; 74 were graduates of the Academic-Technical
Programme, and four of the Commercial Programme. Nineteen students withdrew
from the programme; six for personal reasons, nine were considered unsuited to
psychiatric nursing, and four failed academically. Eighty-five students (78 women
and 7 men) completed the programme. The year-end census was 138 students,
compared to 158 at the end of 1970.
In the Psychiatric Aide Programme, instruction for aides at the Riverview
Hospital and The Woodlands School was provided by the In-service Education Coordinators. This department conducted classes for three aides employed at the
Valleyview Hospital. The aides had previous service experience and required only
a 16-hour orientation course.
One hundred and twenty-nine affiliate students—61 from Royal Columbian
Hospital and 68 from St. Paul's Hospital—completed their affiliation in psychiatric
nursing. The instructors from the hospital
schools of nursing continued to assume
responsibility for the teaching and supervision of the students. The programme
for public health nurses, which was discontinued last year, was not reinstated.
However, the Director of the Family and
Children's Clinic at the British Columbia
Youth Development Centre prepared an
educational programme which will be
given twice; the first course took place
November 15 to November 26, 1971, and
the second is scheduled for January 1972.
The facilities of this department were
made available for lecture and discussion
sessions and living accommodation.
Nursing graduate award winners Miss
Dorothy Jennings and Miss Sharon
Smith with Dr. F. G. Tucker and the
Honourable Patricia J. Jordan.
59
RIVERVIEW
HOSPITAL
GENERAL COMMENTS
Throughout the year, Riverview Hospital continued to provide a wide range
of psychiatric in-patient and out-patient services for adult mentally ill residents of
British Columbia.
While the necessary community resources such as acute-care psychiatric beds
in general hospitals, out-patient and day-care services, special extended care and
boarding-homes, and similar facilities were being increased in many communities
of the Province toward meeting the total needs of the population, Riverview Hospital's goal was to use its resources as effectively as possible in meeting the needs of
those areas where local resources had not yet reached an adequate level.
To achieve this goal of providing the most appropriate types of services to the
areas of population in greatest need, the administration of Riverview Hospital continued to review the function of the hospital, within the philosophy that restoration
of the patient to the best possible state of physical, mental, and social well-being
involved consideration of the whole individual in the context of his total environment.
For patients admitted to Riverview,
there continued to be a spectrum of
services and activities available to meet
their individual needs, including assessment and treatment for acute psychiatric illness, rehabilitation programmes,
boarding-home resources, and outpatient services. Psychiatric extended
care, general medical and surgical services, as well as general extended care,
continued to be provided where necessary. These activities were undertaken
by appropriate professionals, using
most of the modalities and techniques
of treatment presently accepted as appropriate in these areas of care and treatment.
The most significant feature of the treatment services was a continuation and
acceleration of the trend toward greater emphasis on out-patient care and rehabilitation. This trend was reflected in the development of pre-admission services, the
initiation of a Home Treatment Project, the expansion of the out-patient programmes, the transfer of boarding-home patients to the Regional Boarding-home
Programme, and the expansion of in-hospital programmes to prepare patients for
transfer to boarding homes in their home communities.
The statistical record of patient movement during 1971 showed a further general increase, compared to 1970. During the 12-month period ending September
30, 1971, there were 3,475 entries into the Riverview mental health facility, compared to 3,276 during the previous year. Direct admissions were reduced from
2,782 to 2,554. However, there was a concomitant increase in the numbers of
patients returning from leave.
Exits from the facility increased by 311 to 3,617 during the same period, with
increases being recorded in both discharge and placement on leave categories, so
that the average resident population, which numbered 2,506 during 1970, was further reduced to 2,433 for 1971.
60
Certain brain malfunctions can be identified
by electoencephalogram tracings.
IN-PATIENT SERVICES
L 61
Winter at Riverview, 1970/71.
During 1971, Riverview Hospital provided 918,542 patient-days of care and
treatment for in-patients in the facility.
In addition, an average of 1,101 patients per month received out-patient psychiatric supervision and care at the Aftercare Clinic.
Throughout the year aU departments of
the hospital diligently and effectively carried out their varied responsibilities toward
the common goal of providing a co-ordinated therapeutic service to the residents
of Riverview Hospital, through the leadership of then department heads and supervisors, and the dedication and co-operation of all staff in both the clinical and nonclinical services. The following is a
brief outline of the highlights and significant trends developed at Riverview during
1971:
TREATMENT SERVICES
In July the Admitting Officer for the Crease Unit, with the co-operation of the
Vancouver General Hospital, began visiting the Vancouver General Hospital Outpatient Department to examine patients being referred to Riverview Hospital for
care. At the same time, the Home Treatment Project, with Dr. Peter Schieldrop
heading a multidisciplinary treatment team, and Dr. Donald Coates the research
team, began operation. This group is providing and studying psychiatric home
treatment as an alternative to hospital admission for selected cases. Following the
initiation of these services, both the number of patients admitted to the Crease Unit
and the delays in admission markedly decreased. Both the pre-admission service
and the Home Treatment Project will be based in the new Out-patient Department
quarters to be located in Vancouver at 96 East Broadway early in 1972.
A Pilot Regionalization Project was planned for the Centre Lawn Unit, whereby
all patients requiring care who reside in the Lower Fraser Valley will be admitted
to the care of the staff assigned to this project. In order to provide a much-more
comprehensive service and an increase in the continuity of care, there will be a
partial integration of the hospital and mental health centre staff in the region.
With the development of a Regional Boarding-home Programme by the Mental Health Branch, and the recruitment of additional social workers for this programme, 450 patients in boarding homes located near the hospital, formerly under
the care of Riverview Hospital staff, were referred to the care of the mental health
centre in the region during the latter part of the year.
Involvement of the hospital in educational programmes was further developed
during the year. On July 1 an intern-
placement programme was initiated in the
Centre Lawn Unit for medical interns
from the Royal Columbian Hospital in
New Westminster. Each intern spent
three weeks at Riverview and received a
rich psychiatric experience under the di-
Riverview staff celebrated the Province's rect supervision and instruction of one of
centennary with old-time dress. the Staff psychiatrists.
L 62 MENTAL HEALTH BRANCH REPORT, 1971
Postgraduate training of residents in psychiatry of the Department of Psychiatry of the University of British Columbia was enhanced during the year by the appointment of Dr. John Duffy as full-time Clinical Supervisor of the university-
affiliated Clinical Teaching Unit on Ward West-3 of the Crease Unit. It was possible during the year to maintain a full medical complement in this teaching area.
Early in the year, Riverview Hospital was accredited by the Canadian Council
for Supervised Pastoral Education as a recognized centre for the training of clergy
in this field. On January 1 a residency programme for hospital chaplains was initiated under the supervision of the British Columbia Pastoral Institute. In August,
Rev. Lloyd T. Dahl was appointed as Protestant Chaplain for Riverview and has
since received certification by the Canadian Council of Churches as a Supervisor
of Pastoral Education.
Practicums, field experience, and internship programmes in the Laboratory,
in the Departments of Psychology, Social Work, Occupational Therapy, and in the
Patients' School continued for students in the relevant disciplines from the British
Columbia Institute of Technology, from Simon Fraser University, and the University of British Columbia. Programmes in public education were continued, by means
of tours, orientation programmes, visiting lectures, for school, professional, and
other groups from the community.
On October 1, Riverview Hospital adopted the metric system and in all areas
of clinical measurement converted to the metric system of weights and measures,
and the use of the 24-hour clock.
An outbreak of bacillary dysentery unfortunately occurred in the West Lawn
Unit early in the year. A thorough review of dietary procedures was undertaken
and recommendations made for improved screening and training of food-handlers,
improved physical facilities, and other procedures as recommended by the Medical
Officer of Health, many of which have since been implemented.
Several research projects, initiated the previous year, were continued and others
initiated. The Operant Conditioning Project in the East Lawn Unit, involving a
token economy, was continued. Dr. Greiner's study of the basic biochemical factors
in schizophrenia also continued. The research into the predictive factors in suicide
led to the development of a suicide screening procedure which, it is hoped, will help
further reduce the incidence of suicide.
The reorganization of the Medical Records Department, as recommended by
the Canadian Council on Hospital Accreditation, was initiated.
The Medical Staff Organization and its various committees, as outlined in its
by-laws and as required for accreditation purposes, continued their functions
throughout the year.
The Nursing Department continued to
strive for improved standards of nursing
and the maintenance of a stable and adequate complement of trained nursing staff
on the wards. Achievement of the latter
goal was of great concern, due to delays in
the recruitment of staff, the high average
of staff illness, and the lack of sufficient
skilled nurses for vacation and illness
relief.
In the Riverside Unit, the maintenance
of a treatment programme, concomitant
Comfortable patient lounge areas for visiting with the requirement of providing special
and relaxing. security supervision, continued to be of
IN-PATIENT SERVICES
L 63
great concern, particularly as there had been an increase in the referrals of non-
psychotic, psychopathic individuals from the courts for psychiatric assessment. In
August, 11 of these security patients were successful in a planned escape from Ward
R3, during which serious threats to the physical well-being of several nursing staff
were made. This group of prisoner patients continued to be disruptive to treatment
services, and further illustrated that the Riverside Unit can only be considered as
being able to provide minimal security, compared to prison standards.
Efforts to improve standards of nursing care were greatly enhanced with the
appointment in February of Miss J. Welsh as Co-ordinator of Staff Development and
In-service Education.
The prime objective of staff development is to improve patient care, and
requires action by everyone who participates in nursing care. It is conceived as the
way in which staff members are oriented, supervised, guided to learn, counselled,
evaluated; in short, "encouraged to grow." Concentration on strengthening staff
members in this way is considered the most positive way to provide improved
nursing care to patients.
Early in February a change in assignments of nursing supervisors took place,
with six supervisors being assigned as nurse clinicians to work directly with the
staff education aspects of nursing supervision. The first emphasis of the programme
was placed on orientation of new staff and the present staff who are promoted to
administrative positions.
