DEPARTMENT OF HEALTH
Mental Health Branch
PROVINCE OF BRITISH COLUMBIA
ANNUAL REPORT
1973
Printed by K. M. MacDonald, Printer to the Queen's Most Excellent Majesty
in right of the Province of British Columbia.
1974
To the Honourable Walter S. Owen, Q.C, LL.D.,
Lieutenant-Governor oj the Province oj British Columbia.
May it please Your Honour:
The undersigned respectfully submits the Annual Report of the Mental Health
Branch, Department of Health, for the year 1973.
DENNIS G. COCKE
Minister oj Health
Office oj the Minister oj Health,
Victoria, B.C., January 31,1974.
1
Department of Health,
Mental Health Branch,
Victoria, B.C., January 31, 1974.
The Honourable Dennis G. Cocke,
Minister oj Health, Victoria, B.C.
Sir: I have the honour to submit the Annual Report of the Mental Health
Branch for 1973.
F. G. TUCKER, M.B., B.S., C.R.C.P., M.Sc
Deputy Minister oj Mental Health
DEPARTMENT OF HEALTH
MENTAL HEALTH BRANCH
The Honourable Dennis G. Cocke, Minister of Health
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 and
Children's Psychiatric Services.
H. W. Bridge, M.A., M.B., B.Ch., B.A.O.,
M.Sc, M.R.C.PSYCH., F.R.C.P.(C),
Co-ordinator of Adult Psychiatric Services.
F. A. Matheson,
Departmental Comptroller.
R. H. Goodacre, B.A., M.A., C.P.H.,
Sociologist.
Miss M. N. Lonergan, B.S.N.Ed., M.N.,
Nursing Consultant.
R. S. McInnes, B.A., B.D., M.P.H.,
Co-ordinator of Mental Health Centres.
A. G. Devries, Ph.D.,
Consultant in Psychology.
Mrs. F. Ireland, B.A., M.S.W.,
Co-ordinator of Boarding-homes.
P. Bingham, M.S.W.,
Assistant Co-ordinator of Boarding-homes.
G. L. Tomalty, B.A., M.P.A.,
Departmental Personnel Officer.
A. A. Bishop, B.Ed.,
Assistant Personnel Officer.
K. Denecke, B.Com.,*
Mrs. C. W. Porteous, B.A., M.A.,t
Statistician.
W. A. Blair,
Management Analyst.
R. H. Thompson,
Director, Information Services.
N. W. Wylie,
Administrative Officer.
Mrs. P. A. West, R.R.L.,
Consultant in Medical Records.
COMMUNITY MENTAL HEALTH CENTRES
P. Adrian, M.S.W.,
Administrator, Abbotsford Mental Health
Centre.
A. L. Aranas, M.D., D.Psy.,
Administrator, Victoria Mental Health
Centre.
Y. Bledsoe, M.S.W.,
Administrator, Powell River Mental
Health Centre.
V. N. Brown, M.S.W., A.C.S.W.,
Administrator, Port Alberni Mental
Health Centre.
R. L. Cameron, M.S.W., R.S.W.,
Administrator, Trail Mental Health
Centre.
M. A. Carvell, R.N.,
Administrator, Squamish Mental Health
Centre.
R. Gracey, B.A., B.D., M.S.W.,
Administrator, Prince Rupert Mental
Health Centre.
F. J. Hannah, M.A.,
Administrator, New Westminster Mental
Health Centre.
A. I. Holmes, B.A., M.S.W.,
Administrator, Kelowna Mental Health
Centre.
W. C. Holt, B.A., M.D., C.R.CP.(C),
Administrator, Burnaby Mental Health
Centre.
P. Humphrey, B.A., M.S.W.,
Administrator, Williams Lake Mental
Health Centre.
J. A. Hutton, M.S.W.,
Administrator, Duncan Mental Health
Centre.
* Resigned August 31.
t Appointed November 15.
J. Kanevsky, M.A.*
Administrator, Courtenay Mental.Health
Centre.
K. Lerner, B.A., M.S.W.,
Administrator, Langley Mental Health
Centre.
E. Little, B.S.N.,
Administrator, Fort St. John Mental
Health Centre.
E. Luke, M.B., Ch.B., D.P.M., F.R.C.P.,
M.R.C.Psych.,
Administrator, Maple Ridge Mental Health
Centre.
P. McArthur, P.H.N., R.N.,
Administrator, Port Coquitlam Mental
Health Centre.
A. J. McSweeney,
Administrator, Sechelt Mental Health
Centre.
D. L. Mitchell, B.Ed., M.A.,
Administrator, Surrey Mental Health
Centre.
J. M. Mossing, R.N., B.N.,
Administrator, Penticton Mental Health
Centre.
B. Schikowsky, B.A., M.S.W.,
Administrator, Chilliwack Mental Health
Centre.
J. M. Smith, Ph.D.,
Administrator, Whalley Mental Health
Centre.
J. Snyder, B.Sc, B.S.W., M.S.W.,
Administrator, Prince George Mental
Health Centre.
E. J. Sopp, M.S.W., R.S.W.,
Administrator, Nelson Mental Health
Centre.
M. Stephens, M.S.W.,
Administrator, Cranbrook Mental Health
Centre.
S. G. Travers, M.S.W.,
Administrator, Terrace Mental Health
Centre.
R. D. Turner, B.A., B.S.W., M.S.W.,
Administrator, Nanaimo Mental Health
Centre.
P. Wheatley, M.S.W.,
Administrator, Kamloops Mental Health
Centre.
J. T. Wood, M.D.,
Administrator, Saanich Mental Health
Centre.
S. Zimmerman, B.S.W.,
Administrator, Vernon Mental Health
Centre.
MENTAL HEALTH SERVICES
J. C. Johnston, M.D., F.A.C.H.A.,
Executive Director, 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.,
C.R.C.P.(C),
Superintendent, Geriatric Division.
J. Bower, M.D., M.R.C.Psych., D.P.M.,
Superintendent, Tranquille.
A. P. Hughes, M.D., B.Sc, C.R.C.P.,
Executive Director, Woodlands.
Mrs. E. Paulson, B.S.N.,t
Acting Director of Nursing Education.
BRITISH COLUMBIA YOUTH DEVELOPMENT CENTRE
A. G. Devries, Ph.D.,
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.
* J. L. Kyle, M.A., on educational leave, effective September 17.
t Retired July 31.
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11
HISTORICAL FEATURE
TABLE OF CONTENTS
Page
11
GENERAL ADMINISTRATION
The Year in Review
Business, Construction, and Maintenance Review..
Personnel
Adult Psychiatric Services
17
20
22
24
Retardation and Children's Psychiatric Services 26
Nursing Consultation Services 27
Boarding-home Programme 29
Sociology Consultation Services 31
Psychology Consultation Services 32
Management Analyst Consultation Services 33
Statistics and Medical Records 34
Information Services 36
COMMUNITY MENTAL HEALTH SERVICES 39
Abbotsford Mental Health Centre 40
Burnaby Mental Health Centre 40
Chilliwack Mental Health Centre 43
Courtenay Mental Health Centre 44
Cranbrook Mental Health Centre 45
45
46
47
48
49
49
51
52
53
54
56
57
58
Duncan Mental Health Centre
Fort St. John Mental Health Centre..
Kamloops Mental Health Centre
Kelowna Mental Health Centre
Langley 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 Alberni Mental Health Centre
Port Coquitlam Mental Health Centre
Powell River Mental Health Centre.
Prince George Mental Health Centre 59
Prince Rupert Mental Health Centre 60
Saanich Mental Health Centre 60
Sechelt Mental Health Centre 61
Squamish Mental Health Centre 61
Surrey Mental Health Centre
Terrace Mental Health Centre
Trail Mental Health Centre
Vernon Mental Health Centre
Victoria Mental Health Centre
Whalley Mental Health Centre
Williams Lake Mental Health Centre..
13
62
63
64
65
66
67
68
Page
IN-PATIENT SERVICES
Department of Nursing Education 73
Riverview Hospital 75
Geriatric Division 79
Woodlands 83
Tranquille 89
British Columbia Youth Development Centre 92
PATIENT MOVEMENT
Patient Movement Trends 99
Patient Movement Data 100
FINANCIAL STATEMENTS : 103
14
GENERAL ADMINISTRATION
The Year in Review
Business, Construction, and Maintenance Review
Personnel
Adult Psychiatric Services
Retardation and Children's Psychiatric Services
Nursing Consultation Services
Boarding-home Programme
Sociology Consultation Services
Psychology Consultation Services
Management Analyst Consultation Services
Statistics and Medical Records
Information Services
■A
GENERAL
ADMINISTRATION
THE YEAR
IN REVIEW
F. G. Tucker, M.B., B.S., C.R.C.P., M.Sc.
Deputy Minister oj Mental Health
The mental health programme of this Province continued to evolve satisfactorily
in 1973 with significant advances in the field of community care and a continuing
readjustment and realignment of in-patient resources to complement the regional
programmes. These changes called for hard work and a high degree of co-operation by all concerned. Staff had to assume new attitudes, roles, and responsibilities
as they pioneered programmes which, by their very nature, were often experimental
and lacked the support of a well-tried administrative structure.
For details of the various programmes, reference should be made to the appropriate section of this Report. However, I would like to draw attention to a number
of developments which I believe warrant special mention.
I am pleased to report that in February the Metropolitan Board of Health for
Greater Vancouver agreed to assume responsibility for administration of the Greater
Vancouver Mental Health Project. This can be viewed as a "bed replacement
project" in that its intent is to assist and support the chronically disabled mentally
ill individual, so that he or she can function adequately in the community and thereby
avoid, or minimize, hospitalization. The basic team consists of nine or ten mental
health personnel who are located in a variety of accommodation in the community
they serve. This professional group attempts to work in co-operation with involved
local residents in the development of the programme. During the year, the Mental
Health Branch agreed to the establishment of seven teams and approved the necessary funds. These teams are coming into operation as quickly as suitable staff can
be recruited. It should be emphasized that this project is only one limited component of the over-all mental health programme for Greater Vancouver.
In the early summer, steps were taken to implement a comprehensive mental
health programme for Burnaby. This is the first attempt in this Province to provide
a truly integrated mental health programme for a clearly defined region. It will be
noticed that there is a heavy emphasis on back-up services in this particular programme, in the form of the three community care teams and a large day-hospital
component. Only 25 in-patient beds for a population of 140,000 are presently
planned, in anticipation that these additional ambulatory services will provide an
effective and less expensive alternative to the traditional hospital admission.
A variation in the pattern of community care is being set up in the Lower
Fraser Valley. This region is already served to a limited extent by five mental
health centres and relies on the Riverview Hospital for the majority of its in-patient
care. Steps have now been taken to deploy hospital psychiatrists in the community
mental health centres in order to augment the local services to the adult mentally
ill. They will, when necessary, admit and treat patients from their area at the
Riverview Hospital. Once again we hope that the number of hospital admissions
17
L 18
MENTAL HEALTH BRANCH REPORT, 1973
and the length of stay can be reduced, so that in due course additional hospital staff
can be freed from their hospital base and assigned to the local communities. The
difficulty in recruiting trained psychiatrists seriously impaired the effectiveness of
the Riverview Hospital programme during the first half of this year. By November,
however, almost all medical staff vacancies had been filled by well-qualified physicians. I would particularly like to acknowledge the support and assistance that we
received from the B.C. Medical Association, Section of Psychiatry. A number of
private psychiatrists undertook sessional work in the hospital over and above their
normal office practice. In September, the Branch and Hospital administration took
active steps to divide the Riverview Hospital into five relatively self-contained programmes, each with its own specific goals and objectives. These changes will permit
the resources of the hospital to be more readily adapted to meet the changing needs
of the Province and allow for a more adequate assessment of standards and the
evaluation of the effectiveness and cost of the various programmes. Above all, it
will facilitate the melding of the hospital with the community. I must stress the
magnitude of the task involved in structuring and reorienting a large hospital complex, a task that will require the fullest co-operation and dedication from all levels
of staff if it is to be expeditiously and successfully achieved. There has been a general decline in the patient census at Riverview Hospital with an average bed occupancy for the first nine months of 2,002, compared to 2,240 for the same nine-month
period in 1972. Although there was a substantial increase in staff from 1,667 to
1,986, these staff were required to replace patients formerly employed in various
working situations, to compensate for increased fringe benefits approved by the
Government for employees, as well as generally to improve standards of care.
Delegates from eight Asian countries attended a conference on pyschiatric education
from May 14 to 16 in Vancouver and Victoria. Their North American tour was under the
auspices of the National Institute of Mental Health (U.S.A.), and during their two-day
visit to the Province they were guests of the Department of Psychiatry of the University
of British Columbia. The above photograph was taken at the Provincial Museum, Victoria.
GENERAL ADMINISTRATION L 19
There has been no major expansion of the Community Mental Health Centre
Programme. During 1973, centres were established at Abbotsford, Squamish,
Sechelt, and Langley. After a long delay, the Prince Rupert Centre was also brought
into operation.
On August 9, the last class of psychiatric nurses graduated from the Department of Nursing Education at Essondale. Over the past 42 years, 3,065 nurses have
graduated from this school, and the Province owes a debt of gratitude to the many
dedicated faculty members who have served the programme during this time. We
look forward to the first graduating class of psychiatric nurses from the B.C. Institute of Technology in 1974.
While there have been no major changes in the field of retardation and psycho-
geriatric care, these units continued to refine their programmes and to upgrade their
standards and expectations. In all units there has been a general increase in the
severity of illness of patients, as increasing numbers of more easily cared for
patients and trainees are retained in the community. Nevertheless, these units
continued to operate at a high level.
The Mental Health Branch provided grants, under the auspices of the Treatment Resources Act, to a variety of agencies who care for both the retarded and
emotionally disturbed:
$
Alberni District Association for the Mentally Retarded 20,000
B.C. Association for the Mentally Retarded 60,000
Burnaby Association for Mentally Retarded 46,667
Children's Hospital, Vancouver 6,667
Rotary Club of Chilliwack 17,000
Maple Ridge Association for Retarded 21,707
M.S.A. Association for Retarded 8,332
Prince George and District Association for Retarded 28,666
Salmon Arm Association for Mentally Retarded 16,667
Terrace Association for Retarded Children 14,000
Vernon and District Association for Retarded 6,333
Williams Lake Association for Retarded 14,691
Kinsmen Club of Salmon Arm 32,927
Nanaimo Vocational Rehabilitation Workshop for
Handicapped 22,783
Reorganized Church of Jesus Christ of Latter Day
Saints (B.C. Division) 14,408
Terrace District Christian Council for Social Resources 13,333
During the year the Mental Health Branch has been stimulated by the new
potential for change so that the Department may more readily meet present and
future challenges in the field of mental health. It has not been free of anxieties
and frustration, as pressing needs have called for staff to move forward often in the
vanguard of the health care system.
BUSINESS, CONSTRUCTION,
AND MAINTENANCE REVIEW
Riverview Hospital, Essondale
A new recreational facility was under way at the Riverside Building, as well
as general renovations to the building.
The old Colony Farm cottage building was demolished and replaced by a
new bunkhouse building to accommodate Colony Farm staff.
Renovations to Nurses' Homes 6, 7, and 8 were completed.
Planning was completed for the renovation of the second and fourth floors
in the Crease Unit.
Planning progressed in connection with the renovation of the Pennington Hall
Canteen.
Planning for a new laundry was held up pending a report from the Vancouver Regional Hospital Board regarding their requirements. In the meantime, the Department of Public Works endeavoured to find a new site
for this laundry.
Woodlands, New Westminster
An addition to the industrial therapy building was completed and officially
opened on May 9, 1973.
An addition to the transport building was completed.
Work progressed on renovations to Nurses' Home 3, to convert it into an
academic and activity building.
A site on the Woodlands property was selected to construct a 250-bed extended-care unit, which would be operated by the Queen's Park Hospital
Society. Planning for the unit was proceeding.
Tranquille, Tranquille
The Department of Public Works awarded a contract in the amount of
$1,800,000 for the construction of five 20-bed units, and work got under
way in the late summer.
Valleyview Hospital, Essondale
Planning was under way to update Valleyview buildings and the 100-bed
units, which would consist mainly of improvements in electrical services,
plumbing, and the provision of oxygen.
Dellview Hospital, Vernon
Planning started for the renovation of the hospital building.
A contract was entered into with the Jubilee Hospital, Vernon, to supply
laundry services to the Dellview Hospital. Dellview's laundry facilities
would be converted to other uses.
Skeenaview Hospital, Terrace
Preliminary planning started on the 75-bed replacement unit.
At the year-end, Public Works was making a survey regarding the replacement of the Skeenaview Hospital laundry and constructing a new regional laundry to serve the Terrace area.
20
GENERAL ADMINISTRATION L 21
The Skeenaview Lodge Society was formed to take over the operation of the
Skeenaview Hospital, possibly early in 1974.
Mental Health Facilities, Burnaby
Plans were completed to convert the Family and Children's Clinic, located
in the Burnaby Mental Health Centre building, into a 25-bed in-patient
unit.
Mental Health Centres
A new mental health centre was opened in Abbotsford, located in the Public
Health building. New mental health centres were also opened in Langley, Sechelt, and Squamish in leased accommodation.
The mental health centre in Fort St. John moved from leased premises into
the new Peace River Health Unit building.
The New Westminster mental health centre moved from its old office space
to more adequate leased quarters, centrally located.
The mental health centre in Port Coquitlam was provided with additional
office space.
General
The Department of Public Works let a contract in the amount of $158,690
to convert St. Eugene's School, Cranbrook, into a residential and training unit for approximately 70 retardates, which would be operated by
a private society.
Arrangements were made during the year to provide all patients, who could
benefit from such a programme, with $120 per year, in order that they
might purchase their own clothing rather than be provided with institutional stores supplies.
Arrangements were also made, with the Department of Human Resources,
to provide patients, who qualify, up to $18.50 per month Comforts Allowance.
Institutional Estimates for the fiscal year 1974/75 were prepared on a programme budget basis.
PERSONNEL
During the year the Mental Health Branch establishment of permanent positions was increased by 225 positions. In addition, the Mental Health Branch hired
240 students under the Government's Summer Programme. They were employed
in regular types of jobs, in research projects, and to help on a number of summer
activity programmes for patients and residents.
The staff turnover in established positions for the fiscal year 1972/73, temporary staff excluded, was 30.5 per cent, up from the 13.36 per cent of 1971/72.
Sick leave with pay during 1973 averaged 8.5 days per employee, and sick
leave without pay averaged 1.6 days per employee.
As of November 1, 1973, the Branch employed 167 handicapped persons.
Increased salaries and sessional fees for psychiatrists, late in 1972, resulted
in a much improved situation during 1973. The serious shortage of nurses that
developed during 1972 continued throughout the year. Extensive advertising in
Canada was not successful. Advertising in the United Kingdom was continued
and 46 were hired from that source during the year. Recruitment of occupational
therapists and physiotherapists was unsuccessful and there were 14 vacancies at
the end of the year.
The system of using on-call to provide relief for minor illness, minor WCB
cases, and recruitment lag, was extended to cover nursing at Riverview Hospital
and a number of smaller departments such as housekeeping and dietary.
A trial roster system of four days on and two days off (repeated) was started
in the Nursing Department at Woodlands in August for a six-month period.
A new series of Nurses 1 to 9 was approved, which replaced the former
Psychiatric Nurse and Staff Nurse series and included nurses from the beginning-
level (Nurse 1) to the Director of Nursing at Riverview Hospital (Nurse 9).
During the year the Civil Service Commission studied the classifications of
Recreational Therapists, Instructor Handicrafts, and some Rehabilitation Officers.
They proposed a series of Activity Therapists to replace these positions in the Mental Health Branch, and the proposal was being studied by the Branch at the year-
end.
Fifty-seven requests for classification reviews were received during the year,
of which 34 were reviewed by the Branch Personnel Officers, who refused two and
forwarded 29 to the Civil Service Commission for upgrading or a salary review.
The Civil Service Commission approved seven, turned down two, and had 20
under review at the end of November. The balance were in various stages of
review.
Eighteen grievances were handled at the second step, six were denied, eight
were referred to the Chief Personnel Officer for mediating, and four were resolved.
Four others were still being investigated or mediated at the year-end.
Thirty-two Mental Health Branch Personnel Circulars were issued during
1973 covering travel, benefits, vacation leave, recruitment, grievance procedures,
training assistance, and many changes in routine procedures.
The statistics in Tables 1 and 2 were based on the fiscal year ending March
31, 1973.
22
GENERAL ADMINISTRATION L 23
Table 1—Comparison oj Staff Totals, Showing Totals jor the Preceding Fiscal Year
Fiscal Year 1971/72
Positions in
Establishment as of
March 31,
1972
Number on
Staff as of
March 31,
1972
Fiscal Year 1972/73
Positions in
Establishment as of
March 31,
1973
Number on
Staff as of
March 31,
1973
General administration-
Department of Nursing Education
Mental health centres and Boarding-home Programme.
Subtotals
60
68
166
58
59
155
61
68
173
294
272
302
In-patient care—■
Riverview Hospital..
Woodlands
Tranquille..
Valleyview Hospital—
Dellview Hospital _
Skeenaview HospitaL
British Columbia Youth Development Centre..
Subtotals
1,677
924
396
449
98
74
143
1,777
990
411
492
100
73
140
3,761
3,983
Total Civil Service positions-
Student psychiatric nurses
Totals- _
4,055
325
4,255
87
4,380
4,342
1,678
924
408
449
98
74
142
3,773
4,075
325
4,400
56
46
148
250
1,822
1,056
446
470
104
81
140
4,119
4,369
31
4,400
Table 2—Breakdown by Classification of Recruitment and Separation
Activity for the Mental Health Branch, Excluding Student Psychiatric Nurses.
Recruited Separated
Physicians 43 42
Medical interns 5 5
Registered nurses ) 357
Psychiatric nurses)
Female psychiatric aides
Male psychiatric aides
Teachers
Occupational therapists
Seamstresses
Recreational therapists
Psychologists
Psychiatric social workers
Dietitians
Cook's helpers
Clerks
Clerk-stenographers
Laundry workers
Child care counsellors
Miscellaneous professionals
Miscellaneous technical
Miscellaneous
419
513
403
154
137
9
6
11
15
7
7
14
16
21
16
27
20
2
2
93
95
59
49
61
46
76
70
25
25
15
19
48
60
435
404
Totals
1,975
1,856
ADULT
PSYCHIATRIC
SERVICES
The functions and responsibilities of the Co-ordinator of Adult Psychiatric
Services were reviewed and redefined in the second half of 1972, and the pattern
of activities decided upon at that time continued to constitute the main work of
the Co-ordinator throughout 1973.
BOARDS AND COMMITTEES
The Task Committee of the Section of Psychiatry of the B.C. Medical Association completed its work early in 1973 and submitted its report. It then disbanded.
Representation on the Graduate Training Committee of the Department of
Psychiatry at UBC contributed to the constructive liaison between the Department
of Psychiatry and the Mental Health Branch.
RIVERVIEW HOSPITAL
The Regional Programme in Centre Lawn continued, with some evidence
of improved communication between in-patient teams and the professionals in the
communities which they served. It made a specific advance during the year with
the establishment of the Community Adult Psychiatric Service, in which a Riverview psychiatrist would be attached to each of the six mental health centre areas
outside Vancouver located closest to Riverview Hospital. The designated psychiatrist worked with the mental health centre in its community, and also provided
in-patient service in Riverview for any patient from his community who could not
appropriately be dealt with by any other resource.
MEDICAL STAFFING
There was great improvement in medical staff in terms both of numbers employed, the number of applicants, and the standard of general and specialist qualifications of both. The number of vacant positions in the Mental Health Branch
diminished rapidly, and very few vacancies remained. Vacancies which did remain were, for the most part, in remote areas. While there seemed some hope
that these may be filled in the near future from the continuing flow of psychiatrists
indicating a wish to locate in British Columbia, it might be necessary to consider
the provision of some special incentives, if this did not take place within a few
months of the filling of the last of the vacancies in the heavily populated areas.
A very encouraging feature of the medical staff situation was the great reduction
in the number of employed physicians with temporary registration. The situation
was rapidly approaching where the physicians in the public service would be equal
in qualifications and skills to their colleagues in other sectors of medicine in the
community.
