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Mental Health Branch PROVINCE OF BRITISH COLUMBIA ANNUAL REPORT 1974 British Columbia. Legislative Assembly 1975

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 DEPARTMENT OF HEALTH
Mental Health Branch
PROVINCE OF BRITISH COLUMBIA
ANNUAL REPORT
1974
Printed by K. M. MacDonald, Printer to the Queen's Most Excellent Majesty
in right of the Province of British Columbia.
1975
  To Colonel the Honourable Walter S. Owen, Q.C, LL.D.,
Lieutenant-Governor oj the Province of British Columbia.
May it please Your Honour:
The undersigned respectfully submits the Annual Report of the Mental Health
Branch, Department of Health, for the year 1974.
DENNIS G. COCKE
Minister oj Health
Office oj the Minister oj Health,
Victoria, B.C., February 18,1975.
  Department of Health,
Mental Health Branch,
Victoria, B.C., February 18, 1975.
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 1974.
F. G. TUCKER, M.B., B.S., C.R.C.P., M.Sc.
Deputy Minister oj Mental Health
  The Honourable Dennis Cocke, Minister of Health (left), lent his support to the
November memebrship drive of the Canadian Mental Health Association (B.C. Division)
and is shown receiving a symbolic candle from George Rempel (right), Vice-President and
Campaign Chairman. Viewing the presentation are Dr. Roy Watson, President, and
Lieut.-Col. Douglas Carter, Executive Director. Candles made in sheltered workshops
operated by the CMHA were given with each membership and represented the theme of
the drive, "Light a Candle for Mental Health".
  DEPARTMENT OF HEALTH
MENTAL HEALTH BRANCH
The Honourable Dennis G. Cocke, Minister oj 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.,
Consultant in Sociology.
Miss M. M. 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.
Mrs. C. W. Porteous, B.A., M.A.,
Statistician.
W. A. Blair,*
Mrs. B. Hopkins, B.Ed.,t
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.
Y. Bledsoe, M.S.W.,
Administrator, Powell River Mental
Health Centre.
J. S. Brown, M.S.W.,
Administrator, Whalley 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, M.N.,
Administrator, Squamish Mental Health
Centre.
R. N. Crawford, B.A., B.S.W., M.S.W.,
Administrator, Victoria Mental Health
Centre.
C. DeWitt, Ph.D.,
Administrator, Fort St. John Mental
Health Centre.
E. M. Forsyth, M.S.W.,
Administrator, Cranbrook 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.C.P.(C),
Administrator, Burnaby Mental Health
Centre.
J. A. Hutton, M.S.W.,
Administrator, Duncan Mental Health
Centre.
* Resigned June 15.
t Appointed Augubt 12.
 J. Kanevsky, M.A.t
Administrator, Courtenay Mental Health
Centre.
K. Lerner, B.A., M.S.W.,
Administrator, Langley 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, M.A.,
Administrator, Sechelt Mental Health
Centre.
D. L. Mitchell, B.Ed., M.A.,
Administrator, Surrey Mental Health
Centre.
J. M. Mossing, R.N., B.S.N.,
Administrator, Penticton Mental Health
Centre.
A. Newton-White, M.S.W.,
Administrator, Saanich Mental Health
Centre.
B. Schikowsky, B.A., M.S.W.,
Administrator, Chilliwack 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, Williams Lake 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.
S. Zimmerman, M.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),
Director, Valleyview Hospital.
J. Bower, M.D., M.R.C.Psych., D.P.M.,
Executive Director, Tranquille.
A. P. Hughes, M.D., B.Sc, C.R.C.P.,
Executive Director, Woodlands.
BRITISH COLUMBIA YOUTH DEVELOPMENT CENTRE
P. H. Adilman, M.D., F.R.C.P.(C),
Director, Residential Unit.
D. C. Shalman, Ph.D.,
Director, Psychological Education Clinic.
t J. L. Kyle, M.A., on educational leave.