The minimal care resident programme continued to be successful and was
expanded in April with the opening of an additional home for 11 patients from the
West Lawn Unit.
Unfortunately, the annual summer resident camping programme for long-stay
patients could not be carried out during the year, due mainly to shortage of qualified
personnel required for this programme.
Lectures on the use of oxygen, cardiac arrest, and mouth-to-mouth resuscitation were given on a regular basis by the inhalation therapist.
During the year, two nurses obtained dual qualifications by successfully completing the two-year nursing option programme at the British Columbia Institute of
Technology. Another four nurses entered this programme in September.
The Volunteer Programme under the
auspices of the Canadian Mental Health
Association, British Columbia Division,
continued to provide valuable service to
Riverview patients. The 250 volunteers
provided in excess of 20,000 hours of
direct patient service during 1971. In July
a new summer programme was initiated
when five adolescent girls volunteered as
"Junior Stripers." They served on two
infirmary wards where they assisted with
patient-grooming, played games, took
patients in wheelchairs out in the grounds,
and provided patients with personalized
attention and affection.
Volunteers from the Western Institute for the Deaf began visiting the hospital
every week, and developed a socializing programme at the Volunteer Centre for
profoundly deaf patients. In addition, these volunteers provide a "translating"
service when requested by staff who are unable to understand signs and finger
spelling.
New clothes from the Apparel Shop in the
Volunteer Centre.
L 64 MENTAL HEALTH BRANCH REPORT, 1971
ADMINISTRATIVE SERVICES
The emphasis in the administrative divisions continued to be placed on the
achievement of maximum effectiveness of service, at minimum cost. The continuing
decline of reliable and effective patient help and the problems of staff recruitment
were again of special concern throughout the year.
During 1971, emphasis in the Personnel Department was toward the upgrading
and reclassification of employees and positions to meet the more complex and expanded service demands of such services as transportation, social service, rehabilitation, clerical, industrial therapy, and nursing. Toward this end also, the Personnel
Officer conducted training sessions with supervisors in several departments, on more
effective use of employee-appraisal procedures and supervisory techniques. A closer
liaison with the Civil Service Commission was established to assist in seeking out and
screening more effectively applicants for new positions, or for promotion.
The welfare of staff was promoted,
wherever possible, through the development of an intensive safety programme,
continued liaison with local representatives of the Psychiatric Nurses Association and the British Columbia Government
Employees' Union, as well as direct supportive consultation to departments or
individual employees regarding personnel
problems. Special consideration this year
was given in conjunction with the Occupational Health Department to the improved
Patients receive workshop instruction. , .. - ,
and systematic screening of employees
with excessive sick-leave absences. This programme resulted in a marked improvement in sick-absence figures.
During the year the Personnel Officer provided service to the community
through participation in career-counselling sessions for some 60 commercial grade
students in the Vancouver area, and in assisting Mr. R. Cosser, Assistant Nursing
Supervisor, who directed a highly successful United Good Neighbour Campaign
among employees of Riverview Hospital.
During the year a number of benefits accrued to the hospital and patients
through the dedication and interest of the staff of the administrative and service
departments.
Of note has been the reorganization of the laundry and linen services, which
provided improvements in processing, delivery, garment identification and appearance, and economy of operation with a net gain of 8 per cent in production over last
year.
The introduction of cost-saving quota systems in the Pharmacy and staff-
training programmes proved effective. In addition, the provision of prescription
services showed an increase of 4,500 prescriptions over last year.
The former Executive Housekeeper, Mr. W. H. Newman, retired on December
31, 1970, and was replaced by Mrs. M. Y. Glendinning. This department continued
to offer a five-day week service, which taxed their resources in the care of the hospital
geared to a seven-day week operation. Nevertheless, they managed to do an
excellent job in maintaining the cleanliness of the areas they service.
The library services were enhanced by the appointment of Miss K. M. Cox as
Librarian in May of 1970. Miss Cox introduced improved services to patients and
IN-PATIENT SERVICES
L 65
staff, and the library continued to provide a key link in the administrative and professional services divisions.
A personalized shoefitting department was established in the Industrial Therapy
Department. This provided an extra service to patients, and at the same time effected
a considerable economy in repairs, purchase, and supply of shoes.
The new patient bed-wardrobe units
which were designed to provide patients
with their own personal "corner" continued to be the main item of manufacture
in the furnishings division this year.
Cost savings accrued from administrative procedures and control systems on
the issue and use of supplies, coupled with
on-site inspections. A comprehensive report was prepared on rehabilitation and
ward workshop activities, and management studies were carried out in effective
utilization of physical facilities.
The Public Works Department carried
out normal maintenance of the buildings
and there were no major breakdowns in
utility service. The second phase of the renovations to West Lawn Unit were completed by the year's end. The modernization of the washrooms and wards, and the
colourful and modern furniture installed in the newly renovated wards, added much
to the comfort and welfare of the patients.
During the latter part of the year a start was also made on the long-needed
renovations to the Centre Lawn Unit, especially in the provision of expanded occupational therapy facilities.
Patients relearn old skills in the Hillside
Unit prior to discharge.
GERIATRIC
DIVISION
This Division is made up of three mental health facilities with a total complement of 1,306 beds. Valleyview Hospital is the largest of the three units, with 767
beds, and accepts patients from the Lower Mainland and adjacent areas of the
Province, as well as from Vancouver Island and the Gulf Islands. Dellview Hospital, Vernon, consisting of 239 beds, accepts patients from the Okanagan and
Kootenay areas. Skeenaview Hospital, Terrace, with 300 beds, all male, accepts
patients from the northwestern part of the Province. Boundaries are not clearly
drawn, and for convenience of transportation the patients from the extreme northern
areas may have to be admitted to Valleyview Hospital. Persons aged 70 years and
over suffering from psychiatric illness and in need of treatment, or whose behaviour
due to psychiatric illness is so disturbed that they cannot be adequately cared for
elsewhere in the community, are accepted for admission. Organic deterioration
leading to dependency without a behaviour problem is not considered sufficient to
warrant committal to Geriatric Mental Health facility. Pressures to admit patients
are unequally distributed and Valleyview Hospital, on which the pressure is greatest,
transfers patients to other units when possible to relieve this pressure. The least
demand for the beds available is in the Skeenaview Hospital area.
Dr. John Walsh, who had directed this Division for eight years, retired at the
end of May. During his period of time, Valleyview Hospital had become steadily
more active therapeutically. With the development in the community of boarding
homes, nursing homes and, more recently, extended-care facilities, it had been possible to develop Valleyview as a specialized psychiatric unit operating in the geriatric
field, and in this way it uses to best advantage its mental health professionals and
special mental hospital facilities. The credit for much of this development within
the Geriatric Division is due to Dr. Walsh, who will long be remembered by his colleagues and staff.
VALLEYVIEW HOSPITAL
During 1971 the rate of admissions and discharges continued on much the
same level as through 1970. The practice of seeing most of the patients for whom
admission was requested, prior to accepting them at Valleyview, was continued.
In this way it was possible to ensure the appropriateness of all admissions. On the
average, three out of every four were accepted by Valleyview. Most people not
admitted did not require the special psychiatric services of Valleyview Hospital,
and the problem was usually dealt with
by finding a suitable boarding home or
nursing home, or extended-care placement.
The general health of the patients continued to be satisfactory. In view of the
persistence of recurrent skin infections in
two wards, Dr. Munroe from the Simon-
Fraser Health Unit was consulted, and
with a programme of isolation and intensive treatment, the skin problems ap-
One of Valley view's three 100-bed cottages. peared to have cleared up.
66
IN-PATIENT SERVICES
L 67
The Occupational Therapy Programme for patients continued at much the same
level as formerly, except that the services of Mr. Haughton were discontinued in
the month of September due to his promotion to the Riverview Hospital O.T. staff.
Recreational services were continued with birthday parties, musical programmes
on the wards, and a large programme of bus outings, particularly in better weather.
Approximately 100 volunteers have provided service to Valleyview over the past
few years. No attempt had been made to give formal recognition or reward for this
kind of service, but, on October 4, Valleyview had a lunchtime meeting for the
volunteers, and certificates of service were presented. Some volunteers had contributed as many as 3,000 hours over the last three years.
Medical service to patients continued much as usual, and, in January, Dr.
Maurice was appointed to fill the vacancy created by Dr. Lisicar's departure, providing Valleyview with the full services of four general medical staff. At the end of
August, Dr. John Robertsen, who was Assistant Superintendent, left to work at the
mental health centre at Courtenay and to do some private practice in that area. The
roster of medical surgical consultants who service Riverview continued to provide
services to this hospital and they ensured that a high level of medical care was readily
available to all patients.
The pathological and X-ray laboratories had a slight increase in the amount
of work done during the year. They were a very important part of the medical
services to patients. Another important medical service for elderly patients was
physiotherapy.
Nursing care continued at a high level under the direction of Miss Edith Johnstone and her supervisors. With such a high proportion of mentally deteriorated, and
often physically disabled patients, the demands on the nursing staff were heavy.
The Social Service Department worked throughout the year with a full complement of staff. This was reflected in the continuing high rate of discharges. One
practice, introduced in the past year which proved to be of particular value, was to
involve each of the social workers with a group of patients in the rehabilitation ward,
so that they became familiar with these people even prior to referral for discharge
planning. This undoubtedly saved time in the long run, and made the social service
work that much more efficient.
Regular maintenance was provided efficiently by the Public Works Department. The Dietary service continued at a high level under the direction of Miss
Thomson.
DELLVIEW HOSPITAL, VERNON
The demand for beds for geriatric patients in the Interior section of British
Columbia was sufficient to keep this hospital operating at 95.4 per cent of full
capacity throughout 1971. The average
admissions were almost 10 per month,
with a total complement of 239.
A good standard of nursing care was
provided by registered psychiatric nurses
and in-service trained psychiatric aides.