MENTAL HEALTH CENTRES AND GENERAL
HOSPITAL PSYCHIATRY
Work related to the mental health centres was largely involved with the local
general hospital psychiatric programmes. During the year, visits were made to
Duncan, Port Alberni, Nanaimo, Courtenay, Port Coquitlam, Maple Ridge,
24
GENERAL ADMINISTRATION
L 25
Whalley, Abbotsford, Penticton, Vernon, Kamloops, and Cranbrook. Consultation in the centres was chiefly related to their relationship to psychiatric services
in the general hospitals of these communities. The Co-ordinator continued to
provide limited clinical consultation service to Sechelt and Gibsons, both in the
medical clinics and in St. Mary's Hospital. Similar service was provided to the
newly established mental health centre, pending the recruitment of a psychiatrist
to that centre.
PROJECTS
Forensic Psychiatric Services Committee—This committee was a major project, which was time-consuming and greatly limited all other activities between
February and October. The work of the committee resulted in the preparation of
a report and recommendations, which were completed in mid-October.
RETARDATION AND
CHILDREN'S
PSYCHIATRIC SERVICES
There were few advances in the provision of psychiatric services for children
during the year; however, some progress was made in providing comprehensive,
integrated programmes for the mentally retarded. Optimism was expressed that
when the problems associated with the desirable change in emphasis from central
delivery of services to community and regional responsibility were sorted, co-ordinated programmes would be developed in the future.
It was disappointing to note that there was no evidence of decreasing incidence of handicapping conditions in the newborn. With the general lowering of
the age at which the majority of women have their children, the availability of
family planning advice and genetic counselling, and widespread efforts to ensure
optimal perinatal conditions, it had been expected that primary prevention would
show some results during the year. Perhaps it was too early to see such a trend.
Secondary preventive services, however, were having an effect, and the identification of high-risk cases, followed by the provision of therapeutic and stimulation
programmes, had already markedly improved the functions of many handicapped
children. General recognition was needed, that expert professional evaluation of
all pre-school children should be a priority, followed by appropriate intervention.
In the pre-school age-group, the remediation of problems, both physical and psychological, paid high dividends in subsequent function.
Pre-adolescent school-age children were adequately cared for and in most
instances the back-up services required for the family and teacher were available.
During the year the ability of some schools to hire special assistants for teachers in
difficult cases meant that fewer children were rejected from school. Special programmes for severely disturbed adolescents, however, were far from adequate.
There was no residential programme that could really provide intensive treatment
for the most difficult problems. Such a programme should be a "health" responsibility, rather than a "social services" responsibility, although obviously there must
be close interdepartmental and interdisciplinary co-operation.
As fewer adult handicapped people were being admitted to institutions, more
community services were required in the form of residential care and day activities.
The Associations for the Mentally Retarded continued their efforts to expand such
programmes during the year and, with Provincial Government support, progress
was made. Once again, close co-ordination was required between different agencies
to ensure that such people were integrated into the community as much as possible
and that not only were they provided with the special services they needed but
they were also provided with opportunities to five their lives as normally as possible.
During 1973 the Co-ordinator continued to meet regularly with his colleagues,
officials from other departments of Government, and with private social agencies
that provided care and treatment for both emotionally disturbed children and mentally retarded of all ages.
26
NURSING
CONSULTATION
SERVICES
Nursing consultation services during 1973 focused on the nursing component
of a wide variety of programmes, services, and activities. Studies were undertaken
which prepared material for the development of nursing care policies. The Consultant was also involved in the following: A revision of nursing position descriptions and classifications; the designation of clinical assignments; a trial project in
altering the rostering system of staffing patterns; the use of teaching positions for
staff-development programmes; determining the effect of recruitment difficulties in
in-patient facilities; proposing new functions for the Education Centre, Essondale;
and facilitating a study of in-service educational needs. A review was made of
nursing staffing patterns and hours of available nursing care at two psychogeriatric
hospitals, and a study undertaken to collect data on present staffing standards
throughout the in-patient facilities. Staffing plans for a new in-patient facility in
Burnaby were reviewed. Recommendations were made regarding the operation
and staffing of a surgical service.
Time and consideration was provided to nursing service departments of the
in-patient facilities with respect to interpretation of policies affecting changes in
nursing positions, hours of work, administrative structures, nursing care projects,
and developing hospital-community services. Efforts were made to interpret the
progress and the needs of nursing departments to decision-making bodies.
Continued direction was provided to the Department of Nursing Education
concerning the processes of terminating the psychiatric nursing programme, and
the closure of teaching, clerical, and business aspects of that operation. The year
saw the graduation of the final two classes in that programme and the retirement
of its Acting Director, Mrs. Elisabeth Paulson, whose years of dedicated service
were acknowledged at a reception in her honour attended by the Deputy Minister
and many of her associates of years past and present. Procedures were instigated
for the continued use of the Education Centre facilities by the B.C. Institute of
Technology and its psychiatric nurse and registered nurse programmes. Arrangements were made for that institution to assume responsibility for providing a qualifying examination service for psychiatric nurses not eligible for registration. These
arrangements were made in accord with the Registered Psychiatric Nurses Association of British Columbia, which assumed responsibility for the registration of
psychiatric nurses on the proclamation of the Registered Psychiatric Nurses Act
in June.
Service was provided to the community mental health programme through
visits to 16 mental health centres, participation in regional meetings, assisting mental health nurses in the task of role definition, arranging conferences and orientation,
and participating in the development of plans to extend services of the centres.
Community visits provided opportunities to confer with head nurses of psychiatric
units in general hospitals, as well as discussion with public health nurses concerning
continuity of care to patients. Other community activities included information-
gathering visits to proprietary residences for care to the mentally handicapped, and
exploratory discussions with agencies intending to initiate psychiatric services.
As usual, assistance was afforded to the Civil Service Commission and to the
Personnel Department is the following ways:
27
L 28
MENTAL HEALTH BRANCH REPORT, 1973
(a) participation in selection panels interviewing for mental health nurse,
Director and Associate Director of Nursing positions;
(b) replying to requests from nurses across Canada and in other countries for employment information;
(c) interviewing nurses both within and outside the service with respect
to employment, promotion, transfer, bursary assistance, and educational leave concerns; and
(d) reviewing submissions regarding merit increases, reclassification,
and grievance matters.
The Nursing Consultant continued to use the vehicles of various committees
and professional channels to communicate the requirements of psychiatric-mental
health nursing practice to health care and supporting agencies. In this respect, she
facilitated conferences of the Nursing Liaison Committee and participated in Advisory Committee meetings of the British Columbia Institute of Technology, the Nursing
Co-ordination Committee of Vancouver Metropolitan Health Services, and the Post
Basic Clinical Course Committee of the Registered Nurses Association of British
Columbia, and reviewed community college proposals for continuing education
for nurses. Discussions concerning the psychiatric nursing-mental health component in developing health care systems were held with members of the Health Security Programme Project staff, and assistance was provided to various groups of
nurses preparing submissions to the project. Information regarding the education
and utilization of psychiatric nurses, and nursing staffing standards, was provided
to nursing consultants in three provinces.
In preparation for changes in the organizational structure of facilities delivering nursing services, the Consultant visited the Programme Review Unit, Department of Mental Hygiene, Sacramento, Calif., and toured several of its psychiatric
and community mental health facilities. This provided useful indices of the effect
of the system change on patient care programmes, community-hospital interrelation,
and staff motivation and effectiveness. The visit served as an orientation to developing changes in the health care system in this Province.
BOARDING-HOME
PROGRAMME
During the year the Boarding-home Programme continued to expand at a
steady pace. At the end of the year there were approximately 1,456 persons under
supervision of the Mental Health Branch in some 200 boarding-homes throughout
the Province.
The emphasis during the year was on an evaluation of the quality of the programme and of individual boarding-homes, and a restatement of the programme
goals, particularly in relation to rehabilitation of individuals. These measures
resulted in the removal of residents from some inadequate homes and the purchase,
with Government assistance, of one large home for retarded persons by the B.C.
Association for the Mentally Retarded; the expansion of the Activities Programme;
and an increase in the number of persons (122) discharged from the programme to
more independent forms of living arrangement.
The Activities Programme, initiated late in 1972, was expanded by the addition of further occupational therapist and activity therapist positions, and by the
employment of summer students. Concentration was on the development of
individualized activity programmes with stated objectives. Several groups of boarding-home residents formed their own clubs, and learned to plan and organize their
own activities. Volunteers continued to support the Activities Programme, and
special projects, such as the Volunteer Instruction Programme in the Fraser Valley,
also provided worth-while services.
The Occupational Therapy Co-ordinator visited several regions, offering consultation to the Boarding-home Programme staff and to local sheltered workshops.
Some new workshops were opened through the work of individual groups of professional people and interested lay persons. A submission was made containing
recommendations for standard setting and funding formulas with regard to sheltered
workshops.
Other submissions made during the year by the office of the Boarding-home
Co-ordinator included
(1) a report on the Boarding-home Programme to the Health Security
Programme Project;
(2) a submission to the Department of Human Resources on the need
for a unified policy throughout the Province with respect to the provision of ancillary social services to Mental Health Branch boarding-
home clients;
(3) definitions of the Mental Health Branch types of care, submitted to
the Chairman of the Community Care Facilities Licensing Board,
Health Branch, for inclusion in the Provincial definitions of levels of
care as adopted by the Health Branch;
(4) job description and analysis of the case aide positions in the Boarding-home Programme, submitted to the Civil Service Commission;
(5) preparation of a Rating Scale, to assist in the determination of an
appropriate rate for individuals placed into boarding-homes.
In the last half of the year some progress was made in the establishment of
intermediate-care resources for Mental Health Branch clients. Several facilities providing intermediate services were funded by the Department of Human Resources
at beginning intermediate-care rates. In June, the Central Mortgage and Hous-
29
L 30
MENTAL HEALTH BRANCH REPORT, 1973
ing Corporation announced a programme
for the provision of mortgage funds of up
to 100 per cent to nonprofit organizations
to provide facilities to serve disabled
groups, and several organizations were in
the process of acquiring a resource in this
way as the year closed. Boarding-home
candidates being presented by Riverview
Hospital for placement were persons
bordering on intermediate-care levels in
their needs, and consultation was given to
the hospital throughout the year in placement possibilities for this group. Placement was also facilitated by visits of Riverview Hospital social service staff to several
regions of the Province, to familiarize
them with possible placement resources.
Throughout the year workshops for
boarding-home operators were held in all
regions. A week-long conference was held
in September for all Boarding-home Programme staff, where the emphasis was on
new approaches to the rehabilitation of
mentally disabled persons. Evaluation
meetings, including staffs of the Health
Branch and the Department of Human
Resources, were held in several regions of
the Province.
In November, Langholm Lodge, a
boarding-home serving 29 adult retarded
persons, burned to the ground. Fortunately there were no injuries, and immediate efforts were made to locate the
residents in suitable alternative accommodation.
Various methods of improving and
extending home activities were discussed
at a workshop held in March for all
boarding-home participants.
Approximately 650 residents, volunteers, and staff attended the annual
boarding-home picnic, held in Queen's
Park, New Westminster, on July 26.
Approximate Distribution of Placements Made and Case Load,
Boarding-home Programme, 1973
Placements Case Load,
Made, 1973 Dec. 31. 1973
Region 1 (Kootenay s) 28 70
Region 2 (Okanagan-Thompson) 150 376
Region 3 (Fraser Valley) 128 685
Region 4 (Skeena) 2 5
Region 51 (Greater Vancouver) 13 38
Region 6 (Cariboo-Peace River) 18 34
Region 7 (Georgia Strait) 86 145
Region 8 (South Vancouver Island) 49 103
Totals
474
1,456
1 Burnaby and North Vancouver were the only municipalities of the Greater Vancouver area where placements were made through the Mental Health Branch Boarding-home Programme.
SOCIOLOGY
CONSULTATION
SERVICES
PSYCHIATRIC HOME TREATMENT RESEARCH PROJECT
The treatment component of the Project ceased on August 31, 1973. Patients
requiring continued care were transferred to Riverview Hospital's out-patient
services and to the community care teams of the Greater Vancouver Mental Health
Project. A total of 213 patients awarded an admission to Riverview Hospital from
the City of Vancouver was studied, having been randomly allocated to one of three
groups—home treatment only, hospitalization followed by home treatment, and
hospitalization without home treatment. The study commenced during the summer
of 1971. At the year-end, data analysis, supported financially by a National Health
Grant, was being undertaken, pertaining to the impact of the project on Riverview
Hospital admissions, the replacement of hospital bed-days, comparative costs, and
the effectiveness of treatment. A final report dealing with the entire project would
be available by March 31, 1974.
GREATER VANCOUVER MENTAL HEALTH PROJECT
In February, the Consultant in Sociology was appointed as Acting Executive
Director of the Greater Vancouver Mental Health Project, pending the employment
of a full-time Executive Director in June. The Greater Vancouver project was
essentially a hospital-bed replacement programme designed to provide a more
appropriate type of service to patients, while at the same time decreasing hospital
admissions and length of stay for the adult mentally disabled. These objectives
were being pursued through the development of a system of community care treatment teams, supported by such services as day treatment, short-term residential, and
sheltered workshop facilities.
GENERAL PLANNING
Progress was made in preparing guidelines designed to assist in planning for
both the number and kind of community mental health facilities required to provide
a spectrum of decentralized services. Guidelines being developed were based on
data derived from the Branch Patient Categorization Surveys of 1970 and 1972,
commonly accepted standards in use elsewhere, and estimates obtained from mental
health centre administrators.
COMMUNITY CARE FACILITIES LICENSING BOARD
The Branch continued to be represented on the Community Care Facilities
Licensing Board, throughout the year, at regular monthly meetings and a number
of special hearings regarding the licensing of special-care and intermediate-care
facilities. Through the Board, the Branch had a further avenue for monitoring the
care and rights of some 1,400 patients in the Mental Health Branch Boarding-home
Programme.
31
PSYCHOLOGY
CONSULTATION
SERVICES
The year 1973 saw a great deal of challenge, reorganization, continued development, planning, and increased emphasis on providing more comprehensive health
care and services. In order to be responsive to the needs of the various groups and
individuals being served, the participation of local citizen groups and the development of local resources continued to be encouraged. The emphasis on assisting
the local communities to deal with their mental health problems resulted in increasing the type and number of responsibilities for all mental health personnel. Because
of the greater number of services being provided by the Mental Health Branch, as
well as by other Government departments and community agencies, co-ordination
of services became increasingly important. The special training of psychologists,
particularly in the areas of programme development, documentation, and analysis,
was reflected in their assistance in developing many innovative programmes and
services and in the added responsibilities which they were asked to undertake.
As services became more established in local areas, it became possible to shift
the emphasis from dealing with accumulated existing problems to providing more
services aimed at preventing problems from occurring. Together with other personnel, Branch psychologists continued to develop a variety of preventive mental
health programmes for the young child, in addition to programmes dealing with
the early recognition of problem areas, with assessing problems, and with devising
remedial techniques.
Services for adults also continued to increase. Improved co-ordination in
terms of better communication and interaction between staff of different Branch
facilities resulted in providing continuity of pre-admission, admission, and follow-up
services for individual clients. New treatment programmes were developed for
continued care of patients, as well as for those problems with which persons need
only casual assistance.
The demand for psychological services was reflected in the inability to fill all
existing vacancies for psychologists with adequately trained personnel. The increased emphasis on health care, and the concomitant necessity to find more qualified
personnel in all health professions, made this problem an area of concern for the
future.
32
MANAGEMENT ANALYST
CONSULTATION
SERVICES
Services of the Management Analyst were provided to various areas throughout the Mental Health Branch during the year.
The spectrum of involvement covered such activities as systems and procedures development; forms analysis, design, and control; and studies relating to
dietary, pharmacy, nursing, and general office organization and procedures.
The necessary communication, preparation, and submission of material to
the data processing facilities of the Departments of Finance, Industrial Development, and the Division of Vital Statistics, was conducted and channelled through
this office.
Additional statistical tabulations were produced to provide supplemental information for the Patients/Residents Categorization Study carried out by the Consultant in Sociology.
The boarding-home reporting application, which was initially set up to be
handled on a manual basis, was revised. The file maintenance and monthly output
were computer-produced.
A system to provide "positive" identification for all patients within a major
in-patient facility was implemented. Embossed plastic identity cards and imprinting devices were introduced and located at all nursing stations. As a result,
time required by professional staff in the performance of clerical duties was reduced,
errors inherent in manual entry eliminated, and an increase in the document flow
realized.
The Management Analyst was appointed as Chairman of the Forms Control
Committee and in this capacity carried out functions involving new forms design,
the review and revision of existing forms, and associated reprinting requirements.
With the previously mentioned implementation of the patient-identification system,
it was necessary to revise all forms relating to an individual patient, to provide an
imprinting area which was standard to all.
Through the assistance of the summer student programme, a project was initiated to produce a Forms Catalogue which provided information relative to all forms
used throughout the Mental Health Branch.
Information was made available to a telecommunication consulting firm, delegated by the Provincial Government to investigate all communication media presently used within the Government Service.
The area of programme budgeting (forms and methods) constituted a significant time involvement on the part of the Analyst.
During the year, support was extended to Glendale Lodge in the development
of an input data sheet. Data entered on this form would serve to create a data
base from which required clinical assessment information could be obtained.
33
STATISTICS AND
MEDICAL RECORDS
During 1973, emphasis was placed on the preparation of data to assess the
future demand for mental health facilities in the Province. Some of the statistical
procedures were revised and the processing of statistical forms from all Branch
facilities was directed to head office in Victoria. Three new mental health centres,
at Prince Rupert, Abbotsford, and Langley, and the West End, Strathcona, and
Mount Pleasant Community Care Teams, were incorporated into the statistical
system.
Research projects during 1973 concentrated primarly on the analysis of patient characteristics and the provision of Branch data to other departments and the
public in general.
Summer employment was provided for three university students who assisted
in the compilation of a facilities inventory preparation of data to project future
demand for mental health facilities, and in the tabulation of the Annual Statistical
Report.
DEVELOPMENT OF THE STATISTICAL SYSTEM
A principal concern was the limited capacity of the data storage and retrieval
system available to the Branch in the Division of Vital Statistics. This problem
was a major topic at Departmental discussions, where a centralized data processing system for all branches was proposed. Data regarding the statistical system
was also made available to the Provincial Health Security Programme Project.
Additional discussions were held with Statistics Canada regarding the publication
of Canada-wide statistics on patients in out-patient departments. Suggestions concerning the format and extent of these statistics were presented to Statistics Canada.
To improve the mental health centre statistical system, more precise activation
and termination criteria were developed and were made applicable to all centres.
The feasibility of a problem-oriented medical records system for the Branch
was investigated and two video tapes on this subject were made available for further information.
Subsequent to the Medical Records Consultant's meeting with the staff in
mental health centres, instructions on medical record-keeping and on completion
of statistical forms were revised and updated.
ROUTINE DATA RETRIEVAL
During 1973 a monthly average of over 1,800 activation and termination
statistical forms were edited at head office, prior to further processing at Vital
Statistics for data storage. In addition to numerous general inquiries, over 30
requests for specific patient-data retrieval were received from the Department and
the public in general. A case-load verification, to verify the number of patients
at each facility with the data on storage, was in progress at the year-end.
Other statistical reports prepared during the year included the Preliminary
Patient Movement Report, the Monthly Statistical Bulletin, the 1972 Annual Statistical Report, and annual reporting to Statistics Canada.
34
STATISTICS AND MEDICAL RECORDS
L 35
ADMINISTRATIVE AND PLANNING STUDIES
A major project was the preparation of population growth data for each
planning region, which, combined with data on the incidence of mental illness and
capacity of existing facilities, provided the basic data to project the demand for
mental health facilities up to 1980. Another important project was the compilation of an inventory of all facilities for the mentally handicapped in British Columbia. A study, showing the time and method of arrival of patients, was completed
for the Riverview Hospital. Other studies included staff-to-population ratio reports for each mental health centre, and an analysis of admissions to Riverview
Hospital by school districts.
MEDICAL RECORDS DEVELOPMENT AND REPORTING CONTROL
In February of this year, the Medical Records Consultant also assumed,
temporarily, the function of medical records librarian at the Riverview Out-patient
Department, located in Vancouver. Consequently, the co-ordination of all statistical reporting was turned over to head office in Victoria. Responsibility for the
distribution of statutory forms was delegated at the beginning of the year to Central Stores, Riverview Hospital. Consultation and orientation on medical records
was also provided to clerical staff at eight health centres, and at head office. In
addition, the Consultant participated in four regional meetings which included all
medical records staff of the mental health centres in each region. Principal results
of these meetings were the clarification of medical records procedures and professional and clerical responsibilities which resulted in a revised procedure manual
for medical records offices in all centres.
Consultation was offered at two special meetings—one with the Lower Mainland mental health centres concerning standardization of the medical records, and
the second with the Community Adult Psychiatric Services in Port Coquitlam,
concerning compatibility of their medical records with the medical records at Riverview Hospital. Several meetings were also held with representatives of the Vancouver Mental Health Project to consider the setting up of a "data base," should
a problem-oriented medical records system be adopted for the project.
In her function as medical records librarian at the Riverview Hospital Outpatient Department, the Consultant initiated and set up the following:
Policies and procedures for the medical records system.
Review and organization of over 500 medical records.
Colour-coding to regionalize the current case load of over 800 patients.
Two verifications of the patient case load with data storage at Vital Statistics.
Recording of interviews by discipline and date of admission as required for
Statistics Canada.
Integration of medical records and clerical staff of the Home Treatment Research Project with the Out-patient Department medical records system.
Setting up of a mechanism to regularly review all out-patient cases.
Appointment to the Out-patient Services Intake Committee.
Assistance to the Metropolitan Mental Health Team.
INFORMATION
SERVICES
One of the major functions of Information Services continued to be the consultative services provided to the Branch's facilities and mental health centres. A
proposed public relations programme was developed for Riverview Hospital, which
included recommendations for appointing a speaker's panel and implementation of
a patients' opinion poll. Assistance was given in connection with media coverage
for the hospital's workshop on "The Potentially Dangerous Patient," held in March,
and a pamphlet outlining Riverview's treatment programmes and services was
developed for distribution to the Canadian Psychiatric Association's annual convention in June. Riverview's Volunteers' Handbook, and Tranquille's pamphlet
For the Professional Worker, were printed, and Valleyview's general information
pamphlet was revised and reprinted.
Assistance was provided to Woodlands in the planning of the official opening
of their new Industrial Therapy Building in May, and in the preparation of their
volunteers' pamphlet.
At the year-end, consideration was being given to having the Director become
more involved in direct media relations on behalf of the institutions.
The Travelling Display was revised during the year, with emphasis
placed on the activities of the local
mental health centre, and it toured
the Province from April through December. The centres were, for the
second year, encouraged to participate in the observance of Mental
Health Week, sponsored by the
Canadian Mental Health Association. Informational literature dealing
with a variety of subjects, including drug abuse, epilepsy, and schizophrenia, was provided to the centres.
Material was being developed for use
by the centres during the annual
Careers Day Programmes observed
by the Province's secondary schools.
At the request of the Board of Directors of Glendale Lodge, assistance was
given in publicizing their Open House Programme for Tillicum Lodge, and in the
development of an informational pamphlet for Glendale.
Other duties undertaken during the year included preparation of 11 issues of
the Newsletter, an in-service publication; writing press releases, and articles for the
journal of the B.C. Medical Association; assisting the Community Care Services
Society in the printing of their reports; maintaining a daily news clipping service;
handling general inquiries; initiating a Branch survey of VTR (video tape-recording) equipment and needs; and editing the Annual Report.
The front of the Travelling Display (above)
placed emphasis on the work of the local
mental health centre. The reverse panels outlined the general Branch programme.
36
COMMUNITY MENTAL HEALTH SERVICES
Mental Health Centres
COMMUNITY
MENTAL HEALTH
SERVICES
During 1973, mental health centre services were extended to Abbotsford,
Langley, Prince Rupert, and Sechelt-Squamish. In addition, in co-operation with
numerous community groups and the Metropolitan Board of Health, the Mental
Health Branch began to develop a specialized service for patients in the Greater
Vancouver area likely to require hospital admission. This programme would focus
on the delivery of services through a community care team of psychiatry, social
work, and mental health nursing. An in-patient service was being planned for
the Burnaby Mental Health Centre to provide a full range of mental health services to the Burnaby community. This service would be tied in closely with the
Vancouver programme and provide community service teams.