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  TABLE OF CONTENTS
GENERAL ADMINISTRATION PA(;E
The Year in Review  17
Adult Psychiatric Services  19
Retardation and Children's Psychiatric Services  21
Nursing Consultation Services  22
Sociology Consultation Services  24
Psychology Consultation Services  26
Management Analyst Consultation Services  27
Boarding Home Programme  28
Personnel  32
Statistics and Medical Records  34
Information Services  37
COMMUNITY MENTAL HEALTH SERVICES
Abbotsford Mental Health Centre  42
Burnaby Mental Health Centre    42
Chilliwack Mental Health Centre  44
Courtenay Mental Health Centre  45
Cranbrook Mental Health Centre  47
Duncan Mental Health Centre  47
Fort St. John Mental Health Centre  49
Kamloops Mental Health Centre  49
Kelowna Mental Health Centre  50
Langley Mental Health Centre  51
Maple Ridge Mental Health Centre  52
Nanaimo Mental Health Centre  54
Nelson Mental Health Centre  55
New Westminster Mental Health Centre  56
Penticton Mental Health Centre  57
Port Alberni Mental Health Centre   59
Port Coquitlam Mental Health Centre  61
Powell River Mental Health Centre  61
Prince George Mental Health Centre  62
Prince Rupert Mental Health Centre  63
Saanich Mental Health Centre  64
Sechelt Mental Health Centre  64
Squamish Mental Health Centre  66
Surrey Mental Health Centre  66
Terrace Mental Health Centre    67
Trail Mental Health Centre  68
Vernon Mental Health Centre  70
Victoria Mental Health Centre  71
Whalley Mental Health Centre  72
Williams Lake Mental Health Centre  73
13
 IN-PATIENT SERVICES
Riverview Hospital  77
Valleyview Hospital  84
Dellview Hospital  8 7
Skeenaview Lodge  90
Woodlands  91
Tranquille  96
British Columbia Youth Development Centre.    99
CONSTRUCTION AND MAINTENANCE REVIEW  105
PATIENT MOVEMENT
Patient Movement Trends  109
Patient Movement Data  110
FINANCIAL STATEMENTS
14
 GENERAL ADMINISTRATION
A
mental
health
branch
  GENERAL
ADMINISTRATION
THE YEAR
IN REVIEW
F. G. Tucker, M.B., B.S., C.R.C.P., M.Sc.
Deputy Minister of Mental Health
The work of the Mental Health Branch has been carried on over the past year
amidst concerns and anxieties that naturally arise at times of major change. At the
conclusion of this fiscal year the Mental Health Branch will cease to exist as an
independent entity and its resources will be assigned to the various components that
make up the revised Departmental structure. There will be an opportunity within
this reorganization for the establishment of new and imaginative programmes, the
development of common standards, and the ability to make effective and economic
use of the Provincial health resources.
Details of the various programmes are contained in the body of this report
and the following comments will merely serve to highlight certain events that have
occurred during this year.
Over the past 15 years the expansion of the community mental health programme has often been a matter of expediency and opportunism, as we endeavoured
to make optimal use of resources within a particular setting and at a particular
point in time. The fact that programmes have tended to vary from region to region
has given us an excellent opportunity to study a variety of models upon which to
base our future planning.
The Greater Vancouver Mental Health Services project has expanded and
consolidated its position. Nine teams are now in operation with a further four
proposed for development in the coming months. The staff, always of high calibre,
have gained in confidence and experience. In July, this service was augmented by
the transfer of the staff of the Family and Children's Programme from the British
Columbia Youth Development Centre to the Vancouver region, augmenting the
work of the teams and establishing a pre-school programme. The Psychiatric Unit
of St. Vincent's Hospital is now functioning, and that of St. Paul's will be open within
the foreseeable future. These units, together with those planned for St. Joseph's
and Shaughnessy Hospitals, will go a long way to meeting the in-patient needs, as
long as these units are effectively used and the back-up resources are available within
the community. The lack of these resources in the form of short-stay hostels, day
care and activity programmes, supervised residences and workshops, has been a
major concern during the past year. Certain steps, however, are now being taken
to improve this situation.
The Burnaby Mental Health Service, which also lacks intermediate care facilities, provides a well-integrated mental health programme under one administration.
Circumstances which were peculiar to the Burnaby area have permitted us to develop
a unique programme on this continent. The support and co-operation of the Community Advisory Board in this area have been particularly gratifying.
The Lower Fraser Valley Regional Programme, consisting of six mental health
centres, working co-operatively with the Centre Lawn Unit of Riverview Hospital
17
 F 18 MENTAL HEALTH BRANCH REPORT, 1974
and other community facilities, has experienced difficulties probably related to the
superimposition of a new programme on established patterns of care. Lack of psychiatrists available to provide after-hour and week-end coverage, on a regional basis,
has presented difficulties and delayed the full implementation of this programme.
The mental health centres throughout the remainder of the Province have
functioned well, but the perennial shortage of psychiatrists in the Interior and
northern parts of British Columbia detracts from the full effectiveness of these units.
It should be noticed that the proper utilization of the increasing numbers of psychiatric beds in general hospitals depends upon the availability of local psychiatric
consultaton.
The "Core Committee" report on the unitization of Riverview Hospital was
received in August. It included reports from unit advisory committees, which were
comprised of a cross-section of hospital staff. This report is currently under consideration in the light of the Departmental reorganization. Within the hospital itself
programmes have been well maintained in spite of the difficulty of recruiting trained
nursing staff and medical staff, particularly in the summer months. The average
bed utilization has been reduced to 1,762, compared to 2,002 over a similar period
last year, and the official bed establishment is now 1,966. In November the hospital
was surveyed for accreditation by the Canadian Council on Hospital Accreditation
but the results are presently unknown.
The Psychogeriatric Programme has been well maintained with continuing
heavy demands placed upon the nursing divisions. In May the responsibility for the
operation of the Skeenaview Hospital at Terrace was transferred to a society and it
appears to be functioning well. This is the first established Provincial mental health
facility to be transferred to a local board.
In July, responsibility for the Provincial Retardation Programme was transferred to the Department of Human Resources and Woodlands and Tranquille were
placed under a Joint Management Committee to facilitate this transfer, which is to
be completed by March 31, 1975. As many of the 1,700 patients in the present
Boarding Home Programme are retarded, this programme has also been placed
under the joint management of the Department of Human Resources and Department of Health indefinitely. The excellent co-operation by all concerned enabled
these major moves to be achieved with minimal difficulty.
In August Dr. P. Adilman was appointed Director of the residential unit at the
British Columbia Youth Development Centre, and this unit will be working in close
collaboration with the Department of Psychiatry, University of British Columbia,
in the training of residents and other staff. This unit operates an assessment team,
day care centre, and three 15-bed cottages, each headed by a psychiatrist. A period
of reorientation is in progress, with full co-operation and participation of the staff.
This unit will concentrate increasingly upon the seriously mentally ill child and
adolescent, rather than the behaviourly disordered.
The Forensic Psychiatric Services Commission Act was passed by the Legislature in March and the first meeting of the Commission took place in July. The
Department is working in close co-operation with this Commission in the planning
and development of services.
In the coming weeks the Branch staff will be assigned to new positions within
the Department, and I would be remiss if I were not to express my sincere personal
appreciation to them for the contribution they have made to the Mental Health
Branch, and for their friendship and loyalty to me over the past seven years.