A seminar on pharmacology was attended
by all nurses on staff.
Medical services were provided by a
local physician with a specialty in surgery,
and a psychiatric consultation service was
provided on a regular basis. The nearby
Recreational therapy plays an
important role.
L 68
MENTAL HEALTH BRANCH REPORT, 1971
location of the Vernon Jubilee Hospital permitted the use of its modern equipment
and facilities for special diagnostic and treatment requirements. Dental, ophthalmic,
and podiatry services were provided by visiting specialists.
A continuing programme of rehabilitation was maintained, with patients being
released to private placements, boarding homes, and nursing hospitals. However,
with new extended-care units in this area receiving patients which formerly may
have been sent to Dellview, the number of patients capable of rehabilitation was
reduced to an average of three persons every two months. A regional social worker
was appointed to the establishment of the Vernon Mental Health Centre, to help
with this work.
A full and continuing programme of occupational and recreational therapy was
maintained for the patients. Willing volunteers from the local branch of the CMHA
help regularly with handicraft sessions and assisted in arranging parties, concerts,
dances, picnics, slides, and movies, and other forms of entertainment.
Credit was due to every member of the staff
for his contribution in practising safety and accident prevention, which enabled Dellview Hospital
to qualify for four safety awards, comprising one
gold, one silver, and one bronze to individual departments, and a silver to the entire hospital.
A major purchase of new modern beds increased the comfort of the patients and improved
the decor of the wards.
Extensive exterior redecorating was performed
in 1971 with a change in colour that enhanced
the appearance of the buildings.
After considerable planning, Dellview joined
forces with the Vernon Jubilee Hospital and other
community organizations to conduct a simulated
disaster in preparation for any emergency of a
Restoring muscular activity. large-scale nature.
SKEENAVIEW HOSPITAL, TERRACE
Medical services were provided by a local doctor on a part-time basis. Special
diagnostic and treatment facilities were available at the local Mills Memorial
Hospital.
Admissions from the northern communities averaged less than one per month,
but the patient count was maintained by transfers from Valleyview Hospital. Two
patients were discharged to the community, and one patient was transferred to
Valleyview for assessment and later released to the community.
During October a psychiatric nurse attended a special "Remotivation Workshop" under the direction of Dr. M. J. Quinn, psychologist, held at the Riverview
Hospital. Upon return to Skeenaview, she assisted Dr. Quinn in conducting sessions for Skeenaview staff in reactivation methods and procedures, to upgrade the
philosophy and theory of general geriatrics and psychogeriatrics.
A small but active group of volunteers assisted greatly in various ways in the
programme. Occupational therapy continued to expand in the activity room and
woodwork shop areas, and local community service clubs and church groups assisted
with outings and in the recreational programme.
A good standard of nursing care was maintained.
IN-PATIENT SERVICES L 69
Business administration—The productivity of the laundry was increased by the
appointment of two additional staff on a continuous casual basis, and the implementation of an additional work shift. Renovation of the kitchen and bathrooms in the
Westlynn and Infirmary Wards was under way and was expected to be completed
early in 1972.
The Skeenaview Safety Committee was established and proved to be a very
active and effective committee.
THE
WOODLANDS
SCHOOL
The Woodlands School is a residential facility for all ages of mentally retarded,
many with additional physical or emotional problems. Its catchment area consisted
of Mental Health Regions 3, 4, 5, 7, and 8, which represented two-thirds of the
population of British Columbia. It was also used as a resource by the Yukon
Territory.
The 1,250 residents of The Woodlands School were divided into three residential units—the Hospital Unit, Training Unit, and Psychiatric Unit—each of
which had its own Director. To meet care, education, and training needs, inter-
discipline teams were assigned to the specific unit wards by Department heads, in
consultation with the Unit Director.
The reorganization of ward population was a prime concern during the year.
This reorganization was facilitated by the transfer of 11 extended-care children to
the Queen Alexandra Solarium, Vancouver Island, and 50 extended-care and ambulatory children and adults to Glendale Lodge Hospital, as well as many placements
in regional boarding homes. Many urgent cases for admission were accommodated
in 1971. Hopefully, 1972 will see a noticeable reduction in the active cases requiring resident services at The Woodlands School.
There was a marked decrease in the number of requests for temporary admission during the summer, in comparison to previous years. The increase in community resources such as short-stay hostels, day-care centres, and summer camps
for handicapped, appeared to be the reason for this change. Of the 45 applications,
Woodlands was able to admit 13 for short periods, and by the year-end seven had
been accepted for long-term admission.
Applications for the waiting-list were
screened by the Deputy Superintendent, or
Superintendent and Supervisor of Social
Service, each week. If sufficient information was not available, a referral to The
Woodlands School Out-patient Department was recommended to the physician
or agency requesting admission. On those
accepted for the waiting-list, a pre-regis-
tration questionnaire was then completed
by parents, social worker, or family physician. This information was tabulated
and forwarded monthly to the computer
in Victoria. At the same time, the local
Public Health Unit was requested to submit a priority rating for admission. Priority
was based on the retarded person's condition, family situation, and the availability
of suitable community resources. Twice a month, a large committee of clinical
staff from the three units met to discuss problem and high-priority cases on the
waiting-list.
The Out-patient Department supplied diagnostic counselling and follow-up
services to the mentally retarded and their families in The Woodlands School catchment area. Consultative services were offered to community agencies. The number
The field-hockey trophy won at the Special Olympics in Toronto in June.
70
IN-PATIENT SERVICES
L 71
of cases seen in the first nine months of 1971 was 105, as compared with 121
patients seen in the same period of 1970. It is of interest to note the age distribution
of those referred:
Years of Age Per Cent
0-6 30
6-12 40
12-18 20
Over 18 10
During the year an effort was made to give more direct service in the way of
back-up support to community resources. In some cases it was possible for one of
the psychologists to work directly with families, and with the teacher where the child
was in school on programmes of behaviour modification. Other team members
offered direct service, ranging from telephone calls and letters to office interviews
and home visits.
There was a noticeable increase in the number of disturbed retarded adolescents
and young adults referred, who did not seem to fit into any presently known facility,
but who obviously required a supervised residential setting. Much improvement was
needed in the increase and co-ordination of resources for the retarded.
Thanks to the initiative of staff volunteers, supported by a caretaking group
from The Maples and Public Works construction, more than 300 residents enjoyed
overnight camping at the much-improved Gold Creek camp-site. During the summer, 1,750 individual trips to day camp were also provided. Sharing daily life and
recreation at camp proved to be an extremely beneficial experience for residents,
staff, and volunteers.
Recognition came to The Woodlands' residents in national community competitions. A cash award and "highly commended" citation was achieved by one resident
in the Annual Geigy Art Competition. In national competition during the Special
Olympics in Toronto, seven residents were part of the winning British Columbia
floor-hockey team that brought back the Clarence Campbell Trophy. They were
coached and trained by The Woodlands' recreational therapy staff.
On April 7 a most successful "Open House" for the general public was held, at
which over 1,400 visitors attended. The local community continued to show their
interest in programmes at The Woodlands School in many ways, and, undoubtedly,
the volunteer programme certainly helped foster this positive attitude.
Thirty children were involved for six weeks in the "Summer Magic" programme
at Bonsor Park in Burnaby. Another group of residents of Alder Lodge, in Mail-
lardville, participated in the weekly com-
f^m^^^—m. munity programme for the mentally re
tarded held at St. James' Park in Port
Coquitlam. Both of these programmes
were sponsored by the local Parks Board.
The Spontaneous Music Workshop,
which was a project sponsored under the
"Opportunities for Youth" Programme,
gave considerable service to The Woodlands School.
Through the Volunteer Services, many
programmes and gifts were donated. Radio Station CKNW in New Westminster
continued to be the most interested sup-
The Minister makes a purchase in the porter of The Woodlands School pro-
"Play to Learn" store. „
1 grammes.
_l
L 72 MENTAL HEALTH BRANCH REPORT, 1971
The Easter Egg Hunt was sponsored by the New Westminster Kinsmen's Club,
and they distributed approximately 3,000 chocolate eggs.
October 1 saw The Woodlands School change to the metric system. No major
difficulties were encountered.
The Woodlands School appreciated the personal support and guidance given
by Dr. H. W. Bridge during his tenure as Director of the Mental Health Services.
There continued to be a close affiliation between The Woodlands School and
university faculties. Field placements were made for social workers, nurses, teachers, rehabilitation medicine, and rotations for pediatric residents.
TRAINING, EDUCATION, AND TREATMENT SERVICES
The Hospital Unit is primarily an extended-care facility, but it also provides
the acute medical care for the entire institution. The programme for the blind has
been in operation since February 1970. The group was comprised of 16 boys, and
the programme was conducted by two psychiatric nurses. The Psychology Department and Department of Training and Education provided consultation. The programme incorporated as much tactile and auditory speech stimulation into every
activity as was possible. All of those residents involved in the programme have
shown improvement. A special programme was started on July 2 on the ward of
the Hospital Unit that prepared small children for transfer to the Training Unit.
This programme was under the direction of the charge nurse, with assistance from
the occupational therapist, recreational therapist, and the head of the Training and
Education Department. A volunteer, who is an educational psychologist, also
participated in this programme. Video-tape recordings were used extensively for
assessing the progress of the youngsters, as well as a teaching tool for evaluation of
approaches and methods used by each individual member. It was generally agreed
that programmes similar to this would be of great help on other wards. Very active
programmes continued to be conducted on the two C.P. wards. Some of the
residents attended the Sheltered Workshop that came under the Training and Education Department. Another workshop was carried out on one of the wards under
the supervision of the nursing staff. The enriched programme on both of these wards
would not be possible without the extensive services of volunteers.