The Branch continued to experience difficulty with the recruitment of mental
health professionals in the far North and eastern Interior, but the situation was
gradually improving. A typical mental
health centre served a population of approximately 50,000, and had a staff consisting of a psychiatrist, psychologist,
social worker, mental health nurse, boarding-home social worker, an activity therapist, and clerical positions. In some less
populous areas the staff was smaller. In
the Metropolitan Vancouver area the
community care team consisted of a psychiatrist, psychologists, social workers or
nurses, an occupational therapist, and a
number of psychiatric nurses. Mental
health centres provided direct services to
persons of all ages with emotional and behavioural problems, and assisted various
community organizations and services in
the promotion of mental health and the
alleviation of mental illness. Most centres reported wide involvement with community agencies and organizations during the year. Because of the array of other
mental health services in the Vancouver area, including private psychiatry, the
Vancouver programme concentrated on services to the adult patient with serious
emotional disturbance.
During 1973 there were more than 8,000 admissions to service at mental health
centres and to the Vancouver programme.
In addition to the extension of community services, there was a substantial
development in the integration of services between the community and the Riverview Hospital. The hospital was divided so that new admissions to each ward in
the acute admitting areas came from a limited area of from 100,000 to 300,000
people. In the area closest to the hospital, the Lower Fraser Valley and Metropolitan Vancouver, psychiatrists working in the community were responsible for
39
A conference on agency integration
was held in Kelowna in January. Shown
in discussion are (left to right) Dr. Frank
McNair, psychiatrist; Ish Holmes, Administrator of the Kelowna Mental
Health Centre; Mrs. Connie Hawley, of
the Health Security Programme Project;
and Colin Elliot, Administrator of the
Kelowna General Hospital.
L 40 MENTAL HEALTH BRANCH REPORT, 1973
admitting patients to Riverview Hospital and their subsequent care in the hospital.
These psychiatrists were supported by other mental health staff to provide a well-
integrated community adult psychiatry service.
During the summer of 1973 the Mental Health Centre Programme was greatly
enriched by the addition of over 50 college students participating in the student
summer programme. They extended services to children and adolescents, and the
chronically disabled in boarding-homes, and also helped mental health centres assess
their services through a series of evaluation studies.
ABBOTSFORD
MENTAL HEALTH CENTRE
Mental health services in this community, previously provided by a Travelling
Clinic from Chilliwack, were expanded during the year with the opening of the
new Centre in September. This Centre served the Abbotsford community, with
the boundaries coincident with School District No. 34. The initial staffing consisted of a social worker who was Administrator, a half-time psychologist, a sessional psychiatrist, and a clerk-stenographer. The boarding-home social worker,
an activity therapist, and a case aide also worked out of this Centre on a part-time
basis.
Direct services were offered, and a number of programmes of an indirect nature initiated. The programme was still in a relatively formative stage while community needs were being assessed, and working relationships with other agencies
being established. Parents' discussion groups, hospital follow-up groups, and consultation to the hospital and social agencies were established. Plans toward developing special projects with specific target population groups, such as single-
parent family and parents of emotionally disturbed children, were being considered
at the year-end.
BURNABY
MENTAL HEALTH CENTRE
In the operation of the Burnaby Mental Health Centre, 1973 was a year of
major changes. The outcome of prolonged negotiations which involved the Mental
Health Branch, the Burnaby General Hospital, the Greater Vancouver Mental
Health Project, and the Metropolitan Board of Health was the approval and the
initial implementation of a plan to provide comprehensive mental health facilities
for the citizens of Burnaby. The "Burnaby Plan" took into account both existing
facilities and deficiencies in service and provided for development of the following
resources:
Community care teams—The community care teams were the core service of
the new pattern of psychiatric care for Burnaby. Three teams, each consisting of
a psychiatrist, two senior mental health workers (i.e., psychologist, social worker,
or mental health nurse), five basic mental health workers (community psychiatric
nurses), and one occupational therapist, would provide the following services to
adolescents, adults, and families in Burnaby:
COMMUNITY MENTAL HEALTH SERVICES
L 41
(a) Twenty-four-hour seven-days per week emergency psychiatric services.
(b) Out-patient assessment and treatment.
(c) Pre-admission and after-care services.
(d) Home treatment services.
(e) Consultation, education, and preventive services.
(/) Collaboration with boarding-home, hostel, partial hospitalization,
and in-patient services, as well as community agencies, including
Public Health.
The community care teams would provide basic services and continuity of care
for the majority of patients entering the system. They would be highly mobile and
co-ordinate closely with other agencies in the community.
Although, initially, the out-patient teams would operate out of the centre, they
would eventually operate in specific catchment areas within Burnaby, and two teams
would be relocated in decentralized offices in North and South Burnaby. Team
members would provide emergency psychiatric services in close association with
the In-patient Unit, in order to provide adequate staff and back-up resources.
The Burnaby Mental Health Centre children's team, which provided services
to children, adolescents, and families, would be expanded by the addition of a part-
time speech therapist and four child care counsellors, who would assist in the operation of a Day Care Programme for emotionally disturbed children and their parents.
The children's team would make some services available through the Branch offices,
and continue its close liaison with the Burnaby schools and public health nurses.
In-patient service—A 25-bed In-patient Unit would be developed by conversion of space on the main floor of the Centre building. Three to four beds would
be used as emergency or short-stay beds, to be cleared in 24 to 48 hours, and one
or two beds would be available for night-stay patients. The unit would utilize
modern techniques of crisis intervention, family therapy, and pharmacological treatment to foster rapid reintegration of patients, resulting in brief in-patient admissions
(usually less than two weeks) and a minimizing of dependency problems. Patients
who required more prolonged milieu therapy would be transferred to day hospital
treatment as soon as possible. The use of a full-time area clinician would ensure
efficient use of the in-patient facility and adequate patient-flow.
Day hospital units—Crucial to optimum patient-flow in the plan was the development of additional day hospital places. Thirty additional day hospital places
would be developed in the existing day hospital space at the Burnaby Mental Health
Centre, and this could be done without significant capital expenditure by alternating
the two programmes in the existing floor space, thus requiring only additional staff.
Short-stay hostel—A short-stay hostel for eight psychiatric patients in the
Burnaby area would meet the needs of a number of patients who would otherwise
require hospitalization. This would also facilitate the operation of the Day Hospital
Units providing occasional supervised overnight accommodation for those patients
experiencing crisis in their therapy or their home environment.
Adolescent services—It was expected that the community care teams would
deal with adolescents and they would be admissible to Hostel, Ward, and Day
Hospital Units.
Other jacilities—When these facilities get into full operation, other needs
would probably emerge, including rehabilitation and sheltered workshops, and an
adequate community transportation system.
In summary, the Burnaby Plan would emphasize the use of highly mobile
mental health teams on a round-the-clock basis, backed up by in-patient hostel, and
day hospital services, to provide the optimum level of care for all patients.
L 42
MENTAL HEALTH BRANCH REPORT, 1973
The transition from the previously
existing adult and child out-patient teams
and 30-space Day Hospital would represent a major increase in resources and
staff and involve a great deal of work in
setting up the new facilities, especially in
recruiting and training personnel. By
the year-end the following had been accomplished:
(1) Recruitment and training of
seven new staff members for
the out-patient teams and the
opening of the North Burnaby
Out-patient Office.
(2) Recruitment and training of 22
staff members for the In-patient
Unit, and the opening on a
limited basis of 12 in-patient
places, while renovations to the
Centre building for the full 25-
patient ward were proceeding.
(3) Formation of a Citizens Advisory Committee to the Burnaby General Hospital and
Project staff, which met regularly to advise on policy and
assist in co-ordination and
integration with community
resources.
While this planning and work was
being accomplished, the Burnaby Mental
Health Centre continued its out-patient
and day hospital assessment and treatment programmes, as well as the training
of psychology, nursing, social work, and
occupational therapy students, and the
provision of educational and consultative
services to the community at large.
Special programmes such as the Tuesday
Evening Social Club, the SeCure organization for agoraphobics, and the marriage
preparation courses sponsored in conjunction with the Burnaby Family Life
Institute were continued and further developed.
Some of the new services offered
during the year included a psychiatric
consultation service to the Burnaby General Hospital, efforts to upgrade and
The moulding of clay into pottery of
various shapes and sizes was one of the
many interesting projects provided in
occupational therapy.
"Healthy bodies for healthy minds."
Group exercises in the Day Hospital
Programme helped tense bodies to relax,
and generally toned up the muscles.
The use of video tape-recording equipment proved to be effective in group
therapy, and in workshop training programmes.
COMMUNITY MENTAL HEALTH SERVICES L 43
increase the numbers of boarding-home places in Burnaby, and the beginning of
programmes of parent effectiveness training, in co-operation with the Burnaby
Family Life Institute.
A number of staff participated in workshops, lectures, student field-work
supervision, and other teaching programmes related to the University of British
Columbia, Simon Fraser University, the B.C. Institute of Technology, and Langara
City College.
Also, during 1973, workshops were held at the Centre on the Day Hospital
Programme, the use of transactional analysis in treatment, and the use of the
problem-oriented record. At the year-end a multidisciplinary committee was at
work on a new integrated system of patient records for all departments, utilizing
the problem-oriented approach.
During the summer a new Day Programme for 40 children and their families
was operated by the Children's Team, with the assistance of a social worker, a
teacher, and a recreational therapist, hired under a Community Care Services
Society grant. This programme worked with groups of children in the 4 to 12 age-
range, and focused on improving the social relationships and behaviour of these
children. In most instances at least one family member was involved one day per
week with the programme, in order to increase their understanding and improve
their management of their child's difficulties. The programme was warmly received
by the community and it was expected that it would be repeated in 1974.
CHILLIWACK
MENTAL HEALTH CENTRE
As the geographical catchment area was again reduced, with the new Abbotsford Mental Health Centre assuming responsibility for services in that community,
1973 was a year of transition. This Centre became responsible for Chilliwack,
Agassiz, and Hope, where biweekly Travelling Clinics were increased to weekly
visits. Along with these organizational changes, there was considerable staff turnover. The mental health nurse resigned and the psychiatric social worker transferred to Abbotsford. Both positions were replaced. Additional sessional psychiatric services were obtained from two local psychiatrists. However, with the closing
of their private practice, direct referrals increased proportionately and a third clerk
was employed on a half-time basis. The net effect of these changes would permit
a more concentrated and effective service in this area.
Throughout the year, constant effort was made to maintain a reasonable
balance between direct and indirect services. Regular liaison was kept with major
medical, social, correctional, and volunteer agencies and organizations. Particularly significant were the interagency efforts of studying and evaluating the implication of the CELDIC Report for this community.
Three programmes of special note initiated during the year were a hospital-
based out-patient group therapy programme, the Ritalin treatment of hyperkinetic
children, and parents' encouragement groups. The hospital out-patient groups were
initially started by the mental health nurse for discharged patients from the psychiatric ward of the General Hospital. The success of this demonstration project, in
terms of reducing the admission rate, resulted in the hospital hiring a psychiatric
nurse to take over this project and further develop out-patient day-care services.
L 44 MENTAL HEALTH BRANCH REPORT, 1973
The Ritalin programme was initiated by the psychologist in co-operation with
schools and family physicians of children diagnosed with a hyperkinetic syndrome.
The use of this drug, combined with behaviour modificiation reinforced at home
and school, appeared an effective method of treating these children. Parents'
encouragement groups were started by the psychiatric social worker. This was a
six-week series of lectures, discussion, and practice exercises, open to all parents,
patients, and nonpatients. This series provided a positive group experience for
parents and dealt with understanding and the management of common behaviour
problems of children, and offered effective communication skills to improve family
relationships. This programme proved to be well accepted by the public and was
subsequently taken over by the public health nurses and the Family Life Institute.
COURTENAY
MENTAL HEALTH CENTRE
The Centre's focus during the year was toward maximizing indirect services to
the community, and co-ordinating direct services with other agencies. During
the first half of the year, the staff developed a co-ordinated and effective approach
in spreading the services more broadly in the Courtenay and Campbell River
areas. The Community Co-ordinator Programme, "Crossroads," Children's Coordinating Committee, and a Big Sisters Association, were all programmes which
Centre staff helped to initiate and continued to develop and support. These were
areas. The Community Co-ordinated Programme, "Crossroads," Children's Coordinating Committee, which biweekly brought together representatives of the
schools and agencies for policy formulation and case conferences. Closer working
relationships among agencies resulted from this regular meeting, and the school
representatives especially valued this contact. The sessional paediatrician represented
the Centre at a similar Children's Committee in Campbell River.
The Community Co-ordinator was hired April 1 by a Subcommittee of the
Union Board of Health to develop a preventive drug programme for the Campbell
River and Courtenay areas. Centre involvement on the subcommittee dated back
to its origin in October 1972, and hopefully would continue in 1974. Workshops
for parents, teachers, professionals, and volunteers were geared to changing attitudes
as well as disseminating information. The programme was strongly supported by
the schools.
"Crossroads," a crisis centre sponsored by the Upper Island Mental Health
Society, began operating in March. Their staff looked to this Centre for training
and consultation. In the latter part of the year, the Centre encouraged them to
assume primary responsibility for training new volunteers, so that Centre staff could
offer more consultation in regard to effective referral procedures and use of community resources.
The co-ordination of services also improved with CFB Comox, and staff met
regularly with their regional social worker and referrals were going more smoothly.
Military families continued to be a significant part of the Centre's case load.
Service to the North Island posed a problem, but requests for direct service
decreased with the opening of offices by the Department of Human Resources and
the Probation Service in Port Hardy, as well as School District No. 85 contracting
with the UBC Department of Education for a Travelling Assessment Team. Efforts
were being made to minimize direct service and support all efforts in the area to
develop their own services.
COMMUNITY MENTAL HEALTH SERVICES L 45
Throughout most of the year the Courtenay staff worked with the Branch's
Consultant in Psychology on designing a model for the delivery of comprehensive
community services.
The boarding-home staff continued to expand their programme in the Courtenay area, Campbell River, and Powell River, and in November accompanied the
Centre's Travelling Clinic to Port Hardy to investigate needs and discuss the programme with the newly formed Co-ordinating Committee there. This committee,
composed of representatives from the Department of Human Resources, Probation,
Public Health, Indian Affairs, and the UBC team, would serve as the Centre's
primary contact in the area.
During the year it was felt that the Centre became a more integral part of the
Courtenay community. With the rapid growth of communities on the northern part
of the Island, efforts to provide adequate service to the designated area would
become increasingly difficult until a resident mental health worker could be assigned
to the North Island.
CRANBROOK
MENTAL HEALTH CENTRE
During the year the staff of the Cranbrook Mental Health Centre continued
to provide direct service to the citizens of the East Kootenay, and consultation to
the various agencies and community groups. The area of the East Kootenay was
expanded to include Golden.
The general hospital in Cranbrook had 10 beds designated as a psychiatric
unit. This unit, in the beginning stages, was slowly developing a treatment programme and philosophy of care. Further impetus in its growth would result from
the commencement of consultative services by a psychiatrist from the University
of Calgary, who would provide monthly visits of one day, bringing with him
residents and students of psychology, social work, and nursing.
The boarding-home project became more a part of the Centre programme,
with the appointment of a full-time case aide. The residents in the boarding-homes
benefited from her efforts in planning for their activities, and by the year-end it was
hoped that several would become part-time employees in the community.
Renovations began to St. Eugene's Mission, which in the new year would be
developed as a resource for the mentally retarded adults in need of training.
In the coming year it would be necessary to develop methods of meeting the
demands for service and consultation. In addition to reviewing the personnel
requirements, consideration would be given to community programmes. The
summer student programme was useful in providing students with an insight into
mental health activities. At the year-end Cranbrook was in the process of coordinating services to school children. Effort toward co-ordination also needed
to be considered for the other communities and services such as the volunteers.
DUNCAN
MENTAL HEALTH CENTRE
The Duncan Mental Health Centre had an active and stimulating year. Staff
consisted of the Administrator, a psychiatric social worker, two sessional psychia-
L 46 MENTAL HEALTH BRANCH REPORT, 1973
trists, a regional boarding-home co-ordinator, a case aide, a secretary, and a clerk.
Psychological services were provided by members of the Victoria Mental Health
Centre on a bimonthly basis. It was anticipated a full-time psychologist would
be hired in the next few months, and at the year-end recruiting was under way
for an activity therapist for the Boarding-home Programme, which continued to
expand over the past year.
The Centre continued to operate on an open referral system, which had proven
to be most satisfactory. Besides the direct service to clientele, staff were active
in community development work to augment present services and programmes.
One of the psychiatrists worked with the Hospital Board and staff toward the
development of a psychiatric ward and Day Care Programme at the Cowichan
District Hospital. The other provided consultation and training to the volunteer
counsellors of the Cowichan-Malahat Family Life Association. This organization
had been most successful in providing a range of services and programmes of a
preventive nature, i.e., courses on child-rearing, transactional analysis, reality
therapy, and many others. The Centre hoped to encourage the development of
more programmes of this sort.
The Duncan Mental Health Centre continued its involvement with the Lake
Cowichan Activity Centre, which had been in operation for approximately two
years. As a result of the success of this project, which was geared to providing
day-time programmes for people of all ages, an Activity Centre was about to
commence service in the Duncan district at the year-end, to be jointly funded by
the regional district and the Department of Human Resources. It was anticipated
that the Activity Centre in Lake Cowichan would evolve into an Activity and
Resource Centre for that district.
The Centre was partially responsible for the development of the Community
Options Society, which was co-ordinating a special project funded by the Department of Human Resources to provide a range of alternative resources, on a
community basis, for young people traditionally referred to placements such as
Willingdon School. The project began operation in June and consisted of a Drop-in
Centre, a Live-in Programme for adolescents with families in the region, and the
Farm Project, which was an intensive group-living situation in a rugged section
of the valley. The purpose of the farm was to provide a real alternative to some
of the young people seeking a more basic life experience. Also in developmental
stages was an Alternative School Programme, being jointly funded through Mala-
spina College, the local school board, and the school-children. The philosophy
behind the Community Options Programme is that these are our children, and we
must learn to meet their needs.
The most recent development in the area was the formation of a Community
Resource Board, a concept that was most worth while but somewhat difficult to
achieve. Progress was being made, however, and it was anticipated that early in
the new year it would become a reality.
As a result of these many activities, the community was developing the ability
to get together to solve some of its own problems.
FORT ST. JOHN
MENTAL HEALTH CENTRE
The Centre was staffed by a mental health nurse until September, during
which time she carried an active case load of persons requiring crisis intervention,
COMMUNITY MENTAL HEALTH SERVICES L 47
family and marital therapy, and long-term chronic care follow-up. Services were
also provided in Dawson Creek and occasionally in other communities, including
Chetwynd and Fort Nelson, and a number of community programmes were
promoted. After September the Centre received service from the staff of the
Prince George Mental Health Centre, and at the year-end efforts were under way
to recruit a psychiatrist, a psychologist, and mental health nurse for the Fort St.
John Centre.
KAMLOOPS
MENTAL HEALTH CENTRE
The Kamloops Centre served a regional district with an estimated population
of 80,000, with a full complement of staff all year. The former Administrator, a
psychiatrist, went on a sessional basis in April, and a psychiatric social worker assumed the position. It was estimated that staff divided their time equally between
direct patient services, educational support to community-oriented preventive programmes, and participation in the development of regional health and social service
planning bodies.
Direct psychiatric treatment services were readily available. Home nursing
care to selected patients resulted in some decreased use of hospital bed space, as did
long-term treatment with lithium carbonate of several patients with manic depressive
psychosis. Medication continued to be rigidly prescribed and closely supervised.
There was an increase in the number of long-term psychiatric patients utilizing the
Drop-in Programme. The latter was attended by patients of the local psychiatric
ward, serving as an effective introduction to the community out-patient services.
A university social work student, hired under the summer employment programme,
was assigned full-time to the psychiatric ward to assist in patient discharges. An
increasing number of psychiatric patients utilized the boarding-home programme,
which housed 80 residents in 34 homes. Strikingly, half of these patients were fully
employed in either industry or at the community workshops. In addition to ongoing
activity and social programmes, boarding-home patients participated in a wide variety of recreational activities, generated by a second student hired by the Centre.
Boarding-home operators formed their own association, and a number of improvements in treatment and standards resulted.
Individual, marital, and family counselling services were utilized. During the
summer a third university student majoring in psychology assisted in the neuro-
psycho-educational assessments of some 30 children. Children referred from the
schools were assisted by an innovative programme placing volunteers, trained by the
psychologist, in the classroom to monitor programmes utilizing behavioural techniques. Its success aroused considerable interest and support in the school system.
Group-treatment methods were used with adolescent girls referred to the Centre for
behaviour problems. The psychologist was moving toward the greater use of group
methods to assist elementary-aged children experiencing interpersonal difficulties.
Staff had considerable involvement in training and educational programmes for
the Homemakers, Crisis Centre volunteers, Family Life counsellors, public health
nurses, and school counsellors. The Centre hosted a two-day Learning Disability
Workshop conducted by staff psychologists from the Victoria Mental Health Centre,
and a YWCA-sponsored seminar on drug abuse. Cariboo College students were
assigned to the Centre for their field placements.
L 48 MENTAL HEALTH BRANCH REPORT, 1973
Centre staff participated in a growing community interest in the planning of
health and social services. The staff psychiatrist, through a health-planning committee, consulted with the regional district, which subsequently retained the services
of an independent firm to carry out a health-needs study. The Centre was an organizational member of the newly formed Community Resources Society, aimed particularly at integrating the planning and development of social services in the region.
The Centre looked forward to an increased use of home care and out-patient
services in the treatment of the mentally ill. With a greater emphasis on regional
planning, a more orderly financing and development of community social services
was expected.
KELOWNA
MENTAL HEALTH CENTRE
During the year a Co-ordinated Community Services Committee assessed the
need for facilities to provide more accessible services and to encourage interagency
co-operation. A number of major agencies required additional space, and, if moves
were necessary, it was felt they should be considered in the light of co-ordinated
services. It was recognized that more services were required, but these services
should be assessed co-operatively. Several all-day seminars were held to allow local
input and to inform Provincial Government representatives about local views.
The Methadone Programme continued to operate successfully under the name
of the Kelowna Addiction Treatment Centre. Group therapy was provided by one
of the Centre's psychiatrists, medical services by six local physicians, space by the
Centre and Kelowna General Hospital, methadone and urinalysis by the Narcotic
Addiction Foundation, and volunteer services by an interested individual. A
request for funding to intensify and expand this service was made to the Drug,
Alcohol, and Tobacco Commission. Many local groups, such as the RCMP, Probation Services, the Pharmacy Association, and local physicians expressed their
appreciation of this service.
The Boarding-home Programme continued to expand. A boarding-home social
worker came on staff to serve the Kelowna area and another social worker operated
out of the Penticton Mental Health Centre to serve the south end of the valley. One
of the boarding-homes in the Kelowna area, with approximately 26 residents, was
closed for not meeting the physical standards of the Community Care Facilities
Licensing Board, and the re-placement of the residents put some pressure on local
resources. The Centre has been exploring the area of family care homes quite
extensively.
A position for an occupational therapist was established in the Boarding-home
Programme for the purpose of initiating life-enriching activities and programmes in
the boarding-homes, and to help boarding-home operators upgrade their services to
their residents.
The Government's announced intention to support the establishment of intermediate care was welcomed. The Centre was fortunate in having a private hospital
as well as extended care in the community, but there were a number of people whose
needs could effectively be met in an intermediate-care facility.
The Centre had the services of several summer students, which provided an
opportunity to do several studies. The psychologist worked with these students, and
COMMUNITY MENTAL HEALTH SERVICES L 49
also continued to produce papers on research for publication. He had a total of 10
papers accepted for publication in professional journals.
The new 23-bed Psychiatric Ward in the Kelowna General Hospital was formally opened on March 31, 1973. Seventeen beds were used for acute in-patient
care, and the six additional spaces were used for a day hospital service.
Discussions continued with the Department of Psychiatry, University of British
Columbia, about the placement of a psychiatric resident in Kelowna. Additionally,
the Department of Psychology, University of British Columbia, requested an internship placement for a psychology student at the Centre. Centre staff were enthusiastic about these discussions, since they considered that exposure to community
mental health at a training level was vital.
All staff members continued to be actively involved in work with other agencies
and professional groups, as well as participating in educative and preventive programmes in the community.
LANGLEY
MENTAL HEALTH CENTRE
The new Langley Mental Health Centre was expected to be ready to provide
service around the middle of December. The Centre was located in the Tower
Building at 20560—56 Avenue, Langley. It had provision for five professional
offices, a sixth space being set aside for either an additional office or play therapy
room, depending on need.