 ADULT
PSYCHIATRIC
SERVICES
The work of the Co-ordinator of Adult Psychiatric Services continued in 1974
along the lines established in the previous year. Specific assignments from the
Deputy Minister were limited in number and essentially investigative. None provided a major work load as had been the case with the Forensic Psychiatric Services
Committee in 1973, when half the available time went into the work of the Committee. As a result, much more time was available for a problem-solving role in
relation to mental health centres and the Boarding-home Programme, and the
amount of travelling undertaken, mainly by air, increased substantially.
BOARDS AND COMMITTEES
The Co-ordinator continued as the Director of the Community Care Services
Society and as a member of the Riverview Hospital Advisory Board.
Useful liaison functions were performed in the Co-ordinator's membership in
the Graduate Training Programme Committee of the Department of Psychiatry at
UBC and membership in the Section of Psychiatry of the B.C. Medical Association.
MEDICAL STAFFING
Advertising, correspondence, and personal interviews directed toward the
recruitment of medical personnel occupied an increased proportion of the working
time available during 1974.
Amongst the institutions, only Riverview Hospital had a medical staff shortage,
and almost all the mental health centres in, or within easy reach of, major metropolitan areas were staffed. In some areas, such as parts of the Fraser Valley, the
mental health centre psychiatric positions were staffed, but the communities were
seriously underserviced through lack of adequate numbers of privately practising
psychiatrists. As a result, centre psychiatrists were overloaded with direct service
commitments, resulting in a relative neglect of some of the community psychiatry
functions for which they are recruited. The more remote communities continued to
have difficulty in attracting psychiatrists in either public service or private practice.
It seemed unlikely that this situation would be resolved until some additional incentives were provided to psychiatrists willing to practise in the less popular locations.
During the year an excellent relationship was maintained with the Registrar and
Deputy Registrar of the College of Physicians and Surgeons of British Columbia,
both of whom, as in the past, were of the greatest possible assistance concerning
medical staff matters.
GENERAL HOSPITAL PSYCHIATRY
Contact was made with a number of general hospitals with regard to their plans
and proposals for in-patient or day hospital programmes. Development in this area
was slow, and the representatives of many communities appeared to regard these
programmes as a desirable bonus over and above essential basic treatment services
for the severely disturbed, which they continued to expect central Provincial programmes to provide. There appeared to be a continuing need for public education
with regard to the prime necessity for services to be provided locally.
19
 F 20
MENTAL HEALTH BRANCH REPORT,  1974
MENTAL HEALTH CENTRES
Work in relation to the mental health centres involved consultation about medical staffing, and a number of attempts to place psychiatrists in centres where they
were needed. Other centre consultations were, for the most part, related to the
solution of specific problems.
The mental health centres in the Lower Fraser Valley were placed under the
administrative direction of the Consultant in Sociology with whom collaborative
attempts were made at developing closer relationships among these six centres, with
an inter-relationship in their programmes, at least in the area of the care of patients
admitted to Riverview Hospital. This had been a complex situation, rendered more
difficult by a shortage of psychiatrists in the centres concerned early in the year.
The project appeared to be progressing more satisfactorily at the end of the year,
with all the mental health centres fully, or almost fully, staffed psychiatrically. With
all these centres having psychiatrists who provided some service in Centre Lawn at
Riverview, there appeared a possibility of movement toward an integrated programme in this region.
The Co-ordinator was able to maintain a realistic contact with the everyday
problems of clinical psychiatry through a one-day-a-week service on the staff of the
mental health centre in Sechelt. This was a salutary experience, supporting the contention that all consultants should retain at least some small direct service responsibility in order to avoid becoming divorced from the day-to-day problems of their
specialty.
It appeared that such a diversity of responsibility on the part of the Coordinator, with all the travelling and consultation involved, constituted a load which
no one individual was probably capable of satisfactorily completing. This raised
the question of whether the responsibility should not devolve upon two or more
individuals regionally assigned, rather than by one individual who could respond
only to those areas where the demand was greatest at any particular time.
 RETARDATION AND
CHILDREN'S
PSYCHIATRIC SERVICES
In the early part of the year a policy decision was made to transfer the responsibility for services to the mentally retarded from the Department of Health to the
Department of Human Resources. Ontario had recently made a similar transfer
and British Columbia was the last Province where the Health Department had such
primary responsibility. In order to arrange the transfer in a smooth fashion, a
Management Committee consisting of representatives from the Mental Health
Branch and the Department of Human Resources was set up to oversee the operations of the three institutions for the mentally retarded, and to plan future programmes of community development. This Management Committee functioned
from July 1 until the end of December, when the Department of Human Resources
took sole charge. It should be emphasized that although the Department of Human
Resources acquired the administration of the institutions and the responsibility for
programme planning, the Department of Health would continue to be concerned
about the prevention and alleviation of handicapping conditions, and through the
mental health centres and the public health units would continue to provide service
to the mentally retarded and their families.
The Co-ordinator spent the majority of his time in the planning for this change,
as the Mental Health Branch representative on the Management Committee. It
was his feeling, and that of his colleagues in the Department of Human Resources,
that a smooth transfer had taken place, and he was enthusiastic about future plans.
During the year there was increased emphasis on the provision of care at the
community level, and the need for early intervention and remediation of problems.
Many areas, particularly in the Lower Mainland, had at least the start of an Infant
Development Programme, which aimed at providing necessary services to any child
who was severely behind in his or her development. Pre-school programmes followed for the 3 to 5-year-olds, so that the early gaps in services were being
filled. Flexible arrangements between Government departments, school boards,
and local agencies meant that many children previously excluded from school were
able to attend, and an increase in activity centre places provided extra service to
retarded young adults. The principal need at the year-end was for a larger number
of appropriately trained staff to work in the developing network. It was hoped that
agreed courses in child care, and in the care of the handicapped, would be set up in
various regional colleges in the near future.