During the year Woodlands received increasing service from the Royal
Columbian Hospital in carrying out emergency and specialized surgery. The Psychiatric Unit introduced two new steps for
care and training. It was possible, because of the moves to Glendale and the
community, to introduce two integrated
wards. The one ward will be planned into
family-type groups of residents, including
both boys and girls with a wide range of
ages, but all of whom have a prognosis
for return to community as independent
citizens. The final step for these residents
should be the placement in a half-way
house in the community. The second integrated ward will be for young adults
Individuality and self-help are prime who wiu be trained foj. boarding-home
objectives at Alder Lodge. , , . , , ... ......
placement, which hopefully will have sheltered occupation, or workshop in conjunction. Therapeutic communities will continue to function on the intensive-care wards.
IN-PATIENT SERVICES L 73
The Training Unit successfully met one of their priorities during the year by
completing annual reports, including management plans, on all residents. The five
divisions of the Training and Education Service made numerous innovations to
enrich, extend, or intensify growth experiences for residents.
Fifty young men and women beyond school-leaving age, who work in the
Sheltered Workshop, became eligible for increased earnings for increased work, as
part of work-adjustment training initiated when the workshop became part of Vocational Services. A pottery studio was set up and was providing therapeutic and
creative experiences for small groups of residents through the Occupational Therapy
Department.
Since all of the students in The Woodlands' Special Education School follow
individual programmes, motivation toward independent study is important to their
success. During the year, under the supervision of a full-time volunteer, audiovisual aids such as film-strips, speaking flash cards, and individual lessons on tape
cassettes were used by pupils for independent assignments.
The use of training and education staff acting as working consultants to nursing
staff giving programmes was increasing, with the establishment of multidiscipline
top-priority programme areas in all three residential units. These programmes supplied not only accelerated treatment and training for residents, but also provided an
intensive learning experience for the staff who took part.
One of the Psychology Department members spent a substantial amount of
time constructing an adapted behaviour-rating scale, similar to the Vineland, but
more appropriate for The Woodlands School. This scale will permit a more adequate assessment of the residents for community placement, as well as give a better
identification of aTeas of weakness where more training is required.
The Social Service Department worked
very closely during the year with the regional boarding-home workers. They
played a major role in the orientation of
these regional workers to the field of
mental retardation. Dr. Tischler, Director of the Hospital Unit, remained a member of the teaching staff of the Department
of Paediatrics, and was also on the attending staff at the Vancouver General Hos-
itiii; pital Health Centre for Children. She
The annual parade and carnival took place continued to offer supervision to the pediatric residents, who were rotated through
The Woodlands School every two months. On July 1, Dr. Brooks, Deputy Superintendent, resigned to assume a clinical appointment at Glendale Hospital.
The dental care of residents was improved during the year through the introduction of general anaesthesia to permit extensive work being carried out at The
Woodlands School.
The Radiological Department continued to provide basic diagnostic facilities
to the residents of The Woodlands School, as well as tuberculosis survey chest X-
rays to both staff and residents. The total X-ray examinations for 1971 was 2,684.
Special examinations were carried out at Riverview or in local hospitals. The medical staff had the benefit of regular and emergency reporting of radiograph by the
exceptionally well-qualified consultant radiologist. The amount of referrals to the
Physiotherapy Department increased. In 1971, 8,200 treatments were given. This
department worked closely with the consultant orthopedic surgeon (a total of 73
L 74
MENTAL HEALTH BRANCH REPORT, 1971
A teacher and her pupils.
cases was seen in 1971). The speech therapist maintained service in audiological
and speech therapy for in-patients and some out-patients. Audiological services
were supplemented by the Western Institute for the Deaf in Vancouver. Considerable planning went into the introduction of two systems to make the delivery of
services more efficient. An "on call" staff was set up to meet emergency shortages
of staff that come primarily due to illness. Planning was progressing on part-time
employment of nursing personnel on a four-hour basis, that will be open to all categories of nursing personnel, in order to meet peak working periods during the day.
The Public Health Nurse continued to
be an important member of the team.
She was involved in informal teaching at
the ward level, as well as the more formal
lecturing on the control of communicable
diseases. She was most helpful in maintaining public health standards, and the
majority of the credit for the lack of serious infectious diseases during the year
was due to her vigil. Her responsibility
also included immunization of the residents.
Other aspects of in-service education were of equal importance. The Hospital
Unit continued to carry out teaching rounds that not only increased the knowledge
of physicians and nurses, but also improved the standards of care. Ten Medical
Grand Rounds during 1971 frequently involved other disciplines. Guest discussants were invited from the universities. Community agencies and other parts of
the Mental Health Services were most helpful in assisting with in-service programmes.
BUSINESS ADMINISTRATION
The former Business Administrator, Mr. H. F. Hayes, completed his last
working day on January 29, 1971, and proceeded to his new appointment as
Administrator of the new Glendale Hospital, Victoria. His position was filled
through the appointment of Mr. F. Wallace, the new Business Administrator.
The staff establishment of The Woodlands School remained at 924 positions.
While staff turnover of registered nurses and female psychiatric nurses increased,
over-all staff turnover dropped during the year.
The Department of Public Works,
Essondale, agreed to provide The Woodlands School with the services of a permanent full-time Fire Prevention Officer.
This person will be in charge of fire safety,
particularly necessary in this period when
many renovations are being made. The
full-time Fire Prevention Officer will be
able to update the fire evacuation procedures and increase the staff training received at Riverview. This appointment
will help augment the over-all emphasis
on safety, which is a prime concern to all
"Talking dolls," equipped with two- staff The Accident prevention Commit-
way radios for speech therapy, pre- , . , ,
sented by Lions Gate Council of Tele- tee held regular monthly meetings,
phone Pioneers to Dr. Pauline Hughes. 1971 saw the final acceptance of phase
IN-PATIENT SERVICES
L 75
three renovations to the Centre Building and cafeteria. Fire escapes and other
modifications to the cottages to meet the Fire Prevention Code were completed. A
contract was awarded to provide ventilation to these four buildings, and will be
completed early in 1972. These renovations required many moves of residents
from one building to another. Special playground equipment was installed, which
was purchased through the Patients' Comforts Fund. A number of meetings were
held throughout the year with Public Works staff to work out details of future building renovations and land-use plans. The Department of Public Works conducted a
study of the present food-delivery system, with a view to updating the procedures.
The important service function of the Institution Industries Department continued for all sections of The Woodlands School. Many custom, hospital, and
other items were fabricated, including orthopedic shoes for the entire Mental Health
Branch, and some community agencies. The sewing-shop, woodworking shop, paint
shop, upholstery shop, metal shop, appliance shop, and shoe shop also repaired and
maintained thousands of articles of clothing, furniture, and equipment.
THE
TRANQUILLE
SCHOOL
Tranquille provided a comprehensive service to the retarded from the eastern
portion of British Columbia.
During the year, considerable attention was given to improving the main
facilities and also to modernizing the plant with a continuing renovating programme.
Work commenced on the provision of new elevators in the Greaves Building,
allowing for more adequate evacuation of the building in the event of an emergency.
The policy of phasing out the oldest buildings was continuing and the male
staff residence was closed. Very few of the nursing staff wish to live in residence
and during the year both men and women staff members, who were still living in
the school, were accommodated in the High Park Building, the men being accommodated on the top floor and the women on the bottom. It was expected that by
February 1972 this building would be totally vacated by staff and would be available
for other than residential purposes.
With the co-operation of the Public Works Department, some modifications
were made in the Administration Building, East Pavilion, and in the Sage Building
to provide adequate office space for increased numbers of senior professional staff.
Play equipment for children was provided by service clubs, and this was installed in the region of the pediatric ward,
where it is easily accessible to the children.
A large paddling-pool was also installed
in the area of the Greaves Building.
Kamp Kiwanis was carried on by Mr.
Knight, Assistant Director of the Training Department, together with the Kiwanis
Club members, and a lot of new work was
undertaken, including installation of a
swimming-pool, the winterizing of accommodations, and a community house at the
camp.
Tranquille is known for its beautiful site and
landscaped grounds.
MEDICAL AND TREATMENT SERVICES
In June, Dr. M. A. Setty, the Director of Clinical Medicine, resigned to take up
residence in North Carolina. During Dr. Setty's year and a half at Tranquille, he
revolutionized the Medical Department, achieving high standards in both the physical
facilities and in the delivery of services. During the remainder of the year the
Superintendent served as Acting Director of Clinical Medicine. The relationship
with the local medical community remained excellent and the specialists in the area
continued to be members of the honorary consultant staff of Tranquille. Many
cases from Tranquille were referred to them during the year, and the school appreciated the co-operation of the Royal Inland Hospital for the facilities extended on
behalf of patients from Tranquille.
The X-ray Department was renovated in 1971 and a part-time radiographer
was engaged.
76
[
IN-PATIENT SERVICES
L 77
PHYSIOTHERAPY SERVICES
The Physiotherapy Department was staffed by one full-time physiotherapist,
Mrs. V. Nadalin. The tremendous volume of work in this area made it necessary
for her to enlist the services of nursing and volunteers to carry out the department's
programmes. The well-equipped department was located in a building away from
the hospital area.
NURSING SERVICES
During the year, attention was fixed on the total involvement of nursing personnel with the other disciplines throughout the whole establishment. This proved
to be very beneficial both to the patients and to staff members of other disciplines.
The problems of ward integration provided areas of anxiety for nursing staff,
but the move proved to be very successful.
The traditional role of the nurse is
always a rather authoritative one, and it
was very good to see how sharing responsibility and authority was accepted by the
many nursing staff. The most sophisticated ward, Deerholme, was run by a
clinical team for the ward, of which a
nurse in charge of the ward was a member.
This team met continuously to advise on
all phases of the ward's actions.
"Homey" lounge areas are located in most
wards.
PSYCHOLOGICAL SERVICES
During the year the Psychology Department, headed by Mrs. A. Harmon,
M.A., was a small department that had a profound influence on the general running
of the school hospital. The psychologist was involved with the senior clinical team,
and also with other ward and clinical teams at the ward level, and she participated
in all manner of therapeutic encounters both between staff, and staff and patients.