Staff included a social worker/Administrator, a part-time psychiatrist (with
a private practice in Langley), a half-time psychologist, full-time boarding-home
social worker, half-time case aide for the boarding-home social worker, and a
volunteer (on a LIP grant) acting as an activity therapist for the boarding-homes
in the area.
Prior to the establishment of the Centre, the Langley area had been serviced
by the Maple Ridge Mental Health Centre. The Centre's serving area had a
population estimated at 31,000, and included Langley city, Langley township,
Fort Langley, and South Aldergrove.
MAPLE RIDGE
MENTAL HEALTH CENTRE
The Centre remained very busy in the field of direct service. There were 687
active cases on the case load as of the end of September, and an average of 40
new cases were seen each month.
The co-operation with local agencies increased during the year. The Centre's
psychologist acted as chairman of a local committee, pointing out the need for a
local resource for disturbed children in the area. After the brief was presented,
a meeting was held with the Central City Mission, who proposed to build a new
modern resource for children, including a group-living home and also a day-care
service, on a 40-acre ranch on the outskirts of Maple Ridge. A bus would transport
the children to school so that there would be as little disruption of their life as
possible.
L 50 MENTAL HEALTH BRANCH REPORT, 1973
Weekly parental education groups were held in the evening at the Centre.
The local Homemakers also held courses at the Centre for disadvantaged mothers,
covering subjects such as nutrition and child care.
An educational psychologist was appointed in the local school district and
worked in co-operation with the Centre's psychologist, screening Kindergarten
and Grade I pupils for early recognition of perceptual disorders.
The local physicians gave approval to the concept of a local psychiatric ward
in the general hospital, which would also serve the Mission area. It was hoped
that the building would be under way during 1974.
The local physicians formed a medical association which dealt with health
concerns within the community, instead of confining their activities, as in the past,
to strictly hospital concerns. The Centre was a member and actively involved in
the association.
The Community Services Council was also very active in this region, pinpointing the social needs of the community and making plans to implement these
needs. The Maple Ridge Mental Health Centre was closely involved with Community Services and the Crisis Centre.
This year marked the start of progress in the local boarding-home programme,
and constructive and long-term planning became possible. This was made possible
by the close teamwork of all involved in this programme—local programme staff,
Centre and headquarters personnel, plus various other multicommunity agencies
and volunteers, residents, operators, and boarding-home staffs. The case load in
the Maple Ridge/Mission areas included an average of 200 residents in various
stages of recovery, in some 15 licensed homes in both areas. Highlights of the
year included the introduction of group sessions for residents; incentive allowances
to give residents work experience; increased activities both within the homes and
in communities, with participation from residents in planning; a workshop to give
more training for boarding-home operators and their staffs; Mission Workshop
established on full-time basis; Summer Camp at Hope, plus regular bus trips; more
individualized personalized services for residents with emphasis on rehabilitation
and self-help; visits to the Centre by Riverview patients, on a pre-boarding-home
programme; the LIP Volunteer Instruction Programme; regular newsletters twice
monthly to boarding-home operators to communicate changes in policy and
programmes.
An occupational therapist was appointed to the area, and she worked in
conjunction with the activity therapist and the total boarding-home staff. A coordinator of volunteers was appointed under a local LIP Programme, and volunteers
were to be trained to help the residents of boarding-homes develop their own
potential.
A survey of sexual attitudes in high school children was carried out by the
Centre and the Narcotic Addiction Foundation. There was also a drop-out study
done during the summer by a university student.
On May 2, 1973, a successful Open House was held at the Centre, with
approximately 60 people in attendance.
On May 22, 1973, the boarding-home social worker and the Centre's Director
presented a brief to the Standing Committee on Welfare and Education on the
need for upgrading the boarding-home programme. The result was an increased
awareness in the boarding-homes, and various workshops were proposed. A new
boarding-home social worker was appointed for the Mission area.
The Centre's psychologist and a public health nurse started a workshop to
help mothers of pre-schoolers improve their relationship and management skills.
COMMUNITY MENTAL HEALTH SERVICES L 51
A class for seven emotionally disturbed boys was set up at the Maple Ridge
Mental Health Centre. The teacher used a behaviour-modification approach to
improve work habits. Parents were invited to six two-hour evening sessions, aimed
chiefly at improving family communication.
NANAIMO
MENTAL HEALTH CENTRE
The staff of the Nanaimo Mental Health Centre consisted of a social worker/
Administrator, a clinical psychologist, a stenographer, and a medical records receptionist. In early October the Centre secured the services of a psychiatric social
worker, who added to the direct and indirect service capability, particularly in the
area of group programmes. There were also a part-time pharmacist and boarding-
home social worker. Psychiatric consultation and assessment services were permitted two days a week.
The Centre served a population of approximately 54,000, extending from
Nanaimo to Qualicum, and south to Ladysmith. The Parksville-Qualicum area was
served by an interdisciplinary travelling clinic on a weekly basis.
A large proportion of staff time during the year was spent in the area of community organization, specifically working with statutory and non-statutory agencies
to establish referral structures, eliminate service overlap, and implement measures
to avoid agency fragmentation. The Centre was deeply involved in the development
of a community Resource Board, which would provide consultation, advisory, and
assessment services to agencies within the Nanaimo Regional District. The Community Resource Board would be a vehicle whereby agency role definitions could
be clarified, and an integrated social service delivery system facilitated. Subcommittees oriented toward specific problem clusters such as special education,
youth, and residential facilities had been established.
The Nanaimo Mental Health Centre provided consultative services related to
mental health programming through representation on such organizations as
NARCO, Steps to Maturity, CMHA, Family Life Association, the proposed Reception and Diagnostic Centre, Family Division of Nanaimo Provincial Court, HOPE
Centre, Malaspina College, and the Nanaimo Neurological and Cerebral Palsy
Association-
Through the Nanaimo Family Life Association, the Centre was active in
facilitating the development of a training programme for volunteers who would
work as lay counsellors in a number of private agencies within the catchment area.
Due to the success of the initial course, the programme was taken over by Malaspina College, with university credit granted upon completion.
In May, in conjunction with the Central Vancouver Island Health Unit, the
Centre's psychologist developed a programme designed to provide, on a continuing
basis, guidance in child development to parents of children under the age of 5. This
preventive "drop-in" programme provided services to approximately 175 parents.
Plans to expand this programme into regional self-help groups were under discussion
at the year-end.
The demand for direct treatment remained relatively high, although there were
indications that the expanded Family Life Association programme would be able
to cope with an increased number of marital and family situations. Centre staff
provided direct service to individuals and families, through individual and group-
L 52 MENTAL HEALTH BRANCH REPORT, 1973
therapy situations. Assessment and consultation services were provided on request,
with a minimum waiting period. Referral sources included all statutory and nonstatutory agencies, with a provision for self-referral.
Two groups of patients were being assessed by the Centre prior to admission
to Provincial hospitals. All psychogeriatric patients referred to Valleyview Hospital
were screened by Centre staff. Either a priority was assigned for admission, or an
alternative resource was suggested. Secondly, the majority of organically braindamaged patients under the age of 70 who were referred to Riverview Hospital were
being assessed by the Centre in an attempt to utilize Riverview in the most productive manner as possible. The Centre was continually involved in facilitating a close
liaison between the Nanaimo Regional Hospital and the Provincial institutions.
NELSON
MENTAL HEALTH CENTRE
In September the Centre acquired a psychiatrist and a community health nurse,
which enabled the Centre to proceed with many new developments. Although
direct therapeutic cases were accepted for service in ratio to the number of problems
in the area, the Centre's main objectives were consultation and community education, which were considered the most effective means of providing the widest
community-based mental health service.
Despite reduced staff during most of the past year, the Centre achieved a
number of direct therapeutic interventions, and was particularly pleased with its
involvement in the community.
There was a strong move in the community toward outright integration of all
statutory and nonstatutory services, which required much intense study.
The Centre provided consultation to, and received direct referrals from, the
Kootenay Vocational School. Staff were involved in the original planning for
ASPIRE, an intensive programme to deal with drop-outs, sponsored by the Department of Human Resources and the School District No. 7 Board. Presentation was
made to the Post-secondary Education Committee concerning the retention of Notre
Dame University. The Centre continued to work toward preventive and therapeutic
measures being applied by nonteachers in classroom settings. Staff pursued case-
finding, primarily through the schools, to locate and treat the 5 per cent of children
who required acute care. More than 12 per cent were mentioned in the CELDIC
Report as requiring some degree of care, which would represent 720 children and
their families in the Centre's serving area. These figures led to meetings with
members of the school system in an effort to cope with this monumental problem.
In addition, the Centre would be increasingly involved in the community and educational television programmes in the area.
The Centre continued to provide consultative service, to utilize volunteer case
aides, and to be involved in their selection and training.
The Nelson Community Service Centre increased in strength and offered wider
services. The Nelson Mental Health Centre provided case consultation and was
also consultant to the Board. The goal of the Nelson Mental Health Centre was to
see similar community service centres, available on a 24-hour basis, established in
all the communities it serves.
The Centre continued to provide programme and case consultation to the New
Denver Youth Centre, a Regional Youth Resource. Similarly, it provided pro-
COMMUNITY MENTAL HEALTH SERVICES L 53
gramme and direct therapeutic consultation to the Dr. Endicott Home. An Activity
or Sheltered Workshop, originally promoted by the Centre through the (Nelson)
Professional Advisory Board, became a reality under the Kootenay Society for the
Handicapped.
The Centre was fortunate in acquiring the services of six summer students, one
of whom served as office and case aide, and five others assisted in developing and
applying the Students Summer Outdoor Activity Programme for a period of two
months, for a number of emotionally deprived or disturbed children ranging in ages
from 10 to 16. This successful programme indicated the need for such activity on a
year-round basis, rather than a short-term student-hiring programme.
Centre staff continued with ward rounds at the Columbia Psychiatric Unit.
The Nelson Mental Health Centre was deeply involved in planning for psychiatric
facilities at the Kootenay Lake District Hospital. Day Care and Rehabilitation
Programmes were established, as well as a group for depressed patients.
During the year the Centre was also involved in a multiplicity of meetings
involving the Canadian Mental Health Association, Mental Health Branch regional
meetings, nurse and other professional seminars, and the United Appeal, and provided consultation to health care and a large number of other nonstatutory services.
NEW WESTMINSTER
MENTAL HEALTH CENTRE
In terms of both direct and community services, 1973 was a very active year
for the New Westminster Mental Health Centre. There was an increase in direct
service to residents of the area, accompanied by an improvement in "sense of community." The latter was evident in increased interaction with a broader array of
local resources-
Centre staff continued to attend to the combined tasks of planning and enacting Riverview Hospital regionalization, as related to the Centre's catchment area.
January saw the beginning of a range of functions, including an evening therapy
group for married couples, field placement of a student public health nurse, a survey
of demand and supply regarding local community mental health facilities, and a
vigorous search for alternative premises for the Centre.
By February the Centre felt an influx in direct service requests. This coincided
with an increase in the demand for community service, including active participation in the development of general hospital psychiatric facilities. The Centre was
able to retain the services of a psychiatrist for four half-days per week, raising the
complement to about V/% mental health centre professionals to serve an urban area
population of approximately 55,000.
Centre staff continued to be involved in advisory-consultative work with community self-help groups such as the local Detached Youth Programme, the Mental
Health/New Westminster (CMHA), City Social Services Department, mental
health centre activity and socializing groups, and the Share Society, including the
Lifeline Crisis and Information Centre in Coquitlam. Liaison was either started
or maintained with Parents Without Partners, the UGN Budget Review Committee,
the YM-YWCA Board of Directors, and a school-organized committee concerned
with developing an anti drug-abuse programme in the schools.
Completion of the Community Mental Health Facilities Survey for the area
was accompanied by continued involvement with negotiations regarding the major
L 54 MENTAL HEALTH BRANCH REPORT, 1973
institutions of the Mental Health Branch (Riverview, Woodlands) and local community resources. These activities, plus the continued flow of direct service demands,
extended the waiting period for service to about two weeks on the average, increased
the need for additional pharmacy service, and forced the Centre to consider its
limitations, particularly in respect to trying to serve adequately the Maillardville
(Coquitlam) portion of its catchment area.
A number of staff was involved with the planning of various picnics and camps
set for the summer.
Co-operative planning of a Conjoint Family Therapy Workshop for the benefit
of workers from various local resources resulted in a programme spanning 10 weeks
at the Centre, led by staff from the B.C. Youth Development Centre's Family and
Children's Clinic.
By mid-summer, another sessional psychiatrist was recruited, enabling more
active involvement with development of the Royal Columbian Hospital psychiatric
facility, and ongoing consultation with school personnel.
The staff moved to much-needed alternative quarters during August, which
relieved the increased congestion, and improved morale of staff and clients alike.
The Centre provided a community placement extending 10 weeks for a number
of students from the Psychiatric Nursing Programme at the B.C. Institute of
Technology.
During the fall the Community Adult Psychiatry Service associated with this
Centre became a priority and more staff would be available for this programme.
It was anticipated that this staff would continue with the planning and operation of
the Day Hospital at Royal Columbian Hospital.
Although there were six privately practising psychiatrists in New Westminster,
strong pressure for direct services remained on the Centre, particularly in the
follow-up of longer-term situations, for family therapy and other group work, and
for assistance when multi-agency work is indicated.
PENTICTON
MENTAL HEALTH CENTRE
In 1973 the Penticton Mental Health Centre witnessed a year of preparation
and hopeful anticipation. The Centre staff included a full-time psychologist, a full-
time boarding-home social worker, and a social worker and mental health nurse
who each worked half-time with the Centre and the Penticton Regional Hospital.
Efforts of lay persons and lay groups, as well as the members of the professional
community, were directed toward review of the Penticton Profile (a community
study done in 1969), of the CELDIC Report, the Hastings Report, and local submissions to Dr. Foulkes' Health Security Programme Project. A widely represented lay and professional Ad Hoc Committee for Penticton and district was formed
to study the implications of the planned integration and co-ordination of health,
welfare, and educational services, both Government and privately sponsored, and
to take the steps necessary to establish a community resources board. As an adjunct
to this future organization and its function, the Penticton Health and Welfare
Association asked its 15-member voluntary organizations within the community to
submit their operating budget for 1973 to the association in efforts to develop a
global budget for voluntary organizations within Penticton and district.
Several features of the Penticton Mental Health Centre influenced its role
within the Penticton community and the Okanagan-Similkameen region during the
COMMUNITY MENTAL HEALTH SERVICES L 55
year. The three private psychiatrists and the child-developmental specialist utilized
sessional time only for consultation and education within the community and region.
Sessional time was allocated by group decision on an ad hoc basis, according to
existing commitments and new requests made to the consultants and staff of the
Centre. The Centre staff and consultants had the support and involvement of a
25-member regionally appointed Board of the Okanagan Similkameen Society for
Community Mental Health. The Board was organized in March 1972 to promote
co-ordination and integration of services to the region through assessment of community needs and through appropriate planning to meet those needs. A 12-member
professional multidisciplinary Advisory Board to this society was also the Advisory
Board to the South Okanagan Human Resources Society, the Penticton Mentally
Retarded Association, the Penticton Health and Welfare Association, and the newly
formed Okanagan Similkameen Housing Society for Handicapped Citizens. The
consultants and the Administrator of the Centre attended the Advisory Board meetings. The efforts of the regional representatives toward increased awareness of their
respective communities, and the promotion of community mental health concepts,
enhanced the Centre staff's involvement in these outlying regions.
The close relationship with the Penticton Regional Hospital, through shared
staffing and regular Centre/Hospital liaison meetings, fostered an orderly network
of psychiatric services to the community. The mental health nurse, the social
worker, and psychiatric unit nursing personnel provided patient assessment and
consultation in the management of nursing care problems within the hospital. The
1973 summer student programme of the Centre, augmented by a hospital-sponsored
summer student programme, permitted a recreational activity programme to be provided from May to September at the hospital for in-patients and day-care patients.
The Centre's involvement with Youth Guidance Councils in schools in the
region (as well as other consultative and educative services to schools), revealed a
mutual concern for the 13 to 14-year-old potential school drop-out. A brief entitled
Nowhere to Turn, prepared by the Summerland Youth Guidance Council, was
presented to various Government departments.
Centre staff were active in the formation of a society to establish a group-living
home for mentally handicapped adults in the Penticton area.
Four street workers were hired through special Federal and Provincial grants
as an alternative response to local public and civic opposition to a summer youth
hostel. Centre staff provided clinical supervision and had membership in the multi-
disciplinary group providing joint administrative supervision. The programme was
continued after the summer months were over.
Major steps were taken to make the Penticton Training Centre a Work-training
Programme and Assessment Centre, as well as an Activity Centre and Sheltered
Workshop. Consultation by the Centre staff focused on assisting the Penticton
Training Centre to provide a broader service to the community.
The Naramata Centre for Continuing Education (sponsored by the United
Church of Canada) provided half-way house accommodation and work experience
for Centre patients. There was also co-sponsorship of educational programmes and
consultation to the Naramata Centre staff. The Sorrento Centre (sponsored by the
Anglican Church of Canada) requested consultation services and offered their
facilities and programmes for patients.
Services begun in the first year of operation by the Centre staff were continued
and extended. Emphasis changed as needs have changed. The philosophy has been
to consider staff roles (as skilled clinicians and community workers) primarily as
enablers or catalysts within the community and region.
L 56 MENTAL HEALTH BRANCH REPORT, 1973
PORT ALBERNI
MENTAL HEALTH CENTRE
During the year a full-time psychiatrist joined the staff of the Centre. Since
the Port Alberni Mental Health Centre opened, the admissions to Riverview dropped
from 30 to 16. Out-patient services to adults were greatly expanded. New referrals reached a high of 60 new adult cases in one month, to an average low of about
30, including approximately five new chronic cases, 17 family and marital problem
cases and eight cases of individual neuroses and psychosis.
The clinical demands for services remained strong in the adult population;
however, other community resources were also meeting these needs. Family Guidance, Human Resources, Public Health, and local physicians carried a large number
of cases, which sometimes required consultative services from Centre staff.
Staff continued to plan to achieve group meetings for chronic patients, through
the use of community volunteers and the creation of some kind of drop-in or daycare centre.
Headquarters and Centre staff met with the administration and Board of the
Port Alberni General Hospital to discuss plans for a 20-bed psychiatric ward,
together with a 30-patient day hospital facility. The Centre's psychiatrist was on
a committee which worked toward developing concrete plans. Services for chronic
patients improved since Riverview staff visited the Centre. The family physician
played a key role as he dealt with most of the chronic patients, and the psychiatrist
was used as a consultant.
About 15 new child referrals were activated each month, most of these were
seen by the psychologist, who was very active in consultation with personnel within
the school system and throughout the school district. Consultation was directed at
helping the school personnel to understand and manage children with emotional
and learning problems.
The psychologist consulted closely with School Board personnel in planning
an alternate school programme, commencing in January 1974, for drop-out secondary school students.
The psychologist, in conjuiction with Human Resources, Public Health, and
the School Board, did an activity-oriented programme for 21 school-aged children
during the summer. It helped children function better, provided clear diagnostic
pictures of children, and aided in making plans for the school-year. Perhaps one
of its major contributions was that it brought many agencies and parents together
working toward helping disturbed children.
The past year was a very active one in terms of Centre involvement in the
community.
An interesting experiment was conducted during the month of October, in
which the psychologist helped school counselling staff select 12 exceedingly disturbed children, suffering from a combination of physical and emotional disturbances, for a special class. The School Board provided a special teacher. In addition,
the Centre's psychiatrist, social worker, and psychologist spent one and a half hours
each day for two weeks in the classroom, in order to arrive at diagnostic and handling
techniques for school personnel. In preparing these assessments the psychiatrist
worked closely with the general practitioners on the medical aspects of each case.
The experience seemed to work well and might prove the basis of further combined
efforts in the area of seriously handicapped children within the school setting. Plans
were made to have a therapy room in the school, where school, public health, and
COMMUNITY MENTAL HEALTH SERVICES L 57
mental health personnel would be used in joint therapy roles for these children outside the classroom as a treatment adjunct to the classroom setting.
At the invitation of the School Board, Centre staff consulted with Human
Resources in the establishment of the day-care centre and a single-parent educational plan for the Alberni school system. It would serve two important functions
aside from the educational goals, one was preventive mental health, and the other
was direct counselling services.
Staff worked with the public health nurse, the school principals, and local
doctors in the Tofino-Ucluelet area. Bamfield was served on an individual case
basis, and in most instances the patients came to the Centre. Several trips were
made to Franklin River and increased service demands were anticipated.
Several meetings were held with representatives of local native groups to discuss mental health programmes relating to their needs.
Staff were involved on a consultative and planning basis for a possible community resources board.
The psychiatrist was actively involved in the West Coast General Hospital on
a consultative basis, which involved approximately 12 additional patients per month.
The hospital agreed to dispense medications from their pharmacy, which were
previously available only by mail from the Nanaimo Centre.
Centre staff continued with all sorts of community activities, perhaps the most
significant single group being the interagency group which met every second week
throughout the school-year.
During the year the mental health staff had direct working relations with Family
Court, Family Guidance Association, Retarded Association, School Board, Service
Groups, Human Resources, Ministerial Association, Parks and Recreation, RCMP,
labour and management groups, medical group, nursing group and others. Staff
relationships with community agencies were gratifying and co-operative.
The Centre was grateful for the co-operation and help of Public Health staff,
whose nurses cared for chronic patients, made home visits for the psychiatrist, and
were very active in the schools.
PORT COQUITLAM
MENTAL HEALTH CENTRE
In August 1973 the Port Coquitlam Mental Health Centre completed its
second year, in a catchment area with a greatly increased population. The main
focus remained on children and their families, both in offering direct treatment
and in providing a consulting service to the community, to help increase services
for children. Staff services were provided through the Centre in Port Coquitlam,
and the Simon Fraser Health Unit in Coquitlam.
During the year the Centre was again instrumental in organizing and running
a camp for children with emotional and social problems. This was the second year
for the camp, and both organization and staffing were also provided by the mental
health centres in Maple Ridge, Chilliwack, and New Westminster, and the Family
and Children's Clinic in Burnaby. The Centre ran several therapy groups throughout the year for early and pre-adolescent boys and girls.
In the community, Centre staff participated on an interagency committee,
working to organize a community school in Coquitlam and one in Port Coquitlam.
L 58 MENTAL HEALTH BRANCH REPORT, 1973
Staff continued to work with a committee toward a residential treatment centre for
children, and along with a committee from Port Coquitlam toward opening a
pre-school day centre for children with emotional and behavioural problems.
The adult services the Centre offered increased greatly with the start of the
Community Adult Psychiatric Service (CAPS) programme in July. The programme was staffed by a psychiatrist who worked half-time at Riverview and half-
time in the community, a community mental health nurse, and a stenographer. The
main focus of the team was toward the patient who may require hospitalization,
with a growing emphasis on preventive services. Prior to the arrival of the CAPS
team, a community-based society had been formed to operate a sheltered workshop
for chronically emotionally disabled adults.
POWELL RIVER
MENTAL HEALTH CENTRE
The Centre's second year of operation, 1973, saw the consolidation of its
total programme. The specific services offered by the Centre were more fully
integrated into the fabric of the total Community Service Network.
A basic problem was striking a balance between direct treatment of referred
patients and indirect treatment through consultation. The patient load grew steadily,
and created difficulties in the provision of sufficient consultative time. However,
regular meetings were established with Public Health and Human Resources
personnel, and on a more spontaneous basis with the school and probation authorities. In addition, the psychiatrist acted as consultant to a burgeoning Association
of Children With Learning Disabilities. He also participated on a Community
Health Committee to look into community health care, and a submission was
prepared regarding the Centre's role in a totally integrated Health Care System
for Powell River. The psychiatric social worker acted as consultant to the Youth
Services Association, a community umbrella group concerned with services to
children. She also held regular sessions at the Group-living Home for Girls, which
took the form of "milieu therapy."
Two programmes of special note were the development of a volunteer group,
and a research project on the effectiveness of direct patient treatment. During the
eight months of operation the volunteer programme proved to be a very successful
venture. One of the most interesting features was that some of the most difficult
"hard-core" cases achieved the most significant improvement with a volunteer.
Prior to the setting-up of the formal research project, a limited project was
attempted by the Centre which involved a questionnaire to find out about the
patients' moods and feelings before they were seen on their first visit. It was
hoped that the questionnaire could then be repeated some three to six months after
the first visit, to determine if there had been any change.