In the Co-ordinator's view the principal requirement for the emotionally disturbed child and adolescent was the provision of regional assessment centres. With
the emphasis on local community care, it became increasingly necessary to have a
clear idea of each child's problem so that an appropriate programme could be
initiated and monitored. The second urgent requirement, unfortunate though it may
be, was for a residential programme with a security provision. There were relatively few young people presenting very difficult management problems, but there
was no setting where they could be adequately cared for and properly treated.
21
 NURSING
CONSULTATION
SERVICES
During the year, nursing consultation services were provided to the Deputy
Minister and his staff, to Mental Health Branch institutions and mental health
centres, to other Government departments, to community agencies and professional
organizations, and to individuals. Within this context a variety of activities were
undertaken directly, or in collaboration with others.
A procedure was developed to acquire nursing staff statistics at the ward level
in each institution, with the analysis of the reporting providing information on
changes in staffing patterns. Assessments were made of the facilities' staffing proposals and nursing estimates. Considerable attention was given to diverse personnel
matters, which included provision of professional references and information on
employment opportunities; a review of performance appraisals and requests for
changes in employment conditions; the assessment of bursary applications, follow-up
and replacement of bursary students and graduates; recruitment and selection
activities. The serious shortage of nurses with competency in psychiatric in-patient
and community mental health practice, and the general lack of applicants for nursing
position vacancies in the Mental Health Branch facilities, provoked numerous
staffing problems and, consequently, plans to improve recruitment. Through various
channels, these concerns were brought to the attention of the Registered Nurses and
Psychiatric Nurses Associations, the Public Service Commission, and the Health
Manpower Working Group. The recruitment problem was aggravated by the
development of new psychiatric services throughout the Province. In this respect
the Nursing Liaison Committee began to gather information from existing psychiatric
services, in order to develop guidelines for the functional development of in-patient
psychiatric nursing programmes.
The need for nurses to acquire specialized training in community mental health
nursing, prompted the initiation of an educational project to orient and train basic
nurses in community mental health nursing. A full-time director and a teacher were
recruited, an advisory committee established, a curriculum of four months' duration
designed, and testing tools developed to select 20 nurses for newly established basic
community psychiatric nursing positions in mental health centres. A part-time
research officer was employed to evaluate the effectiveness of the course. It was
anticipated that the project would be completed by July 1975.
At the request of the B.C. Government Employees' Union, the Minister of
Health authorized the establishment of a committee to study the role and training
of psychiatric aides. The committee, composed of Union and Branch office representatives, had the assistance of a research officer to develop tools for the study,
to collect and analyse data. Emphasis was placed on providing an opportunity for
every psychiatric aide in Branch facilities to contribute in a variety of ways to the
study, which was expected to be completed by February 1975.
Committee responsibilities provided a means of fostering improvement in
mental health-psychiatric nursing education and practice. These included the
Nursing Liaison Committee; Intradepartmental Senior Nursing Committee, which
provided consultation on nursing to the Health and Human Resources Development
Group; Psychiatric Nurses Educational Advisory Committee, which provided assistance to the Registered Psychiatric Nurses Association in developing registration
22
 GENERAL ADMINISTRATION
F 23
examinations; Advisory Committees to the BCIT Registered Psychiatric Nurse and
Registered Nurse programmes; and the Directors of Nursing Council, which developed material for nursing administration input into the bargaining process for
collective agreements affecting nurses.
An overview of the state of mental health-psychiatric nursing was obtained
through visits to mental health facilities, hospitals and mental health centres, and
opportunities were made to meet with nurses providing psychiatric and support
services in adjacent general hospitals and public health units.
The Education Centre, Essondale, continued to operate under the administration of the Nursing Consultant. It provided facilities for a wide variety of workshops, seminars, and meetings conducted by the Mental Health Branch, community
institutions, and agencies and professional organizations. Two hundred and twelve
sessions were held with approximately 4,430 persons attending. It continued to be
used as a "second campus" by the B.C. Institute of Technology Psychiatric Nursing
Programme with 60 to 110 students two days per week; the BCIT Extension Department used the facilities for 60 students enrolled in a refresher course in basic
nursing, eight students in maternity nursing, and 20 students in basic psychiatric
nursing. Sixty-five students from the Royal Columbian Hospital completed an
eight-week affiliation in psychiatric nursing. In November, 20 nurses commenced
a 16-week course in Community Psychiatric Nursing conducted by the Mental
Health Branch.
Residence accommodation was provided for 319 persons. Library facilities
were made available to Public Service employees and others using the Education
Centre, and these comprised 7,250 recorded users. Throughout the year, assessment
of the usefulness of the Education Centre for teaching purposes was made by a
number of agencies, including the B.C. Institute of Technology, Douglas College,
and the B.C. Medical Centre.
The Consultant had the opportunity to participate in several conferences which
enhanced her awareness of trends in health care systems. These included (a) a
workshop on Industrial Relations sponsored by the Provincial Government; (b)
the Annual Meeting of the Psychiatric Nurses Association of Canada, in the capacity
of consultant to the B.C. Registered Psychiatric Nurses Association delegation; and
(c) an invitational conference of Mental Health Professionals, as the British
Columbia nursing representative.
As the year drew to a close, it became increasingly apparent that the many
changes occurring in Government service, in the Health Department, and in the
Mental Health Branch, mirrored changes in the Province's expectations of the
nursing component of mental health programmes. Since nursing services were the
foundation for such programmes, the challenge to nurses to meet new expectations
was made clear.