As an expert in behaviour modification, she was continually in demand at the
school, in the Out-patient Department, and in the community.
SOCIAL WORK SERVICES
The Social Work Department was headed by Mr. H. K. Maerzke, B.A., M.S.W.,
A.C.S.W., Director. As a result of regionalization and the subsequent increase in
more complex requests for services from Tranquille, in particular the Social Work
Department, it was necessary to create an Out-patient Department. This was
co-ordinated by a social worker who received and processed all applications, made
arrangements for the family and their dependent to visit this facility for the assessment, gathered relevant documentation from Community Agencies, requested the
appropriate health care disciplines from within the institution to participate in the
assessment, completed a comprehensive diagnostic and community care out-patient
assessment from the material submitted by the other professionals involved, and
provided follow-up services on a consultative basis to the referring agency.
Further, as a result of regionalization, more complex services were evolved in
the following areas:
(a) Community employment.
(b) After-care services to the outlying areas, as far away as Fernie.
L 78
MENTAL HEALTH BRANCH REPORT, 1971
(c) The waiting-list administration.
(d) Family services for both waiting-list applicants and institution trainees.
(e) Community liaison and consultation.
(/) Implementation of the ward-team concept in all the training areas.
(g) The complex evolvement of a new training concept in ward management
ideas, resulting in the ward integration of male and female mildly and
moderately retarded trainees.
The administrative, management, and
consultative services involved in admissions and the handling of the waiting-list
resulted in better community understanding and more appropriate handling of
potential admission applicants.
One of the most positive aspects of this
department during the year was the consultative services provided to public health
units, family physicians, mental health
centres, and other referral agencies.
There were two categories of patient
clearly evolving on the waiting-list who
were seeking services from this institution—
(1) pediatric cases of all levels of retardation (ages 3 to 9);
(2) extended-care patients meeting BCHIS criteria.
The regionalization of the Boarding-home Programme for the mentally disordered was implemented during the year, and was reducing considerably the direct
after-care service involvement.
There were 45 new admissions at Tranquille during the past year.
September's outdoor barbecue was a great
success.
GENERAL
The school was visited by many prominent people during the year, and a
seminar on mental retardation was held in March under the auspices of the University of British Columbia.
A good contact with South Central Health Unit was maintained and Tranquille
was appreciative of the services provided by Dr. Hugh Richards, the Medical Health
Officer. A large number of patients went to boarding homes through the year, and
to the new Glendale Hospital in Victoria.
During the year, two senior professional staff members in departments other
than medicine accepted appointments to
Tranquille—Mrs. Maureen Wheatley,
B.Sc.N., R.N., Director of the Department of Continuing In-service Education;
and Mr. Dennis How, M.A., B.Ed., Director of the Department of Training.
These two departments provided a programme for volunteers and other people
interested in the retarded, and approximately 50 people attended the evening
clinical sessions and lectures. The faculty
was provided by the professional staff of the school.
Occupational therapy ranges from simple
pegboards to producing rugs.
BRITISH COLUMBIA
YOUTH DEVELOPMENT CENTRE, BURNABY,
THE MAPLES
The operation of the British Columbia Youth Development Centre (The
Maples) during 1971 was under the direction of a board of management constituted
as follows:
Chairman—
J. S. Bland, B.A., M.B., B.Chir., M.R.C.Psych., D.P.M., Co-ordinator of
Mental Retardation.
Members—
T. D. Bingham, M.S.W., Director of Programmes, Department of Rehabilitation and Social Improvement.
H. W. Bridge, M.B., B.Ch., M.Sc, C.R.C.P.(C), Co-ordinator of Adult
Psychiatric Services.
A. N. McTaggart, M.D., C.R.C.P., private practitioner.
Executive Secretary—
D. R. McCallum, CD., Business Administrator, Mental Health Services,
Burnaby.
The centre was organized into the following functional units:
The Psychological Education Clinic—D. C. Shalman, Ph.D., Director.
The Family and Children's Clinic—A. A. Cashmore, M.D.(Lond.), Director.
The Residential Unit—Miss M. E. Campbell, R.N., B.N., M.A., Acting Director.
THE PSYCHOLOGICAL EDUCATION CLINIC
The Psychological Education Clinic had two aspects to the programme—The
Maples School, and out-patient and consultative service. The Maples School had
seven classrooms which were in full operation. One classroom was for the adolescents in the Residential Unit, while the remaining six were for children from the
community comprising the Lower Mainland areas of Vancouver, Burnaby, New
Westminster, Coquitlam, Surrey, Richmond, North Vancouver, and West Vancouver. One teacher was assigned to the residential class, while 10 teachers were
employed in the remainder of the programme. Two of these teachers were placed in
The Maples programme from the Burnaby School Board.
The children were referred to the clinic after receiving all the special services
that the school district could offer. Following an intake evaluation, they were
observed in their regular classes and direct information was elicited from the
teacher. They were then enrolled in one of the clinic's special classes, which had a
consulting psychologist and teacher forming the treatment unit. The family became
part of the treatment programme and, in some cases, the treatment revolved primarily around the family while the child received additional remediation. In other cases,
the family was seen only sporadically, about once a month, to determine if progress
in behaviour change was being maintained in the home and other places. If improvement was not reported at home, then the family was brought in more frequently to
79
L 80
MENTAL HEALTH BRANCH REPORT, 1971
Play therapy is both a diagnostic and a
treatment procedure.
find out why the child was behaving the way he did in different settings. On some
occasions the parents would avail themselves of the services the clinic provided, and
if the child was greatly in need of the programme he was accepted and home visits
were arranged.
There were many special programmes available to the teachers for use with the
children. Each child was on an individual programme designed to meet his needs.
The gymnasium and swimming programmes were based on a noncompetitive system, where the child experimented
with his environment to find different ways
of exploring and experiencing the equipment. Their behaviour was modified
essentially by following principles of an
operant methodology, where positive responses were encouraged through a reinforcement system, and undesirable behaviour was ignored.
The other part of the service offered the
community was in working with children
not in The Maples School. Frequently,
staff were asked to see children who were unmanageable in the regular school, but
the teacher would be willing to work with the child if she knew what to do. The
clinic's psychologists used part of their time to assist teachers in effecting behaviour
control, which required going to the school to observe the interaction between
teacher and children. This aspect of the programme was very successful. The
Vancouver School Board asked the clinic to set up training workshops or demonstration classes following a behaviour-modification approach.
The clinic attempted to follow up its cases with a one month and one year
follow-up questionnaire. The 95-per-cent response to this questionnaire was most
gratifying.
Although there were no more than 48 children in the school at any one time,
throughout the year the clinic treated 69 in its programme. Of these, 38 (49 per
cent) were returned to the regular schools during this period. This was an encouraging figure, since 5 per cent of the children had been removed from their regular
school setting prior to admission at The Maples, and 32 per cent were in a special
class and were deteriorating.
Training had always been a major aspect of the clinic's community service.
Many teachers came to learn a remedial approach or observe the operant procedure
in classroom operation. The clinic served as a training school for education students
from Simon Fraser University who spend one semester with the staff and then are
followed by a new group of students. The clinic provided a training assistantship for
four summer months, which included some testing experience, school psychology,
and research. Staff also travelled to various centres throughout the Province to
conduct workshops in a variety of topics.
THE FAMILY AND CHILDREN'S CLINIC
During the year the functions of the clinic were modified to meet the changing
needs and demands of the community.
The availability of assessment, consultation, and treatment services to other
agencies decreased. Priority was given to mental health centres, the Special Place-
IN-PATIENT SERVICES L 81
ment Section, and Willingdon and Brannan Lake Schools. The Travelling Clinic
Services were restricted to occasional visits by one or more staff members to centres
requiring specialist services, e.g., training workshops, assessment of difficult family
problems.
Treatment priorities were given to the children in the day and residential programmes at The Maples. The pre-school programme was very active and needed a
greater amount of treatment time for the children and their families. The programme
attracted some increased interest from outside agencies, including the universities,
and was being used for teaching and training purposes. A number of severely disturbed children in The Maples School were seen in individual psychotherapy and
their families were also involved.
The Community Team established its position in the Health Unit 4 region of
Vancouver, and functioned mainly as a treatment team whose services were available
to all agencies in the area, while retaining a close connection with the Public Health
Unit. Several evaluative meetings were held with the public health staff, and reports
prepared which indicate a widespread satisfaction with the "satellite clinic" type of
operation.
During the year there was a marked increase in the number of requests for
training programmes. Brief workshops were held for probation officers, Home-
makers, Family Life Education workers,
groups of social workers from the Department of Rehabilitation and Social Improvement, and a multidisciplinary professional group at The Woodlands School.
A four-week programme was held for
mental health nurses, and similar programmes were planned for public health
nurses. A demonstration 12-hour-day
training workshop was held with 20 staff
members of the Mental Health Section of
Vancouver's Metropolitan Public Health
, Services. A committee on in-service train-
Visual objects aid speech therapy. - »-, , ._ _ , , .
ing for Branch staff who were workmg
with children and their families was set up which would recommend training programmes on the basis of expressed needs of staff, as well as attempt an evaluation of
current programmes.
THE RESIDENTIAL TREATMENT UNIT
The year could perhaps best be described as a gradual transition in the unit's
philosophy and identity, from what was a relatively new unit (opened in September
1969) to the centre's present situation where it is able to handle a far-wider spectrum
of disturbed adolescents.
At the year-end, two of the three cottages were being used residentially and the
third as a day clinic. The total for teenagers in care varied between 35 to 45. During the year the average stay was approximately six months.
The camp at Golden Ears Park offered all-year-round facilities for eight adolescents and continued to prove the enormous therapeutic value of a wilderness
setting.
The Day Clinic employed a semester system whereby the teenagers commit
themselves to a three-month period of involvement. The programme placed greater
stress on the arts, crafts, and sporting activities, and less on intensive psychotherapy.