With the employment of a summer student, the research study was designed
around the repeat use of the original Self-evaluation Questionnaire. Also, through
personal interview, as well as measuring the change in people's feelings about
themselves, staff attempted to measure their feelings about therapeutic treatment,
using three categories—satisfied, undecided, and unsatisfied. Changes in feelings
were scored numerically and comparisons made to such things as diagnosis, age,
and number of visits. The major diagnostic categories were family problems,
neuroses, psychoses, and personality disorders.
COMMUNITY MENTAL HEALTH SERVICES L 59
PRINCE GEORGE
MENTAL HEALTH CENTRE
With respect to both in-patient and out-patient psychiatric care, 1973 saw a
significantly more active involvement with the local regional hospital. Regular
direct liaison on in-patients was developed. Out-patient care involved both direct
follow-up by the Prince George Mental Health Centre after hospitalization, and
active participation by the Centre in out-patient programmes. The mental health
nurse and the psychologist each developed group programmes for out-patients in
a private dwelling adjacent to the hospital, which was leased by the hospital for
use as an in-patient and out-patient group and activity resource.
A closer liaison with Riverview Hospital developed in 1973. An effective
Boarding-home Programme meant more communication with Riverview in the area
of planning for local placement of chronic patients. Increased input from the Centre
into the local psychiatric ward of the general hospital was another factor. Visits by
Centre Lawn staff to northern communities were a further significant contribution
to improved communication between Riverview and the Prince George Mental
Health Centre. In June, five staff members from Centre Lawn visited Terrace,
Smithers, Houston, Burns Lake, and Prince George. They met and spoke to various
community groups and met with all staff of the northern mental health centres—
Williams Lake, Fort St. John, Prince George, Terrace, and Prince Rupert. A more
meaningful understanding was accomplished with regard to pre-admission, care, and
after-care- In November, Centre Lawn staff again met with the mental health
centres in Terrace.
At the year-end there were 37 patients in boarding-homes and it was expected
this would increase to at least 50 in a short time.
In addition to direct treatment and consultative and educative relationships
with local public and private agencies, the Centre was closely involved in social
planning. The Centre is a member agency of the newly created Fraser-Fort George
Regional Community Services Board, which held its founding meeting in October.
The Board was patterned after the CELDIC idea of neighbourhood councils represented on a community services board. The Board appointed three committees to
carry on activities—an Interdepartmental Committee to find ways in which public
agencies could work together, a Child Care Resources Committee to determine
needs for new services in the community and to find ways of avoiding duplication,
and an Interdepartmental In-service Committee to provide cross-agency in-service
training. The Centre was represented on all three committees.
Consultative visits to Vanderhoof and Burns Lake were continued throughout
1973, and Mackenzie, with a population of approximately 5,000, was added to the
list during the year.
The Centre's psychologist organized and directed a study in the Burns Lake
area to assess school needs. The study was done in co-operation with the local
school district and Public Health, and was completed and published in August. As a
result of this study the Burns Lake School District provided funds and hired a
psychologist for the district. At the year-end the psychologist was carrying out a
study in Mackenzie to determine community incidence of mental and emotional
problems and to acquire guidelines for needed services. This study was being done
in co-operation with the public health nurse in Mackenzie.
No regular visits were made to McBride and Valemount, but liaison was made
through the public health nurse in McBride. Medication was supplied to patients
L 60 MENTAL HEALTH BRANCH REPORT, 1973
in this area by the Centre through the public health nurse. The latter was instructed
to contact the Centre by telephone for any emergencies, consultations, or requested
visits.
The mental health centre in Fort St. John was left without professional staff
in September on the resignation of the mental health nurse, and a visit was made
by the Prince George Administrator in October to arrange for continuation of
pharmacy services and to meet with local representatives of Public Health, Department of Human Resources, RCMP, and the hospital.
PRINCE RUPERT
MENTAL HEALTH CENTRE
The Prince Rupert Mental Health Centre was officially opened on October 5,
1973, by the Co-ordinator of Mental Health Centres. The staff consisted of the
Administrator and a clerk-stenographer. The Centre's catchment area included
Prince Rupert and the Queen Charlotte Islands, with an over-all population of about
27,000. However, referrals for assessment and treatment came from as far south
as Bella Coola, and as far north as Port Simpson and Kincolith. Prior to the opening, which was followed by an Open House, the Administrator had established
liaison with the health, social, and educational agencies in an attempt to communicate and co-ordinate existing services. A Community Resource Council was set up
under the Societies Act to try to co-ordinate the services of many of these agencies.
A Child Guidance Clinic was also established to assess and review the needs of
children.
Although Prince Rupert was expanding slowly and steadily, it remained a
transient area, with a very high turnover of population and a heavy demand for
direct services. The total case load at the end of October was 89. Prince Rupert
also had a strong cosmopolitan population.
Consultation work with teachers, counsellors, probation officers, social workers, public health nurses, and day-care workers was a vital part of the Centre's role.
The Centre operated on an open referral system, but referrals came through most of
the established agencies. Consultation also took place with the planning groups on
the Queen Charlotte Islands, including the Regional Queen Charlotte Islands Health
and Human Resources Council and the Masset-Haida Steering Committee, as well
as the Queen Charlotte City, Sandspit, and Skidegate Steering Committee. The
Queen Charlotte Islands was one of four communities that had been selected as
a pilot project to establish a Human Resource and Health Centre. This ground swell
of interest in community involvement, planning, and restructuring, in order to coordinate existing services and allow for greater accessibility and availability of services, meant more intense involvement in consultative work. The clinical aspect of
the services also remained an important function of the role of the Centre.
SAANICH
MENTAL HEALTH CENTRE
The Saanich Mental Health Centre continued to operate under the open referral system and accepted referrals from many community agencies, individuals,
COMMUNITY MENTAL HEALTH SERVICES L 61
and from the community physicians. The active case load continued at a high level,
and the pattern of referrals seemed to indicate that the Centre was providing services
for clients from more remote areas in the district, as compared with the Centre's
first months in the Royal Oak area. All staff members continued to work in close
collaboration with the public and private agencies serving the people of Saanich,
Central Saanich, North Saanich, Sidney, and the Gulf Islands. Principal activities
included diagnostic assessment, treatment, and many supportive services in consultation with other community agencies. Staff were concerned with the need to extend
preventive services to try to reduce the incidence of emotional illness.
In addition to activities at the Centre in Royal Oak, visiting teams or staff
members worked in Ganges, Sidney, and Brentwood. Part of the purpose for this
was to assess the local community need for a service delivered in close geographic
proximity to the location where the problems were occurring. In most instances
the principal utilization of these outreach facilities was by persons who, for reasons
of infirmity, illness, or poverty, were unable to arrange transportation to the central
location.
Staff members from this Centre participated in supportive work with the Cornerstone Project, a resocialization and rehabilitation programme developed jointly
by the Canadian Mental Health Association and the Cordova Bay Irregulars, a
citizens' group in Cordova Bay. Personnel also worked with several other projects
initiated by laymen to develop programmes to train laymen in the area of providing
services to those in need. Of these programmes, the Centre's participation in the
Citizens' Counselling Centre in Victoria was particularly rewarding. Staff worked
closely with this group and the Saanich Peninsula Guidance Association, as well as
marriage-counselling services conducted by volunteers in 25 other British Columbia
communities to help establish the B.C. Family Life Association. This was a
Provincial organization to support, encourage, and help initiate new marriage
counselling and guidance facilities staffed principally by volunteers. The Centre was
particularly concerned with problems related to the selection, training, and supervision of voluntary counsellors.
Staff members in the Saanich Mental Health Centre developed close, cooperative, and effective working relationships with staff members of other agencies
serving people in need of help, and it was planned to continue to expand and develop
this interagency involvement. In the new year the Centre also hoped to expand
indirect services, and maintain the assessment and treatment load.
SECHELT AND SQUAMISH
MENTAL HEALTH CENTRES
Mental health centres were established in Sechelt and Squamish toward the
end of the year. A psychologist was recruited for the Sechelt office and a mental
health nurse for Squamish. In addition to serving the Sechelt area, the psychologist
would provide some consultation to Squamish. Staff time was initially occupied
with orientation to various community agencies and practitioners, and the setting-up
of an office operation. Prior to acquiring office space, a number of patients were
given direct treatment in the psychologist's home, the client's home, or in offices
provided by other Provincial agencies.
L 62 MENTAL HEALTH BRANCH REPORT, 1973
SURREY
MENTAL HEALTH CENTRE
Approximately half of the staff psychiatrist's three to five sessions per week
comprised assessments of new clients, and half comprised ongoing assessments of
regional boarding-home residents. Weekly sessions of group therapy were also
provided.
The mental health nurse spent approximately two-thirds of her time on direct
and consultative services to clients, including group work, and the remainder of
her time in helping to develop community services. She left on an educational
leave of absence in June and her replacement was mostly involved in direct service
to Centre clients, which included an emphasis on service to children in play therapy
and child management counselling. Other direct services included individual
counselling for adults with chronic and acute problems, marital counselling, and
some family and group-therapy sessions. Her involvement in community services
included a number of community organizational meetings and educational sessions.
The boarding-home social worker was highly successful in organizing the
Boarding-home Programme; and the case aide spent some time doing behaviour
modification with several individuals in the boarding-home. The activity therapist
promoted independence among the boarding-home residents and was gradually
achieving her objectives. The Co-Getters Club, a social activity club, was run
entirely by the boarding-home residents. She also spent considerable time in
organizing transportation, and other volunteer services, for the Boarding-home
Programme.
The mental retardation social worker continued her survey of services to the
retarded in the areas served by the Surrey and Whalley Mental Health Centres.
She also had some direct service responsibilities and continued to act as liaison
between Woodlands and the community.
The pharmacist provided medications to the Centre's clients and the boarding-
homes.
The social worker (regional consultant) was the most active direct service
team member throughout the year and also continued to participate in community
projects. He was active in Deltassist and on the Delta Social Agencies committee,
ran Post Partum Depression groups, training groups for public health nurses,
marriage counselling groups, and a group for parents of children on drugs.
A psychologist and a mental health nurse volunteered up to five sessions a
week to the Centre all year to run groups, do assessments, marriage and family
counselling, and community projects. They provided invaluable assistance.
The Administrator devoted a good deal of her time in community projects and
Centre administration. The projects included development of a Surrey Learning
Disabilities Project Proposal; helping to establish a Surrey-White Rock Family Life
Association; setting up a series of eight free community legal forums ranging from
"Mental Patients and the Law" through "Matrimony, Divorce, and the Law";
participating in several free child management courses; developing a tutorial and
counselling service; organizing and supervising community survey of social services
and learning disabilities services; as well as delivery of individual assistance to
several pre-schoolers who showed signs of autism, with the help of eight incentive
workers in Surrey. Direct service contributions comprised individual assessments
and follow-up, and innumerable group-therapy sessions with adolescents in Surrey
and Delta.
COMMUNITY MENTAL HEALTH SERVICES
L 63
TERRACE
MENTAL HEALTH CENTRE
The primary aims and objectives of this Centre continued to be the development of comprehensive mental health services within the local community. The
focus was in the direction of primary prevention and education. Centre staff promoted the uniting and utilization of nonpsychiatric agencies to assist in this endeavour, as well as to meet the day-to-day requests for direct treatment. It was
felt that gains were made in this direction during the year, with the result being a
more comprehensive and meaningful service to the consumer. An additional benefit
to the unification of resources, both in terms of health and social services, was the
ability to reflect and identify the special needs of the community served.
The development of community services did not negate the responsibility of
the Centre to provide direct treatment, both on an interim and ongoing basis, to
meet the large demand for these services.
The area the Centre covered geographically was extremely large, and included
the Skeena Health Unit (other than Prince Rupert), Ocean Falls, and the Queen
Charlotte Islands. There was a regular travelling clinic to Kitimat, Hazelton,
Smithers, and Houston. The clinic's most northern visit was to Telegraph Creek.
Staff members included a psychiatric social worker, a boarding-home social
worker, and two stenographers. The position of clinical psychologist was filled
until September. Psychological and psychiatric consultation was provided by the
Victoria Mental Health Centre and the B.C. Youth Development Centre. Pasdiatric
assessments were provided on a sessional basis by a local paediatrician. The medical
staff of both the Kitimat and Terrace hospitals appointed a local doctor as a liaison
person between this Centre and the physicians.
The total number of activations and reactivations of files from October 1972
to October 1973 was 417. This is a significantly high number in terms of size of
staff and the large geographical area covered.
The promotion of new services also meant the upgrading and expansion of
the present ones, and a great deal of emphasis was placed upon in-service education.
For example, Centre staff actively provided in-service assistance to social agencies,
schools, the Northern Training Centre, clergy, police, nursing staff, Skeenaview
Hospital, family physicians, and local volunteer groups.
Progress toward regionalization of Riverview Hospital continued throughout
the year. This was received favourably by the local communities, both in terms of
a better service offered and also in terms of co-ordination of services and communication between community and hospital.
The Centre received requests for help from expanding communities and industry. There was a possibility that a small industry might develop in one of the
communities, and the Centre was asked to assist in forecasting some of the social
changes that a new industry would bring a small community. Assistance was also
provided to a local industry which inquired about their responsibility to their employees, over and above the normal salary and staff benefits. Centre staff met with
the management and made some tangible recommendations to assist the employees
and their families.
During the year, Centre staff provided consultation to pre-schools, nurseries,
Community Resource Councils, child care workers, schools, the Northern Training
Centre, the Skeena Union Board of Health, and other social agencies.
L 64 MENTAL HEALTH BRANCH REPORT, 1973
The goals established for 1974 were to continue to assist communities developing local resources, with the emphasis on community involvement, and to continue
to offer indirect services through education, consultation, and community organization, as well as meet the Centre's responsibility to provide direct services.
TRAIL
MENTAL HEALTH CENTRE
During 1973, Centre staff continued to make every effort to maintain an effective service to the people in the region. The problems of quantity versus quality,
direct versus indirect services, expansion versus concentration of efforts, faced by
most mental health centres, were in constant review over the year. A primary
focus of the staff was to press for local integration of health and welfare services.
This was stressed in all aspects of consultation, advisory, and public education
endeavours throughout the region.
The demand for direct services exceeded that which could be effectively met
by available staff. As a result, it was necessary to terminate Travelling Clinics to
the Boundary area in June. This was planned well ahead and had the following
benefits: Mobilizing of community effort to press for residential staff, designation
of Grand Forks as a location for one of the initial integrated community health
centres, physical amalgamation of medical and public health services in Greenwood,
and greater concentration of staff time in the Trail-Rossland and Castlegar-Kinnaird
areas.
Direct service referrals continued to be made at the rate of approximately
20 per month, with a waiting period for service in most cases of about three weeks.
The summer student programme, which employed two young people in the Centre,
was highly successful, as they helped to increase direct services to children and
handicapped adults, as well as gaining valuable experience for their future careers.
In addition, the short-term placement of Public Health and Selkirk College students
was valuable to these people, although additional staff time was required to meet
the training need.
The year saw the Centre closely involved, through staff advisory and consultative roles, in the development of a number of new services in the region, and again
emphasized the need for local integration. As an advisory member to the Board
of the Trail and District Child Care Society, the Centre assisted in planning the
Group Home facility, screening prospective houseparents, and becoming a member
of the Admissions-Screening Committee. By the end of the year the Group Home
had six adolescents in residence. Staff assisted in the research, public education, and
initiation of the Trail Regional Child Day Care Society, with 16 children attending
regularly. After two years of effort the Centre was successful in the establishment
of a viable Big Brothers Association in Trail. As chairman of the Matching-Screen-
ing Committee, the Administrator was closely involved in the progress of the organization. By the end of 1973, there were 12 boys benefiting from this service.
The Centre's close involvement with the Trail Methadone Clinic led to the
continuation of the programme in this area, with greater emphasis on the counselling
and rehabilitative aspects. Changes in both the Aid to the Handicapped Committee
and the Crisis Centre Programmes resulted in part from staff participation as advisory members. These reflected the changing needs of communities, and the importance of agency responsiveness to community concerns.
The Trail and District Youth Liaison Committee continued to be a vital group
for the ongoing resolution of children's emotional, educational, and social problems,
COMMUNITY MENTAL HEALTH SERVICES L 65
as well as a vehicle through which gaps in services could be highlighted and dealt with
more effectively. Through involvement with the Association for Community Planning, Centre staff served in advisory capacities to such groups as Meals-on-Wheels,
Chimo Youth Hostel, Intermediate Care Society, LIP projects, and Project Integration (an ongoing effort by community lay and professional groups to improve
even further one of the best co-ordinated networks in the Province). This was also
fostered through staff membership in the Union Board of Health.
The Centre's close working relationship with the Canadian Mental Health
Association involved staff participation in Mental Health Week through the Centre's
Open House, radio talks, distribution of pamphlets, and other forms of publicity.
More importantly, staff members worked with the executive toward strengthening
of the educational and voluntary functions of the group. Two orientation-training
sessions for volunteers were held during the year, and in co-operation with other
professionals the Centre assisted in the development of an after-care group for those
persons with more difficult and long-standing emotional problems. This closely
involved the Columbia Unit staff of the Trail Regional Hospital in the planning and
implementation of after-care and volunteer programmes.
In the area of public and professional education, all staff were involved in such
activities as family-life group discussions; panels on drug use and abuse; marital
growth; social problems in the region; presentation to the B.C. Teachers of the
Mentally Retarded Workshop; CMHA (B.C. Division) annual meetings in Cranbrook, dealing with the emotional needs of children; and a wide range of presentation
to various groups related to the further development of effective services.
In all, the mental health programme for the year was highly successful, in keeping with the available manpower. Goals for 1974 were primarily to consolidate
the gains made, to foster greater integration, and to respond as effectively as possible
to public need within this region.
VERNON
MENTAL HEALTH CENTRE
During 1973 the staff of the Vernon Mental Health Centre tried to divide their
time appropriately between treatment programmes, consultations, community organization, and education to professional and lay groups. Staff members included
a psychologist, a mental health nurse, two psychiatrists, a social worker in charge
of the Boarding-home Programme, a full-time case aide for the Boarding-home
Programme, two full-time stenographers, a part-time stenographer, and a social
worker/Administrator.
Due to the relatively large staff, and the area's wide range of needs, the Centre
had a variety of treatment programmes, including reality-oriented brief service,
behaviour modification, marriage and family therapy, transactional analysis, and
hypno-therapy and chemo-therapy. There were two group-therapy programmes
involving about 22 patients, and efforts were being made to expand this programme.
Since the arrival of a psychiatrist in July, the Centre was able to again provide the
psychiatric ward of the Vernon Jubilee Hospital with psychiatric consultation. The
programme on the psychiatric ward included group therapy, chemo-therapy, E.C.T.,
and a new programme of behaviour modification which was going into effect at the
year-end.
L 66 MENTAL HEALTH BRANCH REPORT, 1973
All the staff members were involved in a number of community programmes
during the year. The mental health nurse helped organize a volunteer bureau.
There was a programme in Sorrento (a small community about 60 miles outside
of Vernon), where one of the psychiatrists and the social worker were used as
consultants and teachers in family therapy. This programme expanded to provide
a number of families with family therapy for a full day, each family being interviewed by three therapists.
The Centre organized a number of meetings with Public Health, school counsellors, and Department of Human Resources personnel to arrive at more specific
plans to help co-ordinate community services. It was felt that a more concerted
effort at co-ordination would provide a better delivery of services in general.
Vernon's volunteer committees and associations, such as the Social Planning
Council, North Okanagan Youth Resources Society, Canadian Mental Health
Association and CACLD were all serviced by the staff of the Centre, either as
members of the associations or on the advisory boards.
The Centre continued to provide travelling clinic services to Salmon Arm and
Revelstoke, which meant servicing a population of about 60,000.
Staff were involved in education of both professional and lay groups. For
example, under the auspices of Adult Education, the Centre provided a parent-
education course in which 90 people enrolled.
The psychologist provided consultative services on behaviour modification to
school personnel, psychiatric nurses (both in the psychiatric ward of the general
hospital and Dellview Hospital), local physicians, Department of Human Resources
staff, and public health nurses.
The Boarding-home Programme continued to be extremely active under the
supervision of the boarding-home social worker, with approximately 160 people
receiving care.
It was considered that some of the unmet needs in the area included more
intermediate care homes, and a better crisis intervention service in the outlying
areas.
During the year the Centre utilized five summer employment students, who
provided a useful addition to staff services.
VICTORIA
MENTAL HEALTH CENTRE
During the year the Victoria Mental Health Centre, with its multidisciplinary
staff, continued to meet the increasing demands for services by the community
and the various agencies. In spite of the increasing number of psychiatrists in
private practice, the Centre was still asked to give direct patient care. The Centre
was becoming highly specialized in many areas of discipline.
The Psychology Department continued to be a very busy group, providing
neuropsychological and educational evaluation to hundreds of children with learning disorders, and suspected minimal brain dysfunction. This specific function of
the Centre resulted in the development of integrated services for children and their
families. In the future this facility would become a focus for co-ordinating existing
services for children with learning disorders, minimal brain dysfunctions, autism, and
mental retardation. Such co-ordination would eliminate expensive duplication of
valuable manpower and its expertise.
COMMUNITY MENTAL HEALTH SERVICES L 67
As the service for children and families became autonomous, the remainder of
the Victoria Mental Health Centre staff would continue to provide its services to
adult patients.
Various members of the Centre staff maintained close liaison with the Attorney-
General's Department through their active involvement in the forensic field. The
Regional Consultant of Psychiatric Social Work provided a weekly visit to the
William Head Correctional Institution, as the demands for treatment for inmates
and consultation with the correctional staff increased.
The Art Therapy Programme, as in previous years, developed extensively. It
participated in the annual Geigy Pharmaceutical Art Competition and "Achievement '73," an arts and crafts show sponsored by the Community Art Council and
the Community Council of Greater Victoria.
In observance of Mental Health Week, the Centre held an Open House on
May 4, 1973, with approximately 100 people in attendance. There was excellent
coverage of this event through local television, radio, and newspapers.
Participation with various community agencies and committees allowed the
staff to become closer to other workers interested in the mental health field.
During the summer months the Centre employed university students in various
aspects of its activities. Although there were a considerable number of staff changes,
both in the professional and clerical group, the function of the Centre was never
interrupted to the detriment of patient care.
The Administrator's regular visits to the Terrace Mental Health Centre
assisted in maintaining an amicable liaison with the local physicians and other
community resources.
WHALLEY
MENTAL HEALTH CENTRE
During the year the Whalley Mental Health Centre carried between 124 and
324 cases per month. During the first 10 months of 1973, 258 new cases were
activated. In addition, the Centre also carried 42 boarding-home cases.
Whalley staff were involved in the development of the Surrey Rehabilitation
Workshop, which served up to 30 handicapped people and provided consulting and
treatment services. Clients with physical, intellectual, or psychiatric disabilities
were accepted.
Centre staff also offered social work and psychological consultation to special
teachers who were initiating a new programme for children who dropped out of
school or who presented severe behaviour problems in school. The teachers worked
individually with the children and were in contact with them in the community as
well as in the school.
In conjunction with Surrey Youth Services a continuing adolescent group session was held once a week for emotionally troubled youths.
A number of special projects were developed in the community. The Centre
assisted community groups at organizational meetings and in the provision of services. Meanwhile, Centre staff continued to work with established agencies such as
the Surrey Social Service, the Probation Department, the schools, and Public Health.
Whalley Mental Health Centre also provided speakers for groups such as the Association for Children With Learning Disabilities, the Twins' Club, Single Parents, and
the Homemaker Programme.
L 68 MENTAL HEALTH BRANCH REPORT, 1973
A summer student was employed to carry out a survey of the Centre's intake,
including all the cases which had been opened in Whalley since the Centre started.
The survey covered data on the previous psychiatric history of the clients and the
extent to which their problems involved other family members.
WILLIAMS LAKE
MENTAL HEALTH CENTRE
During its first full year of operation the personnel of this Centre, two professionals and one clerical staff, continued to provide service to the 50,000 people
in the 50,000 square miles of the Cariboo. Located geographically in Williams
Lake, staff travelled monthly for three consecutive days to Quesnel, and on an "as
needed" basis to Lac la Hache, 100 mile House, the Chilcotin, Bella Coola, and
other smaller isolated outposts.
Familiarization with people and programmes in the variety of communities was
an ongoing priority, as was the establishment of working relationships with professional and lay workers.
The model introduced in this newly established Centre accentuated the consultation and public education approaches, with limited direct service offered in
Williams Lake. All other locations were served exclusively via consultation.
In an attempt to render a communicable and responsible service, staff documented in two written briefs the Centre's semiannual goals and programmes, with
the aim of stimulating ongoing dialogue and continuing adaptation of mental health
services to community needs.