 SOCIOLOGY
CONSULTATION
SERVICES
PSYCHIATRIC HOME TREATMENT RESEARCH PROJECT
A pilot study of psychiatric home treatment as an alternative to Riverview
Hospital admission began in the summer of 1971. Based in Vancouver, the study
was designed to compare domiciliary care with mental hospital care, by means of a
multivariate cost effectiveness analysis of the two methods of treatment. Analysis
of the results to date indicated that one-third of those patients who otherwise would
have been admitted to hospital, were treated in the community, without having to
be admitted to hospital during the one year follow-up study period. During the
entire study period, hospital staff shortages led to restricted admissions to Riverview
Hospital, and consequently the subjects of the study were drawn from a severely ill,
and highly pre-scrcencd, psychiatric hospital admission cohort. In fact, at initial
assessment, 43 per cent of the patients examined were found to need hospital care,
despite their experimental assignment to home treatment.
However, for those who were hospitalized, contact with the home-treatment
team in this particular project did not have any significant effect on the length of
initial hospital stay, the number of readmissions during the year, or hospital bed
replacement. One explanation was that this study showed clearly the fallacy in
thinking of home treatment and hospital treatment as an either/or choice. Repeatedly, the treatment team was forced to admit patients who would have been
treatable if partial hospitalization had been available, e.g., day treatment, short-
term residential treatment, intermediate care and personal care homes, etc. After
the initial crises, hospital admission as often reflected the unavailability of essential
support services as it did the clinical severity of the illness.
Analysis of comparative costs and cost effectiveness was still under way at the
conclusion of the year.
LOWER FRASER VALLEY MENTAL HEALTH SERVICE
In line with the development of community services as alternatives to centralized
institutions, the Consultant in Sociology was appointed in May as the Co-ordinator
of the Lower Fraser Valley Mental Health Service, comprising the mental health
centres at Langley, Maple Ridge, New Westminster, Port Coquitlam, Surrey, and
Whalley. Six psychiatric positions were seconded from Riverview Hospital to these
centres, for the purpose of encouraging all referrals to Riverview to be screened by
the appropriate mental health centre staff. Patients were therefore admitted through
the centre and treated by the centre psychiatrist in Riverview, only after available
community resources were considered to be inappropriate.
However, a study made of the first seven months of 1974 revealed that
approximately one-half of all patients from the Lower Fraser Valley were still being
admitted directly to Riverview Hospital, mostly after hours and on week-ends, due
to unfilled psychiatric positions and the resultant lack of an on-call, or similar
system, to provide psychiatric coverage.
The addition of psychiatric nurses to each of these six mental health centres
would enhance their ability to meet the needs of the adult psychiatrically disabled
in the community.
24
 GENERAL ADMINISTRATION
F 25
CONSULTATION SERVICES
As Mental Health Branch representative, the Consultant in Sociology provided
ongoing consultation as a member of the Community Care Facilities Licencing
Board, and of the Psychiatric Services Subcommittee of the BCHIS Planning Committee; also to the Departmental task force to establish a data base, the research
subcommittee of the task force; and also to the development group for community
human resources and health centres, regarding the establishment of a data base for
these centres.
 PSYCHOLOGY
CONSULTATION
SERVICES
A major function of the Consultant in Psychology was to provide consultation
services both to the Mental Health Branch and to the various mental health facilities
throughout the Province. Services in the areas of programme development, implementation, and documentation and analysis were emphasized. More and more resources were being made available in various local communities, with the result that
problems could be dealt with at the local level and with community participation.
Many innovative health care programmes were developed in the Province during the
year. Individual programmes were a balance between direct services, preventive
services, and consultation services from and to a variety of community groups. Preventive services were stressed, especially in the more established facilities.
Special consultation services were rendered to the residential unit of the B.C.
Youth Development Centre, which provided treatment services for the more severely
disturbed youngsters.
As part of long-range mental health planning, a survey was commissioned to
determine the type and extent of physical, mental, occupational, and social health
problems which exist among the people employed in the fishing, mining, lumber,
and construction industries in the more isolated locations in British Columbia. A
knowledge of the specific problems which exist in the various areas would assist in
providing relevant services.
The emphasis on matching programme or service to specific need was reflected
also in a proposed training programme which was developed for child care workers.
The specific training needs for this group were determined by studying the needs of
both those employed as, and those employing, child care workers in the various
types of child care facilities throughout the Province. A similar type of study was
conducted by a committee appointed by the Minister to determine the training needs
of psychiatric aides employed in the various facilities throughout British Columbia.
Another aspect of Branch level activities was related to the development of a
guideline for documenting and analysing the various variables which make up a
comprehensive treatment programme. The variables included those relevant to the
client, the community, the programme administration, and the funding source.
In view of the fact that the delivery of many services was shared by other
Government departments, a determination was made of activities shared by mental
health centres and health units, and mental health centres and human resource
centres. The aim of this study was to clarify the range of services shared, as well as
the degree and type of mutual involvement. The information would be utilized to
further improve communication, co-operation, and planning between departments.
In addition, the information of the type of services which were of mutual interest
with other agencies was important in the development and co-ordination of comprehensive community services. A model for such a delivery system was defined by
first determining the various mental health needs of a community, and then the
services necessary to deal with those needs. The model also provided a procedure
for the assignment of agency resources to each of the services, and an example of
how such services could be co-ordinated for implementation, both within a particular
agency and between agencies.
26
 MANAGEMENT ANALYST
CONSULTATION SERVICES
The services of a Management Analyst were provided to assist the various
areas within the Mental Health Branch in the development and maintenance of
systems and procedures required to carry out their responsibilities efficiently and
effectively. This consultation service included such activities as the analysis of existing systems; the proposal of improved procedures, the design of forms and reports;
the planning of information flow, storage, and retrieval; and assistance with the
implementation of new procedures. The involvement may be with both manual and
automated systems. With regard to the latter, the Management Analyst acted as
liaison with the Division of Vital Statistics and the Computer and Consulting Services Branch of the Department of Transport and Communications, both of which
provided machine processing services to the Branch.