J
L 82
MENTAL HEALTH BRANCH REPORT, 1971
The unit continued to develop the "now" concept of treatment—community
and freedom with responsibility. The milieu was strongly supportive and caring in
nature, which engendered a high level of trust among the residents and staff.
The Arts and Crafts Centre, otherwise known as the "Turn-on Centre," was
linked closely to the educational programme.
Teenagers were offered educational assessments and the opportunities for
remedial education.
During the year the youngsters' involvement in the community was increased
by
(a) encouraging small groups from clubs, schools, organizations, and universities to visit the centre; and
(b) arranging reciprocal visits by the residents.
The year saw an increase in the use of the swim and gym facilities.
Parents' groups continued to thrive. They were held once a week and the
emphasis was on the parents and was primarily an awareness experience.
The staff continued to run the weekly group for those residents who had graduated from the programme.
With the addition of a social worker, the unit was able to offer family therapy
to almost every youngster in treatment. The social workers continued to effect
liaison with the community agencies, group homes, etc., and were able to exercise
a far more comprehensive follow-up after youngsters have been discharged.
During the early summer the Director, Dr. Peter Lavelle, left to take up a
position at the Vancouver General Hospital. Miss Eileen Campbell succeeded him
as Acting Director.
Recent additions to the staff were Dr.
Peter Campbell, psychiatrist, and Dr.
Sabarijah Klein, psychologist. Dr. Klein
directed most of her efforts toward the
needs of staff, namely group therapy and
Gestalt awareness. Both Dr. Campbell
and Dr. Klein contributed, as resource
people, to the in-service training programme for child care counsellors. Other
staff additions were Mr. Richard Wagner,
a teacher specializing in special education,
and Mr. David Sorin, social worker. Mr.
Barry Thomas was promoted to the position of Supervisor.
The unit continued to place particular emphasis on the emotional welfare and
growth of all the staff involved in the treatment programme. Experience seemed
to indicate that the centre's success in effectively treating the youngsters was directly
related to the level of trust and support engendered among the staff.
The year saw an increase in the number of tours that were arranged for professionals in related fields, and averaged approximately one tour per week with
numbers ranging from 5 to 15. The unit also had an increase of field-placement
students.
All in all, 1971 proved to be an exciting year. The possibilities for the future,
especially in the area of community involvement and, in particular, with schools,
were most encouraging.
A teacher stimulates interest.
PATIENT MOVEMENT
Patient Movement Trends
Patient Movement Data
A
mental
health
branch
PATIENT
MOVEMENT
PATIENT
MOVEMENT
TRENDS
TRENDS, SEPTEMBER 1971
Sum of Entries1
Resident or Case Load
Facility
24-12
Months
Previous
12
Months
to Date
Per Cent
Change
12
Months
Ago
End of
Month
Per Cent
Change
10,209
4,306
3,994
3,276
39
679
461
165
53
312
257
55
5,903
4.725
660
269
355
131
160
343
375
104
16
236
613
249
208
53
135
450
368
481
539
89
69
9,871
3,870
3,652
2,962
51
639
500
116
23
218
160
58
6,001
4,958
587
321
255
219
32
1
276
339
276
74
210
193
38
410
240
190
308
207
452
330
385
534
90
34
—3.3
— 10.1
—8.6
—9.6
+ 30.8
—5.9
+8.4
—29.7
—56.6
—30.1
—37.7
+5.4
+ 1.7
+4.9
— 11.1
+ 19.3
—28.2
+67.2
12,088
5,495
3,658
2,469
19
1,170
681
228
261
1,837
1,263
574
6,593
4,965
683
243
340
108
12,179
5,290
3,506
2,326
25
1,155
685
234
236
1.784
1,217
567
6,889
5,422
572
313
178
155
32
1
255
313
404
145
210
98
38
692
368
164
197
157
681
449
1,018
268
156
25
+0.7
—3.7
—4.1
5.8
+31.6
— 1.3
Valleyview
+0.6
+2.6
—9.6
—2.9
The Woodlands School
—3.6
— 1.2
Out-patient programmes
+4.5
+9.2
Burnaby _ _ _
-16.3
+28.8
—47.6
Cranbrook
Duncan (August 1971)2
Fort St. John (September 1971)2
Kamloops '
+43.5
200
438
286
244
14
263
+72.5
— 1.2
—26.4
—28.8
— 18.2
+27.5
—28.5
+41.3
—40.6
—62.7
—33.1
—3.6
— 8.6
+481.1
+53.3
+0.4
— 10.3
— 19.9
-0.9
+ 1.1
—50.7
732
246
178
51
42
570
327
1,085
325
144
74
-5.5
Saanich
+49.6
—7.9
+286.3
Trail
+273.8
+ 19.5
+37.3
—6.2
-17.5
+8.3
—66.2
i Includes permanent transfers, admissions from community, and returns from leave and escapes.
2 Month the centre opened.
3 Not included are 36 patients active in the Centre Lawn out-patient case load.
85
PATIENT
MOVEMENT
DATA
DATA, 19711
Entries
Exits
Facility
Total
Cfl
a.
o
aj Cfl
o ■=
a £
.-.-§
>
a9
il
an.
5 f
a> a.
11
a) a,
C-cH
Total
tn
4)
Oi)
C3
J-
U
03
S
cn
a)
Ca
a
►J
Is
C,a>
a. Ct
<D a.
0.H
C/I
Ca
a>
Q
9,835
3,834
3,616
2,962
51
603
465
115
23
218
160
58
520
451
402
1
48
41
7
69
58
11
33
21
6
15
6
9
12
7
5
9,780
4,075
3,804
3,122
45
637
479
110
48
271
206
65
33
23
9
2
12
9
2
1
10
6
4
3,281
3,144
2,554
50
540
418
108
14
137
95
42
6,001
4,958
587
321
255
219
32
1
276
339
276
74
210
193
38
410
240
190
308
207
452
330
385
534
90
34
2,128
2,050
1,927
39
84
71
10
3
78
70
8
5,705
4,501
698
251
417
172
1,373
1,214
1,065
4
145
132
13
159
112
47
541
517
Riverview2
Youth Development Centre
121
396
267
85
Skeenaview.
Facilities for the mentally retarded
The Woodlands School
44
24
18
6
Burnaby
Duncan (Aug. 1971)3
Fort St. John (Sept. 1971)3
Kamloops..
221
464
158
173
14
358
450
118
204
162
92
341
208
452
591
78
83
Port Coquitlam (Sept. 1971)3
Trail
Riverview out-patient services
i Table compiled from actual date through September 1971, and projected for the remainder of year.
2 About 576 patients active in the Centre Lawn out-patient area case load are not included.
3 Month the centre commenced reporting.
86
FINANCIAL STATEMENTS
The following are financial reports of the Mental
Health Branch for the fiscal year ended March 31, 1971.
mental
health
branch
FINANCIAL
STATEMENTS
FINANCIAL TABLES
Table A—Showing the Average Number of Patients in Residence Each
Year, the Total Amounts Spent for Maintenance, and the Gross
Yearly and Daily per Capita Cost, 1961/62 to 1970/71.
Institution
Average
Number in
Residence
Maintenance
Expenditure
Yearly
per Capita
Cost
Daily
per Capita
Cost
1961/62
241.92
2,824.58
1,351.62
250.33
284.90
736.29
230.38
287.28
$
1,344,906.48
6,927,591.07
3,639,782.25
657,736.27
507,315.85
1,848,097.68
464,314.47
443,255.07
$
5,559.30
2,452.61
2,692.90
2,627.47
$
15.23
Provincial Mental Hospital, Essondale
The Woodlands School, New Westminster
6.72
7.38
7.20
Provincial Mental Home, Colquitz
Valleyview Hospital, Essondale
1,780.68 4.88
2,510.01 6.88
2,015.43 5.52
Skeenaview Hospital, Terrace
1,542.94 4.23
Totals for the year
6,207.30 15,832,999.14
2,550.71 6.99
1962/63
Crease Clinic _ — -
Provincial Mental Hospital, Essondale
The Woodlands School, New Westminster
The Tranquille School
Provincial Mental Home, Colquitz
Valleyview Hospital, Essondale _
236.68 1,371,120.17
2,719.32 7,058,027.01
1,365.03 3,817,685.18
307.13 | 779,642.07
214.18 ! 478,229.75
724.07 j 1,939,191.04
232.55 469,458.08
296.21 \ 441,445.13
5,793.14
2,595.51
2,796.78
2,538.48
2,232.84
2,678.18
2,018.74
1,490.31
15.87
7.11
7.66
6.95
6.12
7.34
5.53
Skeenaview Hospital, Terrace ...
4.08
Totals for the year
6,095.15 16,354,798.43
2,683.25 7.35
1963/64
220.63
2,791.99
1,306.35
433.92
94.07
737.69
236.51
292.83
1,442,627.00
7,534,673.00
3,916,660.00
1,077,011.00
414,787.00
2,029,118.00
512,128.00
713,594.00
6,538.67
2,698.67
2,998.17
2,482.05
4,409.35
2,750.64
2,165.35
2,436.89
17.87
Provincial Mental Hospital, Essondale
The Woodlands School, New Westminster
The Tranquille School
Provincial Mental Home, Colquitz
Valleyview Hospital, Essondale -
Dellview Hospital, Vernon
Skeenaview Hospital, Terrace
7.37
8.19
6.78
14.41
7.52
5.92
6.66
Totals for the year
6,113.99 | 17,640,598.00
2,885.28 7.90
1964/65
227.59
1,573,366.00
6.936.16 i
2,938.71
3,425.17
2,944.57
3,119.58
2,360.40
1,758.29
18.94
Provincial Mental Hospital, Essondale
The Woodlands School, New Westminster
2,740.84 8,054,536.00
1,314.20 4,501,364.00
512.79 1,509,947.00
753.91 tj 2,351,885.00
234.70 [ 553,985.00
290.44 510,679.00
8.05
9.38
8.07
Valleyview Hospital. Essondale
Dellview Hospital, Vernon .—
Skeenaview Hospital, Terrace
8.55
6.47
4.82
Totals for the year
6,074.47 19,055,762.00
3,137.02 8.59
1965/66
2,797.80
1,291.27
562.37
763.44
227.35
295.38
10,230,637.00
4,981,190.00
1,876.093.00
2,510,228.00
595,532.00
551,447.00
3,656.67
3,857.59
3,336.05
3,288.05
2,619.45
10.02
The Woodlands School, New Westminster
10.57
9.14
9.01
7.18
Skeenaview Hospital, Terrace—
1,866.91 5.11
Totals for the year
5,937.61
20,745,127.00
3,493.85
9.57
89
L 90
MENTAL HEALTH BRANCH REPORT, 1971
Table A—Showing the Average Number of Patients in Residence Each
Year, the Total Amounts Spent for Maintenance, and the Gross
Yearly and Daily per Capita Cost, 1961/62 to 1970/71—Continued.