The main focus of the Centre's limited direct service was geared to providing
after-care follow-up for patients who had been hospitalized in psychiatric facilities,
and crisis intervention for people who could be helped to avoid a psychiatric hospitalization. Due to geographical and staffing necessities, this service was offered only
from the Williams Lake office, though anyone in the catchment area could apply to
be seen. Co-ordinated with this service were monthly consultation meetings with
the public health nursing staffs in Williams Lake and Quesnel, during which a joint
review was made of all admission and discharge reports of local patients in Riverview Hospital, and ongoing co-ordinated services to these patients and to their
families were planned.
Consultation was offered either by meeting with one consultee about a problem
in their case load or programming, or by meeting with local teams composed of all
community helpers involved with a referred individual. These team meetings were
a particular asset in facilitating co-ordination and reducing duplication of local services. In the schools, Centre staff included parents and, if appropriate, the referred
student, in the discussions which were based on a problem-solving approach. Detailed records of care consultations were kept, including plans for intervention and
arrangements for follow-up.
The three main geographical areas with which the Centre had most contact
differed greatly. The tremendously rapid growth of Williams Lake created new
community pressures and contributed to the fragmentation of the established socioeconomic structures and services. Growth in Quesnel, with a town population half
that of Williams Lake, was slower, which enabled this community to retain more
COMMUNITY MENTAL HEALTH SERVICES
L 69
consistency of identity and continuity of functioning. The south, Lac la Hache and
100 Mile House, was still sufficiently small to maintain a frontier cohesiveness and
self-reliance. Each area used mental health services differentially. Major clients
in all areas were the school districts, which referred 75 per cent of the total number
of cases conferenced. Cultural conditions proved to be the prime contributing
factor in the cases which were consulted. For children in all geographical areas,
the most prevalent presented problem was aggression in the school, with aggression
at home placing second. The detailed record-keeping and statistical systems yielded
information useful to the Centre in attempting to relate to each area and to stimulate local planning for personnel, resources, and co-operation.
Although the consultation model was workable and productive, legitimate
needs for direct service were going unmet. The Centre's objective for the next year
was to acquire additional staff to be permanently located in the outlying areas, and
to undertake direct service programmes.
IN-PATIENT SERVICES
Department of Nursing Education
Riverview Hospital
Geriatric Division
Woodlands
Tranquille
British Columbia Youth Development Centre,
The Maples, Burnaby
IN-PATIENT
SERVICES
DEPARTMENT OF
NURSING EDUCATION
For 41 years the Department of Nursing Education, Essondale, was solely
responsible for the preparation of psychiatric nurses in British Columbia. With
the graduation of the September 1973 class the department relinquished the task
of educating psychiatric nurses.
The British Columbia Institute of Technology, which assumed responsibility
for psychiatric nursing education in 1972, commenced the second year of its programme, and in September 73 students returned for this second year of study.
One hundred and four new students enrolled in the programme, making a total
of 177 students. The B.C. Institute of Technology continued to use the Education
Centre classrooms, offices, and facilities as a "second campus" for both psychiatric
and registered nursing students.
Fifty-two students of the February and September 1973 classes completed
the programme at Essondale. Students found experience in the community of
considerable value and would welcome more opportunities for experience in acute
psychiatric nursing. Those students who were assigned to the behaviour-modification programme enjoyed being part of the therapeutic team. The popular six-
week elective allowed the students to work as graduates without assuming total
responsibility.
Registered nursing students completing the eight-week affiliation programme
in psychiatric nursing totalled 129, as follows:
Royal Columbian Hospital—78 students enrolled in six rotations.
St. Paul's Hospital—51 students enrolled in six rotations.
The annual review of terms of agreement between the Mental Health Branch
and the General Hospital Schools of Nursing was held in February and the agreement was renewed. With the closure of the School of Psychiatric Nursing, the coordination of the affiliate programme was transferred to the Co-ordinator of Staff
Development, Riverview Hospital. With the phasing out of St. Paul's Hospital
School of Nursing, their last rotation of affiliating nurses was completed on November 26, 1973.
Residence accommodation was provided for 285 persons; this number included 187 students, two staff, and 96 transients. Commencing in September,
accommodation was limited to 92 places in Residence XI only.
In addition to sleeping accommodation, lecture-room facilities were made
available for a wide variety of workshops, seminars, and meetings conducted by
the Mental Health Branch and other groups. Sixteen sessions were held, with
approximately 375 persons participating.
73
L 74
MENTAL HEALTH BRANCH REPORT, 1973
With a gradual reduction of classroom and clinical responsibilities, faculty
members directed their energies toward
the completion of files of former graduates. Academic transcripts and confidential profiles were organized to be available
on request for graduates whose records
had been maintained by this department.
Records were also summarized on graduates of the postbasic programme formerly
offered to registered nurses. Records of
faculty members formerly employed by
this department were forwarded to the
Consultant in Nursing, Mental Health
Branch, Victoria.
The final year of the programme was
marked by several events; two of which
require special mention—
At the request of the graduating
students, two graduations were
held instead of one large Commencement Exercise. Both
graduations were held in Valleyview Auditorium, with receptions following in Residence
XI Lounge.
In June, Mrs. E. Paulson, a devoted
public servant and Acting Director of Nursing Education,
was honoured at a retirement
tea. Mrs. Paulson recalled
events in her 23 years of service and noted especially that,
prior to her retirement, two of
her wishes had been fulfilled—
the proclamation of the Psychiatric Nurses Act, and the transfer of the Psychiatric Nursing
Programme to an educational
facility.
The graduation of the September
1973 class closed a chapter in the education of physchiatric nurses in this Province. All who served in this Department
hoped the major changes that took place
during the year would broaden horizons
for psychiatric nurses, and prepare them
for rewarding professional experiences,
both in the institutions and in the community.
The Honourable D. G. Cocke, Minister of Health, congratulates a graduate
of (he 42nd Graduation Exercise, held in
February.
Ms. Rosemary Brown, M.L.A., and
Dr. F. G. Tucker, Deputy Minister, officiated at the last class to be graduated
from the School of Psychiatric Nursing,
in exercises held in August.
A reception was held in June to
honour Mrs. Elisabeth Paulson, Acting
Director cf Nursing Education, on her
retirement following 23 years of distinguished service to the Department.
RIVERVIEW HOSPITAL
A bookmobile programme for all
hospital units was started in June. Increased circulation figures were indicative of the interest shown in the new
service.
A panel discussed the treatment and
rehabilitation of the homicidal and suicidal patient during a workshop held in
March.
Each year the Recreational
Therapy Department conducts a
two-week vacation programme for
residents. A group is shown on a
visit to the Capilano Salmon
Hatchery.
CLINICAL SERVICES
Specific recommendations, as the result of common planning, were made by
the Deputy Minister in January of 1973
regarding the reorganization of Riverview
Hospital into five programmes. The five
programmes designated were those for (1)
the Greater Vancouver Service area; (2)
the programme for the remaining patients
in British Columbia who were admitted
to Riverview; (3) a programme for patients who would be classified forensic; (4)
a programme to look after the patients
who would ordinarily require infirmary
care; and (5) a programme for patients
requiring a minimum of physical care, but
having long-term mental illnesses. The
programmes would encompass all aspects
of Riverview Hospital operations and
would, at the same time, permit a flexibility and the development of further programmes as warranted.
The plan showed that closer activities
and better working relationships on a regionalized basis could be undertaken.
The programmes would endeavour
to provide comprehensive treatment
coverage for all patients, yet within each
of the separate segments specific and detailed variants would be developed for certain groups of patients. For example,
within the programme providing minimal
care, there could be special programmes
such as operant conditioning, types of retraining, home visiting, a special occupational treatment programme, and so on.
Much time and many hours of effort
were spent in working out details of this
over-all plan from the point of view of
the administrative organization to support
it, as well as details on implementing each
of these programmes.
In keeping with the policy that Riverview Hospital should extend its activities
into communities, efforts continued during the year in joint meetings with the
Greater Vancouver Mental Health Project. Since this involved persons and
75
L 76
MENTAL HEALTH BRANCH REPORT, 1973
groups operating within Vancouver and under
special auspices which were not directly related
to Riverview Hospital, joint planning committees had to be structured. From the Vancouver
point of view, these were set up and put in
operation by the Metropolitan Board of Health.
Special planning groups at Riverview Hospital
were set up also, and the basis of the operating
unit would be the health care team. The concept was for a combined Vancouver-Riverview
Hospital Team, whose members could move in
and out of the hospital and community, which
would permit continuity of care for patients.
Plans were developed to have part of the Crease
Unit designated to provide in-patient care for
the Vancouver service.
By the year-end three Community Care
Teams had been established in Vancouver.
The out-patient services of Riverview Hospital
continued, but where possible, patients belonging to the new service areas were transferred
from the out-patient service roster to the local
community service. Representatives from
Riverview Hospital continued to meet with
representatives for the Greater Vancouver Advisory and Planning Committee, as well as with
the Co-ordinating Committee of the Metropolitan Board of Health.
The programme for patients outside of
Vancouver was established on the basis of the
work being done in Centre Lawn, and at the
year-end clinical staff were working the local
mental health centres. During 1973, for the
first time, clinical team members from Centre
Lawn visited outlying community areas to arrange for local facilities and personnel so that
patients could receive their treatment closer
to home and avoid hospitalization where possible, and in other instances, to facilitate the
transition from hospital to the community.
ADMINISTRATIVE SERVICES DIVISION
Changes in administration and the administrative services were necessary to provide the
proper framework and operating mechanisms
for the development of the new programmes
for Riverview Hospital. Studies, discussions,
and exchanges of ideas took place between
Riverview Hospital administration and Mental
Health Branch senior officers, in an effort to
find the most suitable type of structure.
This game of ring toss took
place during a summer outing.
Residents visited several parks in
July and August.
Two Riverview residents posed
with members of the RCMP when
a group visited their centennial
exhibit at the Cleveland Dam.
A ride on the Miniature Railway was the highlight for many of
those who went to Stanley Park.
IN-PATIENT SERVICES
L 77
In September the Deputy Minister announced the new administrative structure for Riverview Hospital. This structure was such that the programmes would
operate as independently as possible, and have their own administrative organization. Senior clinical personnel in Riverview Hospital were to be assigned consulting positions, and the administrative and support services would be combined under
one administrative authority.
As a result of a successful recruiting effort, a high level of medical staffing
had been achieved by the year-end, and nearly all established positions had been
filled with well-qualified personnel.
Unfortunately, there continued to be a shortage of nursing personnel, particularly of registered psychiatric nurses, and it was necessary to utilize psychiatric
aides in nurse positions. It was expected that this difficulty would be overcome by
a programme of intensive nurse recruitment overseas in November and December.
Within Programme 4, covering medical-surgical and other types of care, the
plan was to have the central paraclinical services, such as laboratories, radiology,
pastoral care, podiatry, and optometry, included within this general programme,
and that as the other four programmes required these services, they would be
arranged between the Programme Administrators.
The planning and administrative structure for the Programme in Forensic
Psychiatry had not been determined by the year-end. However, it was obvious
that special administrative programming would be necessary to provide an improved forensic service.
During the year, major structural changes were underway in the Riverside
Unit, to make this building modern and safer and to provide more recreational
and usable patient space. In order to do this it was necessary to reduce the bed
complement, which was established at 145 patients. Additionally, it was planned
to move patients from the Riverside Annex to other buildings within the hospital.
Those who did not need to be within the Forensic Programme would be assigned
to other programmes. One of the major improvements to the Riverside Unit was
the development of a large recreational hall.
The renovations to Residences 6, 7, and 8 were expected to be completed
and ready for occupancy by the year-end. Residence 6 would provide new and
improved service facilities; and Residences 7 and 8 would be used for patients and
for those ready for discharge into community facilities such as boarding-homes,
sheltered areas, and so on. New fire escapes for East Lawn and Crease Unit were
finished during the year.
The hospital continued to support the Canadian Red Cross Blood Transfusion
Service by holding two major clinics.
The activities of the volunteers continued at a high level and the numbers
of hours of service, in this 20th year under the auspices of the Canadian Mental
Health Association, were significant. The Legal Assistance Programme continued,
and the patients benefited greatly from this generous service on the part of the
participating lawyers.
On October 31, 1972, Riverview had 2,121 patients; at the same date in
1973 the in-patient number was 2,000, and the hospital had provided 60,790
patient-days, a decrease of approximately 5,000 patient-days from the previous
year. The lowest month of occupancy was August, with 1,950 in-patients, and a
total utilization of 6,905 days.
Several hospital committees were active during the year. The Master Planning Committee produced many useful ideas on development and planning. The
Patient Care Committee dealt with all aspects of patient care, and department Di-
L 78
MENTAL HEALTH BRANCH REPORT, 1973
rectors met regularly to review topics of concern and interest in the over-all area of
patient care, such as the types of care necessary in dealing with the potentially
dangerous patient. A successful seminar was conducted on the continuing concerns
for this type of patient.
A special Joint Steering Committee was formed to aid in developing closer
working relationships between the Metropolitan Board of Health and the Riverview Hospital.
The method of physicians' payment by sessional fees became popular during
the year and a good number of the medical staff members who previously had a
salary appointment, either full or part-time, moved on to the sessional method.
It provided for flexibility and increased the number of physicians available to
Riverview Hospital.
GERIATRIC
DIVISION
In 1973 the Geriatric Division consisted of three units, with a total bed complement of 1,216. Valleyview Hospital, the largest, with 726 beds, accepted patients
from the Lower Mainland and adjacent areas, and from Vancouver Island and the
Gulf Islands. Dellview Hospital, Vernon, with 190 beds, accepted patients from
the Okanagan and Kootenay areas, while Skeenaview Hospital, Terrace, with 300
beds, all of them male, accepted patients from the northwestern part of the Province. Patients from the extreme northern areas were admitted to Valleyview Hospital- To be accepted, patients had to be aged 70 or over and suffering from mental
illness and in need of treatment, or suffering mental deterioration due to aging and
with associated behaviour sufficiently disturbed that they could not adequately be
cared for elsewhere in the community. Those showing mental deterioration without
a behaviour problem, however, were not regarded as suitable for admission since
they only require simple personal and nursing care.
VALLEYVIEW HOSPITAL
The rate of admissions during the year was a little below that of last year, as
was the death rate, while resident population and discharges continued at last year's
level. There was increasing evidence that the proportion of resident population
requiring total personal and nursing care was gradually increasing.
The preadmission screening programme continued at a similar level to last
year, and late in 1973 an experienced psychiatric nurse was obtained, to observe
and report on behaviour patterns.
The four general physicians continued their medical care to patients, while the
Assistant Superintendent was responsible for improvements in the quality of psychiatric care. In August the Assistant Superintendent resigned his position, but
continued to serve on a half-time sessional basis. At the beginning of June the
hospital lost the services of Riverview physicians in covering Valleyview at nighttime and Sundays and holidays, which had to be carried by Valley view's doctors.
The staff of the Nursing Division continued to discharge their duties in a responsible and concerned way. A greater proportion of residents required total
personal and nursing care, and the low nurse-to-aide ratio made this more difficult.
The nursing staff again exerted themselves beyond their normal duties to provide
enjoyment on special occasions for patients, for example, each unit arranged its
own summer festival. During the year, staff turnover, particularly among the aides,
was very high, which made it difficult to build up an adequate core of trained and
experienced aides. The Associate Director of Nursing left in June on early retirement and was replaced in September. The health of the nursing staff at all levels
continued to give considerable concern. Some staffing difficulties were relieved by
the use of on-call both for nurses and aides.
Occupational Therapy and Recreational Therapy Programmes continued as in
former years. Two young students hired in the summer brought a great deal of
interest and enthusiasm and were able to carry along a remarkably good programme.
The dentist conducted a thorough survey of patients and drew up a plan for
the guidance of nursing staff in the care of patients' mouths. His enthusiasm, energy,
and knowledge would undoubtedly improve the level of dental care in the hospital.
79
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MENTAL HEALTH BRANCH REPORT, 1973
The work load in the Pathology and
Radiology Laboratory continued at the
same previous levels. The laboratory
changed over entirely to the unit value
scheduled for laboratory procedures,
which gave a better way of measuring
work load since it was expressed in terms
of time taken.
An average of about 15 surgical operations a month were carried out in the
Surgical Unit, Riverview Hospital.
The Physiotherapy Department continued to give the patients excellent service. Staff were very active in educational
sessions for nurses, to demonstrate how to
lift patients so as to avoid back injuries.
The Social Service Department was
involved in work within the institution and
in a major way with activities surrounding
preparations and arrangements for discharge and after-care. One worker was
active in the preadmission screening programme. Social work was vital in all
phases of the hospital's clinical work.
The Department of Volunteer Services completed its first full year of operation. The service provided was as varied
as the needs of the patient. Some volunteers simply visited as a relative or friend
might do, some helped with the personal
needs of the patient, such as hairdressing
or manicuring, some took patients out for
walks, others wrote letters or read to the
patients, some took them for car rides or
to the store for shopping, and some volunteers took patients to their own homes to
visit. Volunteers had always played a
large part in the Recreational Therapy
programmes, but the new department
focused on the many other ways in which
volunteers could be useful and helpful.
The beautician in the beauty parlour
provided a service which was considered a
most valuable one for the patient's morale.
Another valuable service to the hospital was that supplied by the chaplain.
Weekly services were held on each ward
and formal services in the Auditorium at
Christmas, Good Friday, and Easter Sun-
Twice each year Valleyview's Accident Prevention committee awards a
trophy to the team with the best safety
record. Team 2 received their award
(above) at a ceremony held in March.
Discarded pressure cans were a problem because of their explosive nature
when inadvertently incinerated. Staff are
shown receiving instructions on a device,
developed at Dellview, to puncture the
tins before being discarded.
In May, 25 Dellview patients visited
the Okanagan Game Farm in Penticton.
Here they enjoy a picnic lunch at the
farm.
GERIATRIC DIVISION
L 81
day, Thanksgiving, and Remembrance Day. The chaplain also visited seriously ill
patients, including those in Riverview Hospital, for surgery- In addition, he was
widely sought as a counsellor both by patients and their relatives and by staff.
The Safety Committee worked diligently throughout the year.
Administrative—In 1973 a total of 130 new positions was requested, of which
30 were authorized. Twenty-seven of these were filled during the year, which permitted the extension of food service to seven of the nine outside wards. Graduate
nurses averaged a 46-per-cent rate of turnover during the year, the highest rate for
many years. Significant funds were authorized for the employment of temporary
staff, who assisted in meeting needs brought about by staff illness and other reasons.
In the latter part of the year a Co-ordinator of In-service Training was hired,
who began to set up a department for the in-service training of all hospital staff.
Business management—Programme budgeting was introduced April 1, 1973,
and problems related to the introduction of the new system were gradually worked
out.
In buildings and maintenance programmes a significant updating of heating
controls took place in the main building, conversion of a reserved area at the lower
level of the building to serve offices was under way at the year-end, and the Public
Works Department was conducting a comprehensive survey of all projects in the
institution.
A study was made of the proposed expansion in the central administration.
The hospital's ability to cope with a fire emergency, and improvement to the
necessary communication systems, was also under study.
DELLVIEW HOSPITAL
Applications for admission to Dellview Hospital continued at the usual level,
and there was a slight decline in male applications toward the end of the year. Improvements in the standard of nursing care were recorded during the year.
Psychiatric consultations were provided to this unit by the psychiatrist of the
Vernon Mental Health Centre, while regular medical services were provided by a
physician on a visiting basis.
Ministerial services were provided by a local clergyman.
The Volunteer Programme renewed its efforts during the year with assistance
from the local Mental Health Association and the Vernon Friendship Club.
For those patients capable of responding, emphasis was placed on activation,
motivation, and recreational therapy. A psychologist from Riverview Hospital conducted a remotivation workshop for staff, emphasizing reactivation methods and
procedures-
The Director of Nurses transferred to Valleyview Hospital on a promotion,
and the Nursing Supervisor in Valleyview became the new Director of Nursing at
Dellview on October 15. In April, 10 additional staff positions were authorized,
nine of these being nurses. One person from the Education Centre at Riverview Hospital was transferred to Dellview to develop a programme of in-service
education.
In July, Dellview's laundry services were transferred to become part of the
regional operation in the Vernon Jubilee Hospital. Three members of the laundry
staff were utilized to provide a central linen-room service.
A new P.A.B.X. telephone system was installed late in the year. Several proposed renovations to ward nursing stations, assorted storage, a staff dining-room,
and so on, were under consideration.
The hospital Safety Committee met regularly throughout the year.
L 82 MENTAL HEALTH BRANCH REPORT, 1973
SKEENAVIEW HOSPITAL
During the year, Skeenaview was involved with preparations for conversion to
a community operation. The administration placed increased emphasis on the
activation and motivation of patients, and on improved relations with the community. The activation and motivation of patients was achieved through ward-
based programmes, and a variety of recreational programmes. A 10-bed self-care
unit was set up to be used by patients preparing to return to the community- The
27-bed infirmary ward was provided with new beds, chairs, and other equipment.
Means of co-operating more closely with Mills Memorial Hospital were also
considered.
Community involvement was encouraged, and approximately 25 senior citizens
met with 20 patients every second Sunday for dinner and a social evening. With
the appointment of a full-time Co-ordinator of Volunteers, the number and effectiveness of the volunteers increased.
Staff educational activities included several separate programmes. Nurses
took part in two courses offered at the Mills Memorial Hospital, and another in
sociology offered by Caledonia College. The first part of the Community Nursing
course was held at Skeenaview, sponsored by the Registered Psychiatric Nurses
Association (B.C.). The Civil Service Commission had a special session on Management Training for supervisors, and the hospital held a similar one on Management by Objectives.
Members of the Telephone Employee's Community Fund, which provides
support to community health and welfare services, visited Woodlands in September.
Included among those being honoured
at a Volunteers Recognition Evening
was Mrs. Lucy Cross (centre), who had
been a volunteer for 19 years.
The Woodworking Shop (above) is
one of seven workshops in the new
$780,000 Industrial Therapy Building,
which was officially opened May 9.
WOODLANDS
Woodlands is a residential facility
for the mentally retarded of all ages who,
because of the complexity of their problems, are unable to have their needs met
in the community. During the year, diagnostic, treatment, training, and educational services were provided for those
who required specialized services, and
who liyed in the western half of the Province. The resident population for 1973
was approximately 1,100, the same as in
1972. Admissions for 1973, to November 1, totalled 70. During 1973 the waiting-list varied between 13 and 30, with
over half requiring an extended-care type
of accommodation. As of November 1,
1973, only four names of 23 on the waiting-list had been there prior to January 1,
1973.
A multitude of new programmes and
constructive changes at Woodlands had
positive impact on the mentally retarded
during the year. These included: a Halfway House for six mildly retarded young
adults within a residential district of New
Westminster; expansion of the foster-
home project; Woodlands Academic
School Programme being placed on a continuous year basis; enrolment of residents
of Woodlands and Alder Lodge in community schools and sheltered workshops;
introduction of community retarded into
Woodlands' Gold Creek Camp at Alouette Lake; sharing of the facilities in hosting a banquet for 400 participants and
their families at the Annual Fred Dietrich
Swim Meet; comforts allowances for the
adult resident population, granted by the
Department of Human Resources; increased staff establishment; evaluation of
a different method of rostering shift personnel; introduction of addressograph
system and reorganization of clinical files;
special laboratory techniques, such as
micro-method for blood phenylalanine
levels, and special staining techniques for
chromosomal studies.
83
L 84
MENTAL HEALTH BRANCH REPORT, 1973
Innovative programmes initiated or
advanced during the year included a new
wage-incentive structure for residents
working within Woodlands; community
preparation programmes, including how
to spend and budget money independently
for personal needs; a demonstration project for nonspeaking children using a linguistic approach to language acquisition;
a week-long field trip for both Indian and
non-Indian residents to Ksan Indian Village in Hazelton; cooking classes for
severely disturbed older women; participation by residents in Riverview's Nurses
Aide Training Programme; and staff-development courses given at Woodlands,
with recognition assigned by Douglas College.
Students in the summer employment
programme provided services in summer
camping, nature park development, academic tutoring, research, programmes for
severely and profoundly retarded in pottery and other crafts, cooking, and language.
Another successful annual parade
and carnival was held on June 12. For
the third year, Open House was held, with
approximately 2,000 visitors attending.
This provided the occasion for the official
opening of the newly completed Industrial
Therapy Building.