In 1974, service was provided in the following areas:
A Surgical and Pharmaceutical Inventory Control System was implemented for
the Central Pharmacy. This system was expected to result in a considerable reduction in both paper volume and clerical activity.
In co-operation with the Branch statistician, a system was developed to record
patient movement in the Burnaby Mental Health Centre.
A project was undertaken to collect and report ward statistics for residential
facilities. From data submitted by the facilities on a roster-period basis, a series of
reports were produced to summarize such information as bed utilization and hours
of nursing care for the various wards and programmes. Three roster periods were
examined for each facility.
The Pharmaceutical and Surgical Supplies Ordering Guide, issued by the Central Pharmacy, was revised and reprinted. Modifications were made to format as
well as content, resulting in a guide which was more accurate and easier to use. A
corresponding set of index labels was produced to update the Kardex Files.
Glendale Lodge received assistance in the maintenance of their statistical
reporting system. The data collection form was modified and a new file organization was introduced, making it possible to retrieve more comprehensive and accurate information from patient records.
The Management Analyst was named to a task force on the establishment of
a health data base. The task force presented its findings and recommendations in
a report which would serve as a guide to the Data Processing Consultants responsible for the design of the health data base system.
As chairman of the Forms Control Committee, the Management Analyst continued to be responsible for the design of new forms, the review and revision of
existing forms, and the control of reprinting.
Other duties included representing the Branch on the Metric Conversion Committee and, throughout the year, on committees or at meetings whenever systems
expertise was requested.
27
 BOARDING-HOME
PROGRAMME
At the end of 1974, there were approximately 1,700 persons receiving services
in 280 boarding-homes. During the year over 600 placements were made to
boarding-homes, 50 per cent of these being referrals received directly from the
community. One hundred and forty-six persons were discharged from the programme to more independent forms of living arrangement.
Emphasis throughout the year was on the development of innovative motivational programmes for residents of boarding-homes, individual rehabilitation,
development of specialized resources, and projects designed to improve specific
areas of service delivery.
Several community voluntary societies were responsible for developing or
planning new resources to provide supervised accommodation for mentally handicapped persons. These included the Okanagan Similkameen Housing Society for
Handicapped Citizens, which opened a resource for 20 psychiatrically handicapped
persons; the Skeenaview Society, which developed Osborne House for mentally
handicapped in Terrace; l'Arche Foundation (Vanier), which provided a much
needed residence in Burnaby for intellectually handicapped persons; and the
Courtenay Mental Health Society, which opened a rehabilitation house.
Projects designed to improve service delivery that were undertaken during the
year, in some instances utilizing student manpower, included:
(1) A committee of Boarding-home programme staff examined the value
of work done by residents in boarding homes as a therapeutic tool.
(2) A statistical tool to measure the quantity and quality of the services
of the activities personnel, developed and instituted by the Occupational Therapy Co-ordinator.
(3) Input into the formulation of a policy in the Department of Human
Resources to relieve newly employed boarding-home residents of
paying the full cost of their boarding-home care, for a period of time
until they were secure enough to move to less costly living arrangements.
(4) An examination of Literacy Programmes to determine their value to
residents, to evaluate various teaching methods, and to decide the
best approaches to delivery of such a service.
(5) A compilation of the various local interpretations of policy in the
Department of Human Resources in respect of boarding-home rate
setting, and the provision of ancillary services under the Social
Assistance Act.
(6) Employment of a student to code material on boarding-home residents for computer programming, to provide for analysis of resident
make-up and movement within the programme.
Students were also involved in the Boarding-home Programme as part of their
fieldwork experience, including three students from the School of Rehabilitation
Medicine, University of British Columbia. Several students from the Welfare Aide
Training Course, Langara College, did their fieldwork in various mental health
centres. Additionally, staff of the Boarding-home Programme gave assistance to
students hired by the Canadian Mental Health Association to survey boarding-
homes and programming throughout the Province.
28
 These residents from two boarding-homes in Cranbrook were taken on a bus
tour to Expo '74 in June.
Boarding-home staff in Maple Ridge and Mission
attended a home nursing course sponsored by the
St. John Ambulance. Three of the graduates are
shown receiving their certificates.
 F 30 MENTAL HEALTH BRANCH REPORT,  1974
The establishment of higher ranges of personal care home rates and intermediate care rates by the Department of Human Resources had a significant effect
on the Boarding-home Programme. The new rates provided for more flexibility in
rate setting to meet specific client needs. A pilot project was undertaken in the
Upper Vancouver Island region by the Mental Health Branch and the Department
of Human Resources, to test a new payment method which recognized programme
provision by boarding-home operators.
Legislated amendments to the Community Care Facilities Licensing Act had
implications for the Boarding-home Programme. The first of these provided for
decentralization of the issuance of a Community Care Facilities Licence to local
Community Care Facilities Boards, which would speed up the licensing process.
A second amendment provided that licensed Community Care Facilities for nine
or less active persons were required to meet only those municipal by-laws applicable
to private residences, and some defined fire-safety conditions. This should reduce
the cost of converting existing houses to Community Care Facilities use. In addition,
the Community Care Facilities Board authorized the Regional Boarding-home
Social Workers as representatives of the Board, and defined the social worker's role
and responsibilities in relation to the Board.
In order to achieve more definitive co-ordination and co-operation between
the two departments of Government concerned in the Boarding-home Programme,
i.e., the Department of Health and the Department of Human Resources, a Joint
Management Committee for the Programme was appointed by the Ministers of the
Departments to review programme needs, developments and problems, and to plan
co-operatively for programme expansion.