Institution
Average
Number in
Residence
Maintenance
Expenditure
Yearly
per Capita
Cost
Daily
per Capita
Cost
1966/67
Riverview Hospital, Essondale
The Woodlands School, New Westminster
The Tranquille School __
Valleyview Hospital, Essondale
Dellview Hospital, Vernon
Skeenaview Hospital, Terrace
Totals for the year
1967/68
Riverview Hospital, Essondale
The Woodlands School, New Westminster
The Tranquille School
Valleyview Hospital, Essondale
Dellview Hospital, Vernon _
Skeenaview Hospital, Terrace
Totals for the year
1968/69
Riverview Hospital, Essondale
The Woodlands School, New Westminster
The Tranquille School -.
Valleyview Hospital, Essondale
Dellview Hospital, Vernon _
Skeenaview Hospital, Terrace -—
Totals for the year
1969/70
Riverview Hospital, Essondale
The Woodlands School, New Westminster
The Tranquille School __
Valleyview Hospital, Essondale
Dellview Hospital, Vernon -— ~.
Skeenaview Hospital, Terrace.
Totals for the year
1970/71
Riverview Hospital, Essondale
The Woodlands School, New Westminster
The Tranquille School —
Valleyview Hospital, Essondale
Dellview Hospital, Vernon _
Skeenaview Hospital, Terrace
Totals for the year
2,760.21
1,307.53
602.46
760.73
219.13
234.32
5,934.38
2,716.22
1,282.95
660.10
755.53
220.07
290.38
5,925.25
2,643.12
1,283.72
652.61
746.21
225.56
265.58
5,816.80
2,506.21
1,257.98
608.46
711.15
225.36
257.98
5,567.14
2,510.44
1,279.60
579.15
685.33
225.60
254.28
5,534.40
11,162,462.00
5,376,492.00
2,267,399.00
2,668,056.00
635,710.00
589,492.00
22,699,611.00
12,111,825.00
6,001,180.00
2,813,051.00
2,948,516.00
734,800.00
666,762.00
25,276,134.00
13,072,972.00
6,364,354.00
3,096,131.00
3,165,707.00
808,169.00
696,355.00
27,203,688.00
15,423,584.00
7,534,683.00
3,593,393.00
3,698,227.00
922,330.00
814,091.00
31,986,308.00
16,186,488.00
8,168,889.00
3,787,785.00
3,824,163.00
974,623.00
865,471.00
33,807,419.00
4,044.06
4,111.95
3,763.57
3,507.23
2,901.06
2,073.34
3,825.10
4,459.07
4,677.64
4,261.55
3,902.58
3,338.94
2,296.17
4,265.83
4,946.04
4,957.74
4,744.23
4,242.38
3,582.95
2,622.01
4,676.74
6,154.15
5,989.51
5,905.72
5,200.34
4,092.69
3,155.64
5,745.55
6,447.67
6,383.94
6,540.25
5,580.03
4,320.04
3,403.61
^640«T60~
$
11.08
11.27
10.31
9.61
7.95
5.68
10.48
12.18
12.78
11.64
10.66
9.12
6.27
11.66
13.55
13.58
13.00
11.62
9.82
7.18
12.81
16.86
16.41
16.18
14.25
11.21
8.65
15.74
17.66
17.49
17.92
15.29
11.84
9.32
16.74
I
FINANCIAL STATEMENTS
L 91
Table B — Summary Statement Showing the Gross and Net per Capita
Cost of Patients in All Mental Health Institutions for the Year
Ended March 31, 1971.
Gross Operating Costs—
Riverview Hospital, Essondale $16,186,488
The Woodlands School, New Westminster 8,168,889
The Tranquille School, Tranquille 3,787,785
Valleyview Hospital, Essondale 3,824,163
Dellview Hospital, Vernon 974,623
Skeenaview Hospital, Terrace 865,471
Less collections remitted to Treasury
Daily average population
Gross per capita cost, one year
Gross per capita cost, one day .
Net per capita cost, one year
Net per capita cost, one day
$33,807,419
1,994,922
$31,812,497
5,534.40
$6,108.60
$16.74
$5,748.14
$15.75
L 92
MENTAL HEALTH BRANCH REPORT, 1971
Table C—Expense Statement of the Riverview Hospital (Includes Rehabilitation and Out-patient Services) for 12 Months Ended March
31,1971
Salaries, Supplies, and Operating
Expense
Net
Vouchered
Expenditure
Services and
Supplies
From Public
Works
Department
Inventory Adjustment
Actual
Plus on Hand,
March 31,
1970
Less on Hand,
March 31,
1971
Cost of
Operations
$
11,980,241
56,979
21,283
2,836
735,595
1,219,953
45,514
51,200
1,696
24,772
18,345
502,922
14,189
20,416
209
37,248
37,353
1,035
$
$
$
$
11,980,241
Office expense
56,979
21,283
2,836
140,936
139,827
736,704
Dietary
Laundry
1,219,953
45,514
51,200
1,696
Maintenance and operation of equipment...
Transportation
24,772
18,345
151,765
149,673
505,014
Occupational and recreational therapy
14,189
20,416
209
37,248
37,353
1,035
1,520,398
167,485
155,500
1,532,383
Less—•
Increase in inventory for insti-
14,771,786
73,261
5,213
39,180
3,228
1,520,398
460,186
445,000
16,307,370
73,261
5,213
39,180
Sundry receipts
3,228
Adjusted expenditure
14,650,904
1,520,398
460,186
445,000
16,186,488
Yearly per capita cost— $
Salaries 4,772.17
Expense 1,675.67
Total
6,447.84
FINANCIAL STATEMENTS
L 93
Table D—Expense Statement of The Woodlands School,
New Westminster, for 12 Months Ended March 31, 1971
Salaries, Supplies, and Operating
Expense
Vouchered
Expenditure
Services and
Supplies
From Public
Works
Department
Inventory Adjustment
Actual
Plus on Hand,
March 31,
1970
Less on Hand,
March 31,
1971
Cost of
Operations
$
6,624,497
13,954
6,402
1,024
222,732
536,124
36,000
5,502
370
6,050
2,430
247,669
5,070
4,192
3,127
3,761
27,715
138
$
$
$
$
6,624,497
13,954
6,402
1,024
Medical care -
38,550
37,985
223,297
536,124
36,000
5,502
370
Maintenance and operation of equipment.
Transportation -
6,050
2,430
247,669
Occupational and recreational therapy
5,070
4,192
3,127
Motor-vehicles and accessories
3,761
27,715
138
482,761
482,761
Less—■
Increase in inventory from insti-
7,746,757
37,939
23,255
482,761
38,550
37,985
8,230,083
37,939
Board ...
23,255
7,685,563
482,761
38,550
37,985
8,168,889
Yearly
Sal
per capita c
aries
ost—
5
1
$
177.01
206.93
6
Total .....
383.94
L 94 MENTAL HEALTH BRANCH REPORT, 1971
Table E—Expense Statement of The Tranquille School, Tranquille,
for 12 Months Ended March 31, 1971
Salaries, Supplies, and Operating
Expense
Vouchered
Expenditure
Services and
Supplies
From Public
Works
Department
Inventory Adjustment
Actual
Plus on Hand,
March 31,
1970
Less on Hand,
March 31,
1971
Cost of
Operations
$
2,673,782
10,980
5,917
772
100,344
329,196
7,486
4,909
84
5,053
1,185
112,224
9,976
1,313
1,225
12,206
1,349
$
$
$
$
2,673,782
Office expense
Travelling expense
10,980
5,917
772
Medical care.- -— - -
100,344
10,882
11,722
Laundry
7,486
4,909
Patients' library. - -
Maintenance and operation of equipment...
84
5,053
1,185
General supplies
Occupational and recreational therapy
55,223
65,095
9,976
1,313
1,225
General expense
12,206
1,349
Buildings, grounds, etc -
Less—•
553,704
553,704
3,278,001
11,628
21,580
553,704
66,105
76,817
3,820,993
11,628
Board
Adjusted expenditure..
21,580
3,244,793
553,704
66,105
76,817
3,787,785
Yearly per capita cost— $
Salaries 4,616.74
Expenses 1,923.51
Total 6,540.25
FINANCIAL STATEMENTS
L 95
Table F—British Columbia Youth Development Centre
The British Columbia Youth Development Centre expenditure statement covers
the following departments:
General Administration for all units of the Mental Health Branch, Burnaby;
Family and Children's Clinic;
Psychological Education Clinic;
Residential Unit.