Many of the staff and the volunteers
lived in temporary quarters during a renovations programme. When completed,
the building would accommodate the
Academic School, Occupational Therapy,
Sheltered workshops, In-service Education, the Apparel Shop and Canteen, as
well as departmental and programme
offices.
TRAINING, EDUCATIONAL AND
TREATMENT SERVICES
The year 1973 was the beginning of
the reorganization of Woodlands into five
programmes, as opposed to the previous
three units. The unit system emphasized
a medical model. One major group of
residents was those with special physical
A summer student helped instruct
severely disturbed and retarded young
ladies, in a special cooking class in the
Intermediate Care Preparation Programme.
Young residents are shown "scrubbing up" in the Self Care Training Programme conducted in Ward 32.
An Alder Lodge resident disembarks
from the bus after attending Sunny
Cedars School, operated by the Coquitlam School Board.
IN-PATIENT SERVICES
L 85
Woodlands annual parade and carnival took place on June 12. These young
wheelchair residents were followed by
bands, floats, drum majorettes, and
clowns.
Work experience, including clearing
the grounds (above), was part of the
programme conducted by the Training
and Education Department.
A summer student and two residents
are shown working in Woodlands
Nature Park, as they assist in the selective clearing of saplings and brush.
needs, with the balance of the residents
being divided into those requiring psychiatric treatment and those without special psychiatric needs. The division into
programmes was an attempt to provide
more homogenous groupings, with special
emphasis on the type of programmes any
one group required, in order to help them
develop to their fullest potential. General
medical and psychiatric back-up services
were incorporated into all programmes.
Acute physical illness and infectious diseases were treated in special wards within
the Health Care Programme. The very
youngest children who were ambulant
were programmed on a developmental
model within the Developmental Opportunity Programme. Because of increased
community resources, a high proportion
of the ambulant population at Woodlands
was severely or profoundly retarded.
These residents were divided into two
large programmes — Intermediate Care
Motivation and Intermediate Care Preparation. The fifth programme, Life Education, was for the mildly retarded and
brighter who were at Woodlands primarily
because of psycho-social problems. Each
programme had an advisory council, with
the majority of the members elected from
ward teams. In case a specific discipline
was not among the elected, an appointment was made so that the advisory council reflected the views and influence of all
disciplines.
The Health Care Programme consisted of eight wards, with a resident
population criteria of extended care, as
defined by BCHIS From one particular
ward, a number of cerebral palsy residents
participated in teen clubs for the physically handicapped or the adult indoor
sport club. "Operation Wheelchair" was
held in December, to give some of the
physically handicapped residents an opportunity to shop in a department store.
A few residents were enrolled in a Surrey
sheltered workshop, and some were able
to attend Camp Chehalis with other physically handicapped from the community.
L 86 MENTAL HEALTH BRANCH REPORT, 1973
For these residents, to return to the community meant, in the majority of cases,
placement within extended-care or intermediate-care facilities, hopefully in communities close to their immediate family.
The Developmental Opportunity Programme consisted of five wards, with a
resident population of 131. The programme was directed toward community
involvement. Ward 32, with its well-established programme based on developmental
and behavioural principles, enrolled one child in Sunny Cedars School and another
in a community pre-school. Although the five wards were spread around Woodlands, it was expected they would merge into one programme with the completion
of the new proposed 20-bed units and the centralized learning centre. The programme would also need community group-living homes, an increase in foster
homes, and adequate back-up to families, to achieve its objectives.
The Intermediate Care Motivation Programme consisted of eight wards, with
a resident population of 243. Admissions to the wards was expedited when there
was an urgent situation within the community. A ward for severely retarded who
were blind was part of this programme. The special summer student programme
made it possible for some of these blind residents to take part in a pottery programme. A peripatologist doing graduate work at UBC voluntarily conducted
mobility-training sessions. Some residents received individual behaviour therapy
under the supervision of one of the psychologists, with the assistance of a volunteer
group of Douglas College students. The newly instituted comforts fund provided by
the Department of Human Resources was used to provide ward music, picnics, bus
tours, and other socializing experiences. New ward furniture and colourful drapes
were made, and the living accommodation of several of the wards within this programme was much more attractive.
The Intermediate Care Preparation Programme consisted of six wards and
Alder Lodge, with a resident population of 226. The programme gave residents the
training and experiences necessary to facilitate their return to the community, usually
to a boarding-home. Emphasis was placed on behaviour modification, supervised
by the psychology staff. Alder Lodge, a residential facility for 50 in Maillardville,
located 3 miles from Woodlands, facilitated the community placement of these
residents. One of the highlights of the year was the enrolment, for the first time, of
17 residents at Sunny Cedars School under the Coquitlam School District. Recreation and medical care continued to be provided at the community level for Alder
Lodge residents, rather than by the institution.
The Life Education Programme consisted of seven wards and a Half-way
House, with a resident population of 201. Five of the seven wards were renovated
and furnished. It was planned that two of the proposed new five 20-bed units would
accommodate the group with the most severe management problems, as they would
be more amenable to therapy if they lived in smaller units planned to their needs.
The intent of the Life Education Programme was the habilitation of residents
through the concept of normalization, and emphasis was placed on unlocked doors,
integrated living, developing social skills, and a greater attention to personality and
identity development. In addition to the academic classes and limited vocational
training which were provided, a number of the residents were enrolled for vocational
training at the community level, in either workshops or training situations.
Medical care in Woodlands continued to be of a good standard, and close
liaison was maintained with the School of Medicine, University of British Columbia,
particularly with the Department of Paediatrics. Woodlands' Medical Director was
appointed Clinical Assistant Professor with the Department of Paediatrics, and acted
as resource member to one of the teaching teams at the Health Centre for Children.
IN-PATIENT SERVICES L 87
A paediatrician and human geneticist with the Department of Paediatrics spent one
day a week at Woodlands, and provided a great deal of consultation to the Chromosome Laboratory, and genetic counselling to part of the Out-patients Department.
Paediatric residents continued to rotate at Woodlands on a two-month basis. Woodlands continued to be involved in the follow-up of all children with the diagnosis
of homocystinuria and phenylketonuria in the Province.
Medical consultation for Woodlands' residents was offered by a number of
specialists, with approximately 800 appointments set up in 1973. Clinical rounds
were conducted at weekly intervals as a form of in-service education, and allowed
staff to share information gained by attending conferences and workshops. A
research project was conducted to assess the interaction of anticonvulsant medication and calcium metabolism, and preliminary work was undertaken for a project
to evaluate megavitamin therapy.
The Dental Department, in addition to increasing the amount of restorative
work and oral rehabilitation, improved in-service education of nursing personnel
with regard to mouth care.
The Laboratory service set up a micro-method for calculating blood phenylalanine levels. A spectrophotometer was purchased, for enzyme studies by the kinetic
method, and to evaluate blood barbiturate and dilantin levels. The Chromosome
Laboratory technician set up the Giemsa staining technique for chromosomal studies,
for the identification of certain abnormalities. Under the direction of a Genetic
Consultant, a fifing system was established to catalogue genetic conditions, which
would facilitate genetic counselling, and aid the recognition of newly described
syndromes and genetic diseases.
The physiotherapist provided a high standard of consultative service to the
medical and nursing staff.
Three additional clerk positions in the Nursing Department freed nursing
supervisors to provide a more direct service to residents and supervision to staff.
Ten new nursing positions were added to the establishment to carry out the intensive
programme in the paediatric age-group. Six full-time nursing positions on the night
shift provided a greater degree of safety for both residents and staff. An additional
six part-time temporary nursing positions were provided to integrate the two school
pupils' wards in the Life Education Programme. In August a project to evaluate
a new system of rostering was instituted at Woodlands, as a co-operative endeavour
between Woodlands' administration, the Registered Psychiatric Nurses Association,
the Registered Nurses Association of B.C., and the Provincial Government Employees' Union. It was expected there would be greater continuity of care, due to
the same number of staff being available on any given day.
Social workers were assigned to the five programmes, and played an important
role in the team approach to the delivery of service to the residents. Staff were
enthusiastic about the appointment of two mental retardation social workers within
the community, one in the Surrey-Delta area and the other in the North Shore.
During the year the Psychology Department experienced increased involvement by psychologists in many varied facets of facility functioning. This was
evident on ward teams, advisory councils, and committees, as well as in a wide
range of programming activities and in-service functions. There was also increased
interest and participation in research endeavours. One of the psychologists was
asked by the Government of the Northwest Territories to provide consultative
services at Chesterfield Inlet.
The Training and Education Departments maintained their core services,
participated in programme innovation, and assisted in the change to a programme
system.
L 88 MENTAL HEALTH BRANCH REPORT, 1973
In October, two nursing instructor positions were added to the establishment.
Staff development, utilizing a multidiscipline approach, was a top priority emphasis
at Woodlands, and it was recognized that in-service education would play a major
role.
In addition to the services provided by volunteers working within Woodlands,
community organizations expressed their concern for the retarded by providing
funds, equipment, and services. More young people, particularly students, were
becoming interested in volunteer experiences. At a Volunteer Recognition Evening
held June 5, service awards were handed out, and one lady was honoured for her
outstanding record of 19 years of service. The Co-ordinator of Volunteers and the
school Principal arranged a special orientation programme for Grade XII students
in the Lower Mainland in which approximately 400 students took part. Several
workshops and tours were provided to accommodate professional groups.
ADMINISTRATIVE SERVICES
The establishment of Woodlands increased from 924 positions to 973, effective
April 1, 1973, as 49 new positions were approved by Order in Council.
The turnover of male psychiatric nurses declined during the year, and the
increased turnover of female psychiatric nurses was apparently due to a desire to
travel, and pregnancy leave.
Total days lost due to illness in the eight-month period, January 1 to August
31, 1973, amounted to 6,235 days, an increase of 24 days over the same period
in 1972. Workmen's Compensation Board days lost in the same eight-month period
totalled 827 days, a considerable improvement over the 1972 period in which 1,210
days were lost.
Early in the year a monthly meeting of department heads responsible to the
Business Administrator was instituted.
The final inspection was made on the Transport Building addition, which was
accepted subject to minor deficiencies. The Industrial Therapy Building was officially
opened on May 9, 1973.
During the year the municipal supervised fire-alarm system became operational
throughout Woodlands.
The two-way traffic system from the front of the Centre Building to the boiler-
house was reinstated to allow easier road access to the Centre Building from within
the grounds. The paving of the roads and parking-lot at Alder Lodge, and refining
of the parking area in the upper Fraserview, was completed.
A report was completed containing recommendations regarding structural
alterations in the Fraserview Building, required to update the quality of service to
residents.
Regular meetings continued to be held with the Provincial Government Employees' Union, the Registered Psychiatric Nurses' Association, and the Registered
Nurses' Association. Phase I of the Academic and Activity Building was completed,
and the control of Public Works operations at Woodlands continued to be centralized
at Riverview.
TRANQUILLE
HP v
An Exercise Circuit was developed to
help improve the patient-trainees' coordination, sense of balance, strength,
and cardio-respiratory endurance.
sisin." mm
?* <
Exercise equipment included trampolines, rolling cylinders, tumbling mats, a
rowing-machine, and a treadmill.
::
Male patient-trainees received training in the Woodshop in the manufacture
of garden furniture.
At the end of the year, Tranquille, a
residential school-hospital for the mentally
retarded of all ages, had accommodation
for 494 beds, plus 10 sick-bay beds.
There were 448 patient-trainees in residence and 71 in boarding-homes, with
Tranquille having jurisdiction over a total
of 519 patient-trainees.
All types of training and treatment
for the problems of the retarded were provided at Tranquille, primarily directed toward behaviour modification. Some considerable numbers of the patient-trainees
suffered from superimposed psychiatric
illnesses, and these were treated if at all
possible, although there were problems of
security. Some 50 patients were admitted
during the year, and at the end of the year
the waiting-list consisted of four patients.
Visits to Victoria by senior staff continued, on a monthly basis, and in October
the entire senior staff attended a headquarters conference with senior Mental
Health Branch officials.
Kamp Kiwanis again operated efficiently throughout the year, and the
Superintendent, a Kiwanian, maintained
regular contact with the Directors of the
organization.
Throughout the year, regular meetings were held among the Business Administrator, the Director of Nursing, and
the Superintendent, representing management, and representatives of the two
unions operative at Tranquille- The Executive Secretary of the Registered Psychiatric Nurses Association of British
Columbia was a great help in improving
what was often a difficult communications
situation.
During the year, Tranquille was involved with the faculty and students of
Cariboo College. Staff of Tranquille provided programmes at the college, and
faculty members utilized the clinical facilities and expertise of Tranquille to the
benefit of their students. Summer meetings were held with the faculty and the
89
L 90
MENTAL HEALTH BRANCH REPORT, 1973
new Department of Nursing at Cariboo
College, and a continuing association appeared likely.
Good communication between Tranquille and the Royal Inland Hospital continued during the year. The specialists
attached to that institution, who were
elected as Tranquille's consultant staff,
provided excellent service.
Clinical Team—At the beginning of
the year the Clinical Team was reorganized under the chairmanship of the
Director of Clinical Medicine, and consisted of the Director of Social Work, the
Director of Training, the Director of
Nursing, and the psychologist. These
people, with consultations from the two
psychiatrists at Tranquille, were responsible for the programming and treatment of
the patient-trainees in residence. They
also acted as resource personnel to the
ward teams and served as consultants in
problem areas.
Family therapy—Early in the year a
residence was selected as headquarters of
a family therapy unit. This enabled
families with behavioural problem children to live at Tranquille with their child
and professional staff in a family environment. It proved to be very successful,
and it was hoped that a bigger house would
be available in the near future.
Teams from Tranquille also went to
homes in the immediate region to see
problems at first hand and to help families
on an extramural basis.
Training Department—The Training
Department endeavoured to provide a
more effective service during the year by
the use of teachers and other professionals
working in the area.
Construction of the 20-bed units began in the spring, and it was hoped they
would be available for occupancy in the
early part of 1974. The modern facilities
would enable the Training Department to
provide a complete programme in the
delivery of services.
Staff—There were some staff changes
at a senior level during the year. A new
psychologist joined the staff in the summer,
A comfortable garden chair, the finished product of the Woodshop, was a
popular item at Tranquille.
A highlight of the year for many of
the patient-trainees was a summer vacation at Kamp Kiwanis in the Dew Drop
mountain range. A favourite spot was
the swimming-pool (above).
*HW
These young campers examine articles
collected during a nature walk.
IN-PATIENT SERVICES
L 91
and at the end of the year a second psychologist with a post-doctoral degree in
psychology came to Tranquille from the Max Planck Clinic in Munich.
Out-patient Department—The Out-patient Department, which was directed
by a senior social worker, was used quite extensively during the year as a referral
source for a variety of services.
Volunteer services—A new Co-ordinator of Volunteer Services was appointed
in December 1972, and she had remarkable success in activating programmes for
volunteers, in conjunction with the Department of Continuing Education and the
Training Department, and also in organizing the community to extend itself to
Tranquille and the extramural activities of this institution.
Extramural education—With the opening of new facilities at the Fitzwater
School, which were funded by the Mental Health Branch, more children were in
attendance at that institution in 1973. Fitzwater staff took some training at Tranquille, as did people from the workshop operated by the Kamloops Society for the
Mentally Retarded. Communication between the society and Tranquille was good,
with some of the professional staff at Tranquille serving as consultants to, and
officers of, the society.
Extended-care services—Medical treatment service in the Greaves Building
continued apace, utilizing the entire medical staff of Tranquille. All the physicians,
including the Superintendent, took regular night and week-end duties.
Isolation rooms for infectious illness were being equipped at the year-end.
Business Department—The laundry continued to work on a five-day-a-week
basis.
The Transport Department functioned well, although their vehicles required
continual servicing. The Transport Department also serviced the machinery required for heating and lighting at Kamp Kiwanis, and did a superlative maintenance
job.
The Business Administrator, in the dual role of Personnel Officer, continued to
provide invaluable service.
BRITISH COLUMBIA
YOUTH DEVELOPMENT CENTRE
THE MAPLES
FAMILY AND CHILDREN'S
CLINIC
The Clinic's functions of the training
and treatment of young children in the
pre-school programme continued actively
during the year.
Field placements were provided, for
the first time, to counselling students from
the Faculty of Education at the University
of British Columbia, and a good relationship was established with the Department.
There were a considerable number of
requests for brief training workshops, including several from areas outside the
Lower Mainland, and most of these were
met. The longer training programmes for
public health nurses, homemakers, and
probation officers continued during the
year. An ongoing, interagency training
group was set up in New Westminster for
professionals working together in the community with families.
The Day Centre pre-school was busy
with morning programmes for very disturbed, very young children. The staff
also extended their consultative and training functions within the community.
The community team in South Vancouver became increasingly involved in
direct service to families, working with
groups in schools, and providing consultation to teachers and public health staff.
The five staff members became involved
with the four multi-agency "mini-teams"
set up in South Vancouver during the year.
Clinic staff provided training and
consultation for 10 counsellors staffing a
two-month summer camp programme at
Harrison Lake for disturbed children up
to the age of 12 years.
PSYCHOLOGICAL EDUCATION
CLINIC
The Psychological Education Clinic
has evolved a type of programme that
92
Separate tables and small classes facilitate the development of individualized school programmes.
This young lad tries his hand at a
basic arithmetic problem.
A teacher and a pupil work out a
problem together.
IN-PATIENT SERVICES
L 93
The sandpile provided its own special
type of motivation and therapy.
As well as providing fun, this
playground equipment at The
Maples helps youngsters to improve their motor co-ordination.
I
Swimming is a healthful sport that
helps to keep the body fit, as well as providing the opportunity for the emotionally disturbed to play together.
meets the needs of children who have experienced failure in their schooling in every
available setting. The general approach
was to begin with something that the child
could succeed at, and build only as fast as
he was able to go. The day was divided
into academic sessions, recreational activities, snack time, arts and crafts, social
interaction, and at least one day a week
for a field trip. The entire group of about
45 children and 15 staff also went to a
one-week camp, twice a year. Some of
the smaller classes went on additional
camping outings. The camp experience
proved to be a valuable part of the programme, providing the staff with a different
dimension than what they would normally
see in a day setting.
The important part of working with
children with emotional and learning disabilities was family intervention, and staff
endeavoured to see these families at least
once every six weeks to discuss their
child's progress.
During the year the programme consisted of six groups located at The Maples,
and an additional three groups located at
the Granville Centre. The age of the children at both centres was approximately
6 to 13 years, with the Granville Centre
taking children solely from the Vancouver
area, while The Maples accepted children
from the Lower Mainland.
The Psychological Education Clinic
also offered a Travelling Clinic service to
those areas of the Province that requested
psychological consultation. During the
year a psychologist travelled extensively
in Health Unit 16, consulting with the
communities and the schools in Terrace,
Kitimat, Smithers, Hazelton, Aiyansh,
Greenville, Houston, and Kemano. He
conducted workshops on Child Management, The Alienated and Alienating Adolescent, and Programme Evaluation. In
addition, he consulted to the Department
of Human Resources in Smithers and to
the Skeena Mental Health Centre in Terrace.
Over the past several years the clinic
developed a neuropsychological assess-
L 94 MENTAL HEALTH BRANCH REPORT, 1973
ment battery, which provided a comprehensive profile of the relevant strengths and
weaknesses of intellectual motor and sensory functioning. During the past year the
battery was expanded to include a comprehensive examination for aphasia and
language impairments, as well as static and phonetic motor disabilities. This service
was provided not only for clinic cases, but was also made available on a limited
basis to referrals from mental health centres. The clinic assessed both adults and
children, with many of the requests for adult assessment being in relation to acute
brain damage, and for children because of extreme difficulty in learning in school.
A research programme was being planned around the collection of neuropsychological information, which would be of use not only to the unit but would have a
general applicability.
The clinic was involved in a variety of training programmes, both of a direct
and indirect nature. Workshops were set up in the area of behaviour modification,
as well as conducting child-management training courses. During the year the
unit was made available to a large number of professionals in the community and
became more involved in their training.
RESIDENTIAL TREATMENT UNIT
The treatment programme at two of the three residential cottages was aimed
mainly at working with adolescents who had difficulties relating to their family,
the school, and other adults or peers. Referrals were made from a variety of sources,
but came mostly through Special Placement. In addition to providing fairly intensive treatment programmes, the Residential Unit staff also provided assistance to
parents and school personnel.
A special treatment programme for the third cottage was developed in the
latter part of the year, for the more seriously disturbed adolescent. The training of
personnel for this cottage was completed by the year-end, and the first residents
would be admitted in January 1974.
The Day Care Centre, which operated on a school semester system, was located
in the community. The programme was aimed at teenagers who had problems
which were severe enough to need attention but not of such a magnitude that they
required 24-hour care. All activities of the Day Care Centre took place as much
as possible within the community, and were aimed at teaching the teenagers to cope
with everyday life.
A farm programme was specifically designed for a smaller number of adolescents who needed closer interpersonal contacts and supervision, and who were
unable to deal with the more strenuous demands of the other programmes at the
Youth Centre.
Many of the youngsters at the Youth Centre were school drop-outs or had
difficulty with the regular school programme. The educational programme tried to
interest them in attaining skills commensurate with their ability and aptitude.
The outdoor camping programme was designed for teenagers who needed to
be away from it all for a short period of time, or who needed the opportunity to
expend some of their excess energy.
In order to provide follow-up care, the Alumni Programme provided continuity
of treatment. This programme was open to any discharged teenager from the
Youth Centre, and emphasized dealing with problems which the teenager had
encountered after discharge.
Although each cottage operated independently of the others, a number of
support services were shared. These included the swimming-pool, the gymnasium,
a variety of sports, and arts and crafts activities.
IN-PATIENT SERVICES
L 95
Because of the importance of family relations between the teenager and his
family, the Youth Centre staff provided programmes for parent groups. The
emphasis of these groups was on dealing with actual relationship problems between
family and teenager.
Two specialty programmes were developed at the Youth Centre. These were
job survival and school survival. The Job Survival Programme, administered in
close co-operation with the British Columbia Vocational School, prepared teenage
residents at the Youth Centre for employment after discharge. The School Survival
Programme operated along similar lines, and prepared the teenager to deal with the
school personnel, his peers, and the academic course work. Youth Centre staff
worked very closely with the school counsellors and teachers of the schools attended
by the teenagers after discharge.
In order to provide well-qualified staff for working with the teenagers at the
Youth Centre, successive 180-hour training programmes were given for new staff.
In addition, staff-development workshops and seminars were provided to keep the
staff informed about current developments in the area of child care.
A number of institutions for higher education, including Douglas College; the
University of British Columbia Schools of Nursing, Counselling, and Social Work;
and the University of Victoria Training Programme for Child Care Counsellors
asked the Youth Centre to provide training for their students.
PATIENT MOVEMENT
Patient Movement Trends
Patient Movement Data
/<?73
PATIENT
MOVEMENT
PATIENT
MOVEMENT
TRENDS
TRENDS, SEPTEMBER 1973
Yearly Sum of Entriesi From—
Resident or Case Load
Facility
Oct. 1970
to
Sept. 1971
Oct. 1971
to
Sept. 1972
Oct. 1972
to
Sept. 1973
End of
Sept. 1971
End of
Sept. 1972
End of
Sept. 1973
9,871
3,870
3,652
2,962
51
639
500
116
23
218
160
58
6,001
4,958
10,589
3,349
3,059
2,487
39
533
442
76
15
290
214
76
7,240
6,363
11,976
2,650
2,480
1,911
37
532
421
86
25
170
121
49
9,326
8,120
15
524
527
331
157
264
93
330
328
476
224
267
265
201
417
263
320
121
72
304
388
385
226
628
613
357
24
557
114
35
278
52
52
118
12,189
5,300
3,516
2,336
25
1,155
685
234
236
1,784
1,217
567
6,889
5,422
12,025
4,785
3,207
2,100
26
1,081
655
214
212
1,578
1,097
481
7,240
6,097
576
384
172
332
199
119
227
350
371
160
246
136
171
178
94
129
14,017
4,583
3,033
1,976
23
Geriatric facilities ——
1,034
656
180
198
1,550
1,099
451
9,434
Woodlands -
Tranquille
All mental health centres
Abbotsford (September 1973)2
8,175
15
587
321
255
219
32
1
276
339
276
74
210
193
537
387
301
382
189
142
274
330
371
180
152
168
223
572
313
178
155
32
1
255
313
404
145
210
98
567
465
Courtenay
Cranbrook
Duncan
Fort St. John
Kamloops —
126
144
315
74
343
399
687
Nanaimo
296
471
New Westminster
263
241
Port Alberni (November 1972) 2
247
38
283
120
138
38
210
294
410
692
133
Prince Rupert (May 1973) 2
66
240
190
308
207
452
330
301
166
353
207
486
507
166
368
164
197
157
681
449
444
227
147
198
601
520
116
458
Surrey - —
Terrace
Trail — . . -
411
124
218
733
605
Whalley (November 1971)2
258
Williams Lake (Oct. 1972)2
12
385
406
68
28
276
57
42
...