For purposes of evaluation, exchange of information, problem-solving and staff
development, meetings were held throughout the Province with boarding-home
operators and programme staff, and Department of Human Resources and Public
Health local officials.
The Boarding-home Programme had not been seriously affected by the increasing cost of the provision of this type of care, as had happened to the programme for
aged persons. Many licensed homes serving this latter group closed during the year,
particularly in highly populated centres, because of rising costs and diminishing
returns, and opportunities to sell the property at inflated prices. However, this
situation could soon affect the Boarding-home Programme and it might be necessary
to look at more innovative ways of providing residential services to clients in the
community.
 GENERAL ADMINISTRATION F 31
Approximate Distribution of Placements Made and Case Load,
Boarding-home Programme, 1974
Placements Made Case Load
1974 December 31, 1974
Region 1 (Kootenays)      38 74
Region 2 (Okanagan-Thompson)    240 553
Region 3 (Fraser Valley)   144 716
Region 4 (Skeena)        2 2
Region 5 (Greater Vancouver)*      27 51
Region 6 (Cariboo-Peace River)        7 23
Region 7 (Georgia Strait)      84 174
Region 8 (South Vancouver Island)     65 113
Totals   607 1,706
* 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.
 PERSONNEL
The Mental Health Branch establishment was increased by 387 positions during
the year to a total of 4,593. In addition, 501 students were hired under the Student
Summer Employment Programme. They were employed in jobs relating to work
experience, and on innovative projects designed to improve the programmes for
patients and residents.
As of November 1, the Branch was employing 114 handicapped persons.
Staff turnover in established positions for the fiscal year 1973/74 was 30.38
per cent, down very slightly from the 30.5 per cent of the previous year.
Twenty nurses for community service were recruited in October, and started a
course on November 12 to prepare them for their work in 13 mental health centres
throughout the Province.
Forty-four requests for classification reviews were received during the year.
The departmental personnel officer spent four weeks in the United Kingdom
late in 1973 recruiting Psychiatric Nurses. As a result 67 nurses reported for duty
and 16 were preparing to come to British Columbia as soon as plans and immigration
clearances had been finalized. Extensive advertising for psychiatrists and nurses
was carried out across Canada during 1974 with unsatisfactory results. Nursing
recruitment continued to be difficult.
Positions for personnel officers were established at Riverview Hospital, Valleyview Hospital, Woodlands, and Tranquille, and one additional personnel officer
was established for the Victoria Headquarters.
The experiment in using the continuing roster system for nursing at Woodlands
proved to be popular with the staff and it remained in effect.
Twelve nursing positions, which were seconded to various units when the
Division of Nursing Education finished training nurses, were transferred to these
units for in-service education.
Although Skeenaview Hospital was turned over to the Skeenaview Lodge
Society, this office continued to provide consultation on personnel matters. The
office also continued to handle all routine personnel matters to the end of 1974 for
Woodlands and Tranquille, following transfer of these units in July to the Department of Human Resources.
A Safety Officer position was established for the Mental Health Branch to assist
all units with safety matters.   The position had not been filled by the year-end.
The proposed series of activity therapists, to replace recreational therapists,
handicraft instructors, and some rehabilitation officers, was finally agreed to as
Activity Workers 1 to 6.
Two employees applied for, and were granted, a disability pension under the
Superannuation Act.
Twenty grievances were handled by this office, of which 10 were referred to
the Public Service Commission for mediation. Of the 20, nine were resolved, nine
were denied, and two were still under review at the end of November.
The Departmental Personnel Officer, and his assistant, to a lesser extent, were
heavily involved as advisers during negotiations carried out by the Public Service
32
 GENERAL ADMINISTRATION
F 33
Commission with the British Columbia Government Employees' Union, the Nurses'
Union, the Licensed Professionals' Union, and the components. All Master Agreements, and the majority of the component agreements, applied to various employees
in the Mental Health Branch.
Forty-nine Mental Health Branch personnel circulars were issued during 1974
covering all aspects of personnel administration. Many of the former regulations
and procedures were superceded by union contracts.
The on-call system of providing temporary relief for minor illness, minor
Workmens' Compensation Board cases, and recruitment lag was continued and
expanded.
 STATISTICS AND
MEDICAL RECORDS
During 1974, emphasis was placed primarily on the standardization and
computerization of the branch data collection systems. Clerical procedures were
revised and information retrieval improved. Some disruption of the statistical
system occurred with the replacement of the statistician and statistical clerk.
Two new mental health centres (i.e. Langley and Squamish) as well as five
new Vancouver Community Care Teams (i.e., Richmond, Kitsilano, Westside, Blenheim House, and South) were incorporated into the statistical system. In addition,
Burnaby Mental Health Centre's 25-bed in-patient unit, and the Victoria Integrated Services for Child and Family Development (VISC), were incorporated
into the statistical reporting system.
In January 1974, Statistics Canada initiated a monthly out-patient reporting
system.
Research during the year focused primarily on basic analyses of patient characteristics.
Two university students were employed during the summer. One compiled
the Annual Statistical Report, using a computer programme package instead of
the unit record equipment used in the past; the other analysed the data content
of the Mental Health Branch statistical forms and produced a number of statistical
reports on the "Ward Level Reporting" data.
DEVELOPMENT OF THE STATISTICAL SYSTEM
The major concerns of standardization and computerization of the Mental
Health Branch data were pursued both directly and indirectly. A task force on
the Department of Health Data Base compiled basic information on type, volume,
flow, and purpose of the data. A more detailed analysis of the nature of the data
collected was produced by a summer student. Standardization of information,
form format, etc., was postponed because of the possible effects of the reorganization of the Department of Health.
Numerous contacts were made regarding reorganizing the statistical system,
the most recent development was the establishment of a second task force comprised of the research and systems resource staff within the Branch.