General Administration covers 40 staff (salaries, $240,023). The salaries for
General Administration are divided among the following units:
Mental
Health
Centre,
Burnaby
Family and
Children's
Clinic
Psychological
Education
Clinic
Residential
Unit
Total
i i i j
s $ $ $ $
48.005 ! 48.005 24.002 ! 120.011 ! 240.023
241,150 126,500 386,129 753,779
2,000
1,000 6,500 8,056 J 17,556
29,200 J 27,800 60,697 117,697
50,005
22,021
319,355 184,802 574,893 1 1,129,055
12,500 12,500 98,400 145,421
72,026
331.855 ! 197.302 1 673.293 I 1.274.476
;
Table G—Expense Statement of the Valleyview Hospital, Essondale,
for 12 Months Ended March 31, 1971
Salaries, Supplies, and Operating Expenses
Vouchered
Expenditure
Services and
Supplies from
Public Works
Department
Actual Cost
of Operations
$
3,197,013
6,340
3,282
34
153,084
295,858
19,000
2,342
63
4,667
392
89,225
1,656
188
2,811
1,763
138
$
$
3,197,013
6,340
3,282
34
153,084
295,858
19,000
2,342
63
4,667
392
89,225
1,656
188
. .
2,811
1,763
138
Buildings, grounds, etc.
84,615
84,615
Less^
3,777,856
19,623
18,685
84,615
3,862,471
19,623
18,685
Adjusted expenditure
3,739,548
84,615
3,824,163
Yearly per capita cost—■
$
4,664.92
Expenses
915.11
Total
5,580.03
L 96
MENTAL HEALTH BRANCH REPORT, 1971
Table H—Expense Statement of the Dellview Hospital, Vernon,
for the 12 Months Ended March 31, 1971
Salaries, Supplies, and
Operating Expense
Vouchered
Expenditure
Services and
Supplies
From
Public Works
Department
Inventory Adjustment
Actual
Plus on
Hand,
March 31,
1970
Less on
Hand,
March 31,
1971
Cost of
Operations
$
693,830
1,258
766
27,795
95,100
3,868
50
30
100
314
20,700
404
2,661
820
$
$
1
$
$
693,830
1,258
766
6,171 I
3,560
5,522
3,835
28,444
Dietary ,
94,825
3,868
50
30
12,218
100
314
14,310
22,792
404
2,661
820
129,761
129,761
Less—■
847,696
1,580
3,720
129,761
24,041
21,575
979,923
1,580
3,720
842,396
129,761
24,041
21,575
1
974,623
Yearly per capita cost— $
Salaries 3,075.49
Expenses 1,244.65
Total - 4,320.14
FINANCIAL statements
L 97
Table I—Expense Statement of the Skeenaview Hospital, Terrace,
for the 12 Months Ended March 31, 1971
Vouchered
Expenditure
Services and
Supplies from
Public Works
Department
Inventory Adjustment
Actual
Operating Expense
Plus on
Hand,
March 31,
1970
Less on
Hand,
March 31,
1971
Cost of
Operations
$
533,549
763
4,017
228
25,703
117,239
8,200
945
2,618
30,310
619
2,730
2,277
5,618
$
$
$
$
533,549
763
Travelling expense
4,017
228
25,703
8,253
10,186
115,306
8,200
- -
945
2,618
11,981
14,177
28,114
Occupational and recreational therapy
619
2,730
General expense
2,277
5,618
141,927
141,927
Less—.
Rent deductions ,
734,816
4,428
2,715
141,927
20,234
24,363
872,614
4,428
Board
2,715
727,673
141,927
20,234 !
24,363
865,471
Yearly per capita cost-
Salaries
2,098.27
Expenses 1,305.34
Total
3,403.61
L 98 MENTAL HEALTH BRANCH REPORT, 1971
Table J—Expense Statement of the Community Services for
12 Months Ended March 31, 1971
Mental Health Centres-
Burnaby.
Victoria.
Saanich.
Kelowna.
Trail.
Nanaimo.
Prince George.
Kamloops.
Chilliwack
Courtenay.
Cranbrook.
Vernon.
Nelson.
Haney.
Surrey.
New Westminster.
Terrace.
Port Coquitlam
Whalley.
Fort St. John.
Duncan.
Penticton.
Glendale Hospital
Establishment of Community Services, Technical Services, and Development of
New Patient Care Programmes
Salaries
Office expense
Travelling expense
Office furniture and equipment
Medical care
Dietary
Laundry
Establishment of community services
Maintenance and operation of equipment
Transportation
General supplies
O.T. and R.T
Patient education
General expense
Assistance for retarded children
1
$
,146,772
16,102
28,738
20,530
205,089
1,339
1,499
101,419
9,646
1,851
7,765
1,974
320
6,588
20,731
1,570,363
FINANCIAL STATEMENTS L 99
Table K—-Expense Statement of General Administration for the
12 Months Ended March 31, 1971
$
Salaries 491,172
Office expense 13,802
Travelling expense 24,984
Office furniture and equipment 210
Grant to trustees of Patients' Comfort Fund 12,000
Grant to UBC for mental health research 30,000
Audio-Visual 27
General expense 1,369
Administration of Psychiatric Nurses Act 2,818
Mental health care grants 290,658
Stores equipment 2,809
869,849
Table L—Expense Statement of the Department of Nursing Education
for 12 Months Ended March 31, 1971
$
Salaries 865,676
Office expense 5,277
Travelling expense 967
Office furniture and equipment 74
Medical care 944
Dietary 5,721
Laundry 5,000
General supplies 12,609
Audio-Visual 12
General expense 643
Affiliate and postgraduate training 2,232
899,155
L 100 MENTAL HEALTH BRANCH REPORT, 1971
Table M—Institutional Stores
$
Net undistributed stores as per Public Accounts 119,303
Adjustment re farm profit 16,991
136,294
Inventory adjustment, plus on hand, March 31, 1970 603,644
739,938
Less on hand, March 31, 1971 609,115
Net increase in inventory1 130,823
1 The increase in inventory has been transferred to the following institutions proportionately, using the
"vouchered expenditure" as the basis for distribution:
$
Riverview Hospital (56 per cent) 73,261
The Woodlands School (29 per cent) - 37,939
Valleyview Hospital (15 per cent) - - _ 19,623
130,823
Reconciliation With Public Accounts, 1970/71
Table K—General Administration—-
$
Salaries 491,172
Expenses 378,677
As per Public Accounts 869,849
Table L—Department of Nursing Education—
Salaries 865,676
Expenses 33,479
As per Public Accounts 899,155
Table J—Community Services—
Salaries 1,146,772
Expenses 423,591
As per Public Accounts 1,570,363
Table C—Riverview Hospital and out-patients—
Salaries 11,980,241
Expenses 4,206,247
Vouchered expenditure 16,186,488
FINANCIAL STATEMENTS
L 101
Reconciliation With Public Accounts, 1970/71—Continued
Deduct— $ $ $
Buildings and grounds 1,520,398
Decrease in inventories 15,186
Salary adjustments 824,544
2,360,128
Add sundry adjustments, rent, board, etc.
As per Public Accounts
13,826,360
120,882
13,947,242
Table G—Valleyview Hospital-
Salaries
Expenses
3,197,013
627,150
Vouchered expenditure
Deduct—
3,824,163
Buildings and grounds
Portion of farm profit _
Salary adjustments
84,615
1,999
220,848
307,462
Add sundry adjustments, rent, board, etc.
As per Public Accounts
3,516,701
38,308
Table E—The Tranquille School—
Salaries 2,673,782
Expenses 1,114,003
Vouchered expenditure 3,787,785
Deduct—
Buildings and grounds 553,704
Portion of farm profit 6,330
Salary adjustments 184,932
744,966
Add—
Sundry adjustments, rent,
board, etc.
3,042,819
Increase in inventories
33,208
10,712
43,920
3,555,009
As per Public Acounts
3,086,739
L 102 MENTAL HEALTH BRANCH REPORT, 1971
Reconciliation With Public Accounts, 1970/71—Continued
Table F—British Columbia Youth Development Centre— $
Salaries 1,011,358
Expenses 263,118
Vouchered expenditure 1,274,476
Deduct— $
Buildings and grounds 145,421
Salary adjustments 67,728
• 213,149
As per Public Accounts 1,061,327
Table M—Net undistributed stores 119,303
Special Warrants—
Special Warrant 5—Grant to Granville School Society 36,667
Special Warrant 6—Grant to Pacific Centre for Human Development 79,435
Special Warrant 9—Grant to Vanderhoof Association for Retarded Children 17,000
Special Warrant 11—Grant to Powell River Youth Services Council 20,031
Deduct—
Salary adjustments for General Administration, Department of Nursing Education, and Community Mental Health Centres 140,904
Total expenditure as per Public Acounts 33,923,257
Table H—Dellview Hospital— $ $
Salaries 693,830
Expenses 280,793
Vouchered expenditure 974,623
Deduct—
Buildings and grounds 129,761
Salary adjustments 48,504
Decrease in inventories 2,466
180,731
793,892
Add sundry adjustments, rent, board, etc 5,300
As per Public Accounts 799,192
FINANCIAL STATEMENTS
L 103
Reconciliation With Public Accounts, 1970/71—Continued
Table I—Skeenaview Hospital—
Salaries
Expenses
Vouchered expenditure
Deduct—
$
$
533,549
331,922
865,471
Buildings and grounds 141,927
Salary adjustments 34,752
176,679
Add-
688,792
Sundry adjustments, rent, board,
etc. 7,143
Increase in inventories 4,129
11,272
As per Public Accounts
Table D—The Woodlands School-
Salaries
Expenses
Vouchered expenditure
Deduct—
6,624,497
1,544,392
8,168,889
Buildings and grounds 482,761
Decrease in inventory 565
Portion of farm profit 4,664
Salary adjustments 439,308
Add-—Sundry adjustments, rent, board, etc.
As per Public Accounts
927,298
7,241,591
61,194
700,064
7,302,785
Printed by K. M. MacDonald, Printer to the Queen's Most Excellent Majesty
in right of the Province of British Columbia.
1972
785-1271-6308
BC Sessional Papers
Mental Health Branch PROVINCE OF BRITISH COLUMBIA ANNUAL REPORT 1971 British Columbia. Legislative Assembly 1972
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