1,018
821
54
15
221
31
1
773
114
534
90
34
11
268
156
25
229
26
7
West End Mental Health Unit6
99
i Includes permanent transfers, admissions from community, and returns from leave and escapes.
2 Month Centre/Department commenced reporting.
3 Fifteen patients active in the Riverview Hospital Centre Lawn out-patient case load are not included.
<t March 1972. 5 May 1972. 6 March 1973.
99
PATIENT
MOVEMENT
DATA
DATA, 1973
Entries
Exits
Facility
Total
ca
q
o
>
rt
il
3°
5 2
So
Total
eo
%H
ft
O
S
>
rt
u
a a,
da,
11
s- rt
<u ■-.
u
Q
2,655
2,479
1,931
42
506
404
78
24
176
121
55
12,348
2,400
2,263
1,755
42
466
378
65
23
137
89
48
244
209
172
~37
23
13
1
35
28
7
11
7
4
3
3
4
4
2,871
2,665
2,070
45
550
395
113
42
206
120
86
9,018
1,462
1,409
1,283
45
81
70
8
3
53
31
22
884
825
682
143
106
36
1
59
3
56
84
7
6
1
1
77
77
Residential programmes
Facilities for the mentally ill
441
424
99
Youth Development Centre
Geriatric facilities
Valleyview _
Dellview
Skeenaview
Facilities for the mentally retarded
325
218
69
38
17
9
Tranquille
8
9,948
8,636
180
544
542
316
170
261
105
338
341
496
246
291
260
206
479
272
325
136
173
293
409
401
220
623
641
344
24
572
118
35
274
55
56
202
7,556
6,378
~569
494
363
291
181
165
194
308
162
93
31
149
79
212
224
125
118
14
325
184
455
182
593
595
257
15
652
62
44
281
56
50
33
Abbotsford (Sept. 1973)2
Chilliwack -
Courtenay.
Cranbrook
Duncan
Fort St. John...
Kamloops
Kelowna ,
Penticton (Oct. 1971)2
Port Alberni (Nov. 1972)2
Port Coquitlam
Powell River (Jan. 1972) 2
Prince Rupert (May 1973)2
Surrey
Trail
Vernon
Whalley (Nov. 1971)2
Williams-Lake (Oct. 1972) 2
Riverview Out-patient
Woodlands Out-patient
Tranquille Out-patient
B.C. Youth Development Centre
Woodlands waiting-list
Tranquille waiting-list
West End Mental Health Units...
i Table compiled from actual data through September 1973, and projected for the remainder of the year.
(Note—In case of centres/departments opened in 1973: Table compiled on basis of available data for 1973
and projected for remainder of year.)
2 Month Centre/Department commenced reporting.
3 About 228 patients active in the Riverview Centre Lawn out-patient area case load are not included.
t March 1972. 5 May 1972. 6 March 1973.
100
FINANCIAL STATEMENTS
The following are financial reports of the Mental
Health Branch for the fiscal year ended March 31,
1973.
,\ - ;
:. -■ ■ ■ .■■,■■..:■■
0
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, 1963/64 to 1972/73.
Institution
Average
Number in
Residence
Maintenance
Expenditure
Yearly
per Capita
Cost
Daily
per Capita
Cost
1963/64
Crease Clinic
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
7.37
8.19
6.78
Provincial Mental Home, Colquitz
14.41
Valleyview Hospital, Essondale
7.52
Dellview Hospital, Vernon
5.92
Skeenaview Hospital, Terrace.
6.66
6,113.99
17,640,598.00
2,885.28
7.90
1964/65
227.59
2,740.84
1,314.20
512.79
753.91
234.70
290.44
1,573,366.00
8,054,536.00
4,501,364.00
1,509,947.00
2,351,885.00
553,985.00
510,679.00
6,936.16
2,938.71
3,425.17
2,944.57
3,119.58
2,360.40
1,758.29
18.94
Provincial Mental Hospital, Essondale
The Woodlands School, New Westminster
8.05
9.38
8.07
Valleyview Hospital, Essondale
8.55
Dellview Hospital, Vernon _
6.47
Skeenaview Hospital, Terrace
4.82
Totals for the year. _
6,074.47
19,055,762.00
3,137.02
8.59
1965/66
Riverview Hospital, Essondale
The Woodlands School, New Westminster
The Tranquille School
2,797.80
1,291.27
562.37
763.44
227.35
295.38
10,230,637.00
4,981,190.00
1,876,093.00
2,510,228.00
595,532.00
551,447.00
3,656.67
3,857.59
3,336.05
3,288.05
2,619.45
1,866.91
10.02
10.57
9.14
9.01
7.18
Skeenaview Hospital, Terrace
5.11
Totals for the year..
5,937.61
20,745,127.00
3,493.85
9.57
1966/67
Riverview Hospital, Essondale.-
The Woodlands School, New Westminster
2,760.21
1,307.53
602.46
760.73
219.13
284.32
11,162,462.00
5,376.492.00
2,267,399.00
2,668,056.00
635,710.00
589,492.00
4,044.06
4,111.95
3,763.57
3,507.23
2,901.06
2,073.34
11.08
11.27
10.31
Valleyview Hospital, Essondale
9.61
7.95
Skeenaview Hospital, Terrace
5.68
Totals for the year
5,934.38
22,699,611.00
3,825.10
10.48
1967/68
Riverview Hospital, Essondale
The Woodlands School, New Westminster
The Tranquille School
2,716.22
1,282.95
660.10
755.53
220.07
290.38
12,111,825.00
6,001,180.00
2,813,051.00
2,948,516.00
734,800.00
666,762.00
4,459.07
4,677.64
4,261.55
3,902.58
3,338.94
2,296.17
12.18
12.78
11.64
10.66
9.12
Skeenaview Hospital, Terrace
6.27
Totals for the year
5,925.25
25,276,134.00
4,265.83
11.66
103
L 104
MENTAL HEALTH BRANCH REPORT, 1973
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, 1963/64 to 1972/73—Continued.
Institution
Average
Number to
Residence
Maintenance
Expenditure
Yearly
per Capita
Cost
Daily
per Capita
Cost
1968/69
Riverview Hospital, Essondale
The Woodlands School, New Westminster
2,643.12
1,283.72
652.61
746.21
225.56
265.58
$
13,072,972.00
6,364,354.00
3,096,131.00
3,165,707.00
808,169.00
696,355.00
$
4,946.04
4,957.74
4,744.23
4,242.38
3,582.95
2,622.01
$
13.55
13.58
13.00
Valleyview Hospital, Essondale
Dellview Hospital, Vernon ._
Skeenaview Hospital, Terrace
11.62
9.82
7.18
Totals for the year
5,816.80
27,203,688.00
4,676.74
12.81
1969/70
Riverview Hospital, Essondale_.
The Woodlands School, New Westminster
2,506.21
1,257.98
608.46
711.15
225.36
257.98
15,423,584.00
7,534,683.00
3,593,393.00
3,698,227.00
922,330.00
814,091.00
6,154.15
5,989.51
5,905.72
5,200.34
4,092.69
3,155.64
16.86
16.41
16.18
Valleyview Hospital, Essondale
14.25
Dellview Hospital, Vernon.
11.21
8.65
Totals for the year ...
5,567.14
31,986,308.00
5,745.55
15.74
1970/71
Riverview Hospital, Essondale
2,510.44
1,279.60
579.15
685.33
225.60
254.28
16,186,488.00
8,168,889.00
3,787,785.00
3,824,163.00
974,623.00
865,471.00
6,447.67
6,383.94
6,540.25
5,580.03
4,320.04
3,403.61
17.66
The Woodlands School, New Westminster
The Tranquille School
17.49
17.92
Valleyview Hospital, Essondale...
15.29
11.84
9.32
Totals for the year
5,534.40
33,807,419.00
6,108.60
16.74
1971/72
2,363.70
1,216.51
548.76
669.84
227.41
233.91
17,393,443.00
8,745,677.00
4,149,495.00
4,203,564.00
1,055,612.00
941,455.00
7,358.55
7,189.15
7,561.58
6,275.47
4,641.88
4,024.85
20.11
The Woodlands School, New Westminster
The Tranquille School . .
19.64
20.66
17.15
Dellview Hospital, Vernon
Skeenaview Hospital, Terrace
12.68
11.00
Totals for the year
5,260.13
36,489,245.00
6,936.95
18.95
1972/73
2,131.45
1,112.34
485.53
660.32
210.44
212.16
18,757,094.00
9,574,840.00
4,460,869.00
4,512,183.00
1,175,207.00
998,938.00
8,800.15
8,607.84
9,187.63
6,833.33
5,584.52
4,708.41
24.11
The Woodlands School, New Westminster
The Tranquille School...
23.58
25.17
18.72
Dellview Hospital, Vernon
Skeenaview Hospital, Terrace
15.30
12.89
Totals for the year.. _
4,812.24
39,479,131.00
8,203.89
22.47
FINANCIAL STATEMENTS L 105
Table B—Summary Statement Showing the Gross and Net per Capita Costs oj
Patients in All Mental Health Institutions jor the Year Ended March 31,1973
Gross operating costs— $
Riverview Hospital, Essondale 18,757,094
The Woodlands School, New Westminster 9,574,840
The Tranquille School , 4,460,869
Valleyview Hospital, Essondale 4,512,183
Dellview Hospital, Vernon 1,175,207
Skeenaview Hospital, Terrace 998,938
39,479,131
Less collections remitted to Treasury 2,628,600
36,850,531
Daily average population 4,812.24
Gross per capita cost, one year 8,203.89
Gross per capita cost, one day 22.47
Net per capita cost, one year 7,657.66
Net per capita cost, one day 20.97
L 106
MENTAL HEALTH BRANCH REPORT, 1973
Table C—Expense Statement of Riverview Hospital for 12 Months Ended
March 31,1973 (Includes Out-patient Services)
Salaries, Supplies, and Operating
Expenses
Vouchered
Expenditures
Services and
Supplies
From Public
Works
Department
Inventory Adjustment
Actual
Plus on Hand,
March 31,
1972
Less on Hand,
March 31,
1973
Cost of
Operation
$
14,427,367
47,273
20,627
15,943
776,555
1,409,176
12,310
46,973
2,306
26,080
16,786
547,005
17,654
15,037
275
19,039
51,759
923
$
$
$
$
14,427,367
Office expense.
47,273
20,627
15,943
146,818
147,286
776,087
1,409,176
12,310
46,973
127,500
2,306
Maintenance and operation of equipment-
26,080
16,786
134,468
553,973
Occupational and recreational therapy
17,654
15,037
275
19,039
General expense
51,759
210,000
923
1,486,542
165,000
1,441,542
Less—
Increase in inventory, institutional
stores
17,453,088
103,441
4,272
30,343
5,980
1,486,542
446,286
484,786
18,901,130
103,441
4,272
30,343
5,980
17,309,052
1,486,542
446,286
484,786
18,757,094
Yearly
Salar
per capita cc
ies
st— $
6,768.80
2.031.35
i
,800.15
FINANCIAL STATEMENTS
L 107
Table D—Expense Statement of The Woodlands School for 12 Months
Ended March 31,1973
Salaries, Supplies, and Operating
Expenses
Vouchered
Expenditures
Services and
Supplies
From Public
Works
Department
Inventory Adjustment
Actual
Plus on Hand,
March 31,
1972
Less on Hand,
March 31,
1973
Cost of
Operation
$
7,893,977
11,695
8,101
1,183
232,288
551,669
42,186
12,249
176
10,483
2,120
275,855
5,044
6,054
2,117
4,093
32,510
160
$
$
$
$
7,893,977
11,695
8,101
1,183
38,100
38,210
232,178
551,669
42,186
12,249
176
Maintenance and operation of equipment
10,483
2,120
275,855
5,044
6,054
2,117
4,093
32,510
160
546,642
546,642
Less—■
Increase to inventory, institutional
9,091,960
55,415
6,432
1,805
546,642
38,100
38,210
9,638,492
55,415
6,432
1,805
9,028,308
546,642
38,100
38,210
9,574,840
Yearly per capita cost— $
Salaries 7,096.73
Expenses 1,511.11
8,607.84
L 108
MENTAL HEALTH BRANCH REPORT, 1973
Table E—Expense Statement of The Tranquille School,
for 12 Months Ended March 31,1973
Vouchered
Expenditures
Services and
Supplies
From Public
Works
Department
Inventory Adjustment
Actual
Salaries, Supplies, and Operating
Expenses
Plus on Hand,
March 31,
1972
Less on Hand,
March 31,
1973
Cost of
Operation
$
3,232,509
10,034
6,703
1,579
90,202
320,770
16,895
7,515
170
7,171
1,341
130,395
18,330
1,752
1,344
4,409
14,486
425
.
$
$
$
3,232,509
10,034
6,703
1,579
90,202
Dietary..
11,363
12,268
319,865
16,895
7,515
170
Maintenance and operation of equipment.—.
Transportation _ , -
7,171
61,856
1,341
62,741
129,510
Occupational and recreational therapy
18,330
1,752
1,344
4,409
14,486
425
Buildings and grounds
629,147
629,147
Less—
3,866,030
12,870
19,648
629,147
73,219
75,009
4,493,387
12,870
19,648
3,833,512
629,147
73,219
75,009
4,460,869
Yearly per capita cost— $
Salaries 6,657.69
Expenses . 2,529.94
9,187.63
FINANCIAL STATEMENTS
L 109
Table F—Expense Statement of the British Columbia Youth Development Centre
for 12 Months Ended March 31, 1973
The British Columbia Youth Development Centre expenditure statement
covers the following departments:
General Administration for all units of the Mental Health Branch,
Burnaby;
Forensic Clinic;
Family and Children's Clinic;
Psychological Education Clinic;
Residential Unit.
General Administration covers 38 staff (salaries, $257,610). The salaries for
General Administration are divided among the following units:
Mental
Health
Centre,
Burnaby
Forensic
Clinic
Family
and
Children's
Clinic
Psychological
Education
Clinic
Residential
Unit
Total
General Administration salaries
$
51,522
$
$
51,522
240,686
1,700
36,168
$
25,761
122,872
4,834
35,574
$
128,805
439,306
17,585
81,232
$
257,610
46,911
3,932
849,775
904
28,955
Unit expense
152,974
Buildings and grounds
52,426
28,616
50,843
330,076
19,077
189,041
28,616
666,928
114,465
1,289,314
190,774
Totals -
81,042
50,843
349,153
217,657
781,393
1,480,088
Table G—Expense Statement of the Valleyview Hospital, Essondale,
for 12 Months Ended March 31,1973
Salaries, Supplies, and Operating Expenses
Net Vouchered
Expenditure
Services and
Supplies From
Public Works
Department
Actual
Cost of
Operations
$
3,763,269
5,162
7,173
2,136
141,325
333,866
23,212
3,295
6,627
1,518
135,891
2,208
2,211
2,754
2,538
80
$
$
3,763,269
5,162
7,173
2,136
141,325
333,866
23,212
3,295
6,627
1,518
135,891
2,208
2,211
2,754
2,538
120,542
80
Buildings, grounds, etc.
120,542
Less—
Increase in inventory for Institutional Stores
4,433,265
25,861
15,763
120,542
4,553,807
25,86i
15,763
4,391,641
120,542
4,512,183
Yearly per capita cost-
Salaries
Expenses
5,699.16
1,134.17
6,833.33
L 110
MENTAL HEALTH BRANCH REPORT, 1973
Table H—Expense Statement of the Dellview Hospital, Vernon,
for the 12 Months Ended March 31,1973
Salaries, Supplies, and
Operating Expense
Vouchered
Expenditures
Services and
Supplies from
Public Works
Department
Inventory Adjustment
Actual
Plus on
Hand,
March 31,
1972
Less on
Hand,
March 31,
1973
Cost of
Operation
$
828,316
1,486
1,608
29,591
445
103,569
5,943
66
38
997
40,072
58
527
3,884
2,135
$
$
$
5,728
4,437
$
828,316
1,486
1,608
5,817
4,268
12,891
29,680
445
103,400
5,943
66
12,685
38
997
40,278
58
527
3,884
2,135
161,670
161,670
Less—
1,018,735
1,104
4220
161,670
22,976
22,850
1,180,531
1,104
4,220
Adjusted expenditure ...
1,013,411
161,670
22,976
22,850
1,175,207
Yearly per capita cost-
Salaries
Expenses
3,936.11
1,648.41
5,584.52
FINANCIAL STATEMENTS
L 111
Table I—Expense Statement of the Skeenaview Hospital, Terrace,
for the 12 Months Ended March 31,1973
Salaries, Supplies, and
Operating Expenses
Vouchered
Expenditures
Services and
Supplies
From
Public Works
Department
Inventory Adjustment
Actual
Plus on
Hand,
March 31,
1972
Less on
Hand,
March 31,
1973
Cost of
Operation
$
653,753
1,676
1,839
1,238
38,593
113,391
7,604
22
270
521
267
32,989
1,465
2,932
54
2,604
3,142
$
$
13,248
12,145
$
14,714
14,154
$
653,753
1,676
1,839
1,238
38,593
111,925
7,604
22
270
521
267
30,980
Occupational and recreational therapy
1,465
2,932
54
2,604
147,590
3,142
147,590
Less—
862,360
3,935
3,602
147,590
25,393
28,868
1,006,475
3,935
3,602
854,823
147,590
25,393
28,868
998,938
Yearly per capita cost—
Salaries
Expenses ~
$
3,081.41
1,627.00
4,708.41
L 112
MENTAL HEALTH BRANCH REPORT, 1973
Table J—Expense Statement of the Community Services jor
12 Months Ended March 31,1973
Mental health centres—
Burnaby.
Victoria-
Saanich.
Kelowna.
Trail.
Nanaimo.
Prince George.
Kamloops.
Chilliwack.
Training programmes
Courtenay.
Cranbrook.
Vernon.
Nelson.
Maple Ridge.
Surrey.
New Westminster.
Terrace.
Port Coquitlam-
Whalley.
Fort St. John.
Duncan.
Penticton.
Port Alberni.
Prince Rupert.
Williams Lake.
Powell River.
$
1,477
Assistance for retarded children 121,595
Development of pyschiatric home treatment services
Operation expenses of Glendale Hospital
Technical services and development of new patient-care programmes
Establishment of new mental health centres
Salaries
Office expense
Travelling expense
Office furniture and equipment
Medical care
Dietary
Laundry
Maintenance and operation of equipment
Transportation
General supplies
Occupational and recreational therapy
Patient education
Motor-vehicles and accessories
General expense
Less salary adjustments
33,000
16,392
310,483
4,083
1,819,868
19,659
69,896
29,039
361,685
509
24,273
12,560
1,072
5,604
2,864
253
10,788
18,458
2,863,558
104,764
2,758,794
FINANCIAL STATEMENTS L 113
Table K—Expense Statement oj General Administration jor
the 12 Months Ended March 31,1973
$
Salaries 589,131
Office expense 14,186
Travelling expense 30,644
Office furniture and equipment 1,613
Grant to Trustees of Patients' Comfort Fund 12,000
Printing and publication 8,900
Grant to UBC research 30,000
Audio-Visual 52
General expense 1,258
Administration of Psychiatric Nurses Act 3,582
Council of Psychiatric Nurses' Bursary Trust Fund 1,200
Mental health care and training grants 240,279
Stores equipment 415
Social Service Index subscription 32
933,292
Less salary adjustments 29,052
904,240
Table L—Expense Statement oj the Department oj Nursing Education jor
the 12 Months Ended March 31,1973
Salaries 557,105
Office expense 5,906
Travelling expense 263
Office furniture and equipment 796
Medical care 713
Dietary 3,394
Laundry 4,957
General supplies 9,933
Audio-Visual 3 7
General expense 568
Affiliate and postgraduate training 6,479
Bursaries for psychiatric nurses 73,348
663,499
Less salary adjustments 26,124
637,375
L 114 MENTAL HEALTH BRANCH REPORT, 1973
Table M—Institutional Stores
$
Net undistributed stores as per Public Accounts 267,784
Adjustment re farm profits 9,149
276,933
Inventory adjustment—
Plus on hand March 31, 1972 564,843
841,776
Less on hand March 31, 1973 657,059
The increase in inventory has been transferred to the
following institutions proportionately, using the vouchered
expenditure as the basis for distribution:
Per Cent
Riverview Hospital 56 103,441
The Woodlands School 30 55,415
Valleyview Hospital 14 25,861
184,717
Reconciliation With Public Accounts, 1972/73
Table K—General Administration
$ $
Salaries 589,131
Expenses 344,161
933,292
Deduct salary adjustments 29,052
As per Public Accounts 904,240
Table L—Department oj Nursing Education
Salaries 557,105
Expenses 106,394
663,499
Deduct salary adjustments 26,124
As per Public Accounts 637,375
Table J—Community Services
Salaries 1,819,868
Expenses 1,043,690
2,863,558
Deduct salary adjustments 104,764
As per Public Accounts 2,758,794
FINANCIAL STATEMENTS
Table C—Riverview Hospital and Out-patient Services
$ $
Salaries 14,427,367
Expenses 4,329,727
Vouchered expenditure 18,757,094
Deduct—
Buildings and grounds 1,486,542
Salary adjustments 796,356
2,282,898
16,474,196
Add—
Sundry adjustments, board, etc. 144,036
Increase in inventory 38,500
182,536
As per Public Accounts
L 115
16,656,732
Table G—Valleyview Hospital
Salaries
Expenses
Vouchered expenditure
Deduct—
Buildings and grounds 120,542
Salary adjustments 202,380
Portion of farm profits 798
Add—Sundry adjustments, board, etc.
As per Public Accounts
3,763,269
748,914
4,512,183
323,720
4,188,463
41,624
4,230,087
Table H—Dellview Hospital
Salaries
Expenses
Vouchered expenditure
Deduct—
Buildings and grounds
Salary adjustments
Decrease in inventory _.
161,670
43,620
126
Add—Sundry adjustments, board, etc.
As per Public Accounts
828,316
346,891
1,175,207
205,416
969,791
5,324
975,115
L 116 MENTAL HEALTH BRANCH REPORT, 1973
Table I—Skeenaview Hospital
$ $ $
Salaries 653,753
Expenses 345,185
Vouchered expenditure 998,938
Deduct—
Buildings and grounds 147,590
Salary adjustments 32,112
179,702
819,235
Add—
Sundry adjustments, board, etc. 7,537
Increase in inventory 3,475
11,012
As per Public Accounts 830,247
Table D—The Woodlands School—
Salaries 7,893,977
Expenses 1,680,863
Vouchered expenditure 9,574,840
Deduct—
Buildings and grounds 546,642
Salary adjustments 407,400
Portion of farm profits 1,294
955,336
8,619,504
Add—
Sundry adjustments, board, etc. 63,652
Increase in inventory 110
63,762
As per Public Accounts 8,683,266
Table E—The Tranquille School—
Salaries 3,232,509
Expenses 1,228,360
Vouchered expenditure 4,460,869
Deduct—
Buildings and grounds 629,147
Salary adjustments 170,856
Portion of farm profits 2,201
802,204
3,658,665
FINANCIAL STATEMENTS
$
Add—
Sundry adjustments, board, etc.
Increase in inventory
As per Public Accounts
32,518
1,790
34,308
L 117
3,692,973
Table F—B.C. Youth Development Centre
Salaries
Expenses
Deduct—salary adjustments
As per Public Accounts
Table M—Net Undistributed Stores
New patient-care programmes .
1,205,820
152,974
1,358,794
69,480
Special Warrant 8—Grant to Granville School
Special Warrant 9—Grant re Treatment Resources Act
Special Warrant 17—Grant to Kamloops School District No.
24
Total expenditure as per Public Accounts
1,289,314
267,784
175,400
4,150
507,913
75,000
41,688,390
Printed by K. M. MacDonald, Printer to the Queen's Most Excellent Majesty
in right of the Province of British Columbia.
1974
780-773-6112
BC Sessional Papers
Mental Health Branch PROVINCE OF BRITISH COLUMBIA ANNUAL REPORT 1973 British Columbia. Legislative Assembly 1974
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