All 1973 data (admissions, discharges, and case load as of December 31,
1973) was stored on computer tape. Data for the mental health centres for 1974
was loaded onto computer tape and could be accessed via a set of computer programmes called SPSS (Statistical Package for the Social Sciences).
Data compiled for the Riverview Out-patient Department since its inception
in May 1972, and Riverview's case load, were supplied to the Psychology Department at Riverview Hospital for storage and data analysis via Simon Fraser University. The Medical Records department at Riverview Hospital revised the Riverview statistical form. Data for Riverview was coded according to the new format
since January 1974.
ROUTINE DATA RETRIEVAL
Routine statistical reports were generated throughout the year, including the
Preliminary Patient Movement Report, the Monthly Statistical Bulletin, the 1973
Annual Statistical Report, the Annual Statistics Canada Institutional Report, and
the Statistics Canada Monthly Out-patient Report.
34
 GENERAL ADMINISTRATION
F 35
A monthly average of over 2,000 activation and discharge statistical forms
were edited by the statistical staff, before being processed and stored by the Division
of Vital Statistics. A case load verification was made at the beginning of the year,
and a number of units requested subsequent case-load listings.
Specific studies included an analysis of the utilization of the psychiatric units
of general hospitals; an analysis of admissions to each institution and out-patient
service by diagnosis and school district; and a count of discharge and withdrawals
from treatment by primary staff members for each mental health centre.
CONSULTATION
Consultation services were provided to several agencies throughout the year.
Issues requiring greatest attention were the transfer of the statistical system for
Woodlands and Tranquille to the Department of Human Resources; the transfer
of cases from the British Columbia Youth Development Centre statistical system
to the out-patient statistical system, initiated by the transfer of the Family and
Children's section of British Columbia Youth Development Centre to the Greater
Vancouver Mental Health Service, the transfer of cases from Victoria Mental
Health Centre to Victoria Integrated Services for Child and Family Development;
and the development of the Ward Level Reporting system, which provided a reporting mechanism on patient/staff ratios in the institutions.
Support service was provided in other areas, such as destruction of medical
records; retardate diagnostic classification; Glendale Lodge statistical system problems; and the Boarding-home Programme's statistical system problems.
MEDICAL RECORDS DEVELOPMENT AND REPORTING CONTROL
The Medical Records Consultant continued to assume temporarily the duties
of a medical records librarian at Riverview Hospital Out-patient Department in
Vancouver. Responsibility for co-ordinating and compiling the monthly patient
movement report for the residential facilities was assumed from July 1974.
The Consultant, in the role of medical records librarian to the out-patient
department, implemented several new procedures with a view to improving the
standards of the medical records and to providing new statistical information for
Statistics Canada and the Psychiatric Audit Committee. As a result of the Statistics
Canada monthly out-patient requirements, a Therapists' Index was designed to
provide a monthly unduplicated count of patients treated at the out-patient department. To meet the Psychiatric Audit Committee's requirements the statistical form
was adapted to include a therapist's code and length of stay information. In addition, a mechanism was designed to record home visits made by the out-patient department staff.
Three meetings with the Psychiatric Audit Committee were held and information regarding quality of care provided to patients was supplied. Research
assistance was given to a psychology student and orientation was given to two
health data technology students.
Consultation services and clerical aid were provided when the in-patient unit
was opened at Burnaby Mental Health Centre. The Consultant joined with the
staff of Burnaby, the systems analyst, and the statistician in designing a system for
the Burnaby complex. An evaluation of Valleyview Hospital's medical records
system was made with a view to obtaining accreditation.
Orientation was provided to new clerical staff in the mental health centres.
The new administrative assistant, and assistant executive director of medical ser-
 F 36
MENTAL HEALTH BRANCH REPORT,  1974
vices at Riverview Hospital, were oriented by the Consultant regarding the medical
records service at the out-patient department.
The Consultant met with the Vancouver Community Care Teams on both a
group and individual basis, in order to clarify statistical instructions and definitions.
Advice and instruction regarding medical records policies and procedures for
the mental health out-patient service was given to the instructor for community
mental health nursing from Riverview's Education Centre. British Columbia Hospital Insurance Service representatives were assisted in their study on linear responsibility.
 INFORMATION
SERVICES
With the completion of a major priority of the Branch's information service
programme, the preparation and printing of informational literature for inservice
and public distribution, increased emphasis was placed on assisting the institutions
with the development of programmes to meet their specific needs. On the recommendation of the Director of Information Services, a Public Education Committee
was appointed at Riverview Hospital, with representation from the hospital's administration, medical and nursing staffs, personnel, housekeeping, and volunteer
services. The Director served as a consultant to the committee, which held monthly
meetings. Similar committees were proposed for Woodlands and Tranquille. The
operation of these two institutions was handed over to the Department of Human
Resources in July, and the Director met with his counterpart in that department to
discuss the gradual transfer of information services.
Co-ordinated programmes on a departmental basis were facilitated during the
year with the introduction of bimonthly meetings of departmental information
officers. Subjects for discussion included integrated mailing lists, mid-year reports,
mobile exhibits, feature articles, and the production of video tape-recording programmes. A VTR production of the Day Programme at the Burnaby Mental Health
Centre was made in August, with the assistance of personnel of the Division of
Health Education.
Contemporary educational materials continued to be provided to the mental
health centres, the primary sources being the National Institute of Mental Health,
and the National Clearinghouse for Drug Abuse Information. For the third consecutive year the centres conducted Open House programmes during national
Mental Health Week, in conjunction with the local branches of the Canadian Mental
Health Association. The Travelling Display was not rescheduled throughout the
Province but, instead, was made available upon request.
The pamphlet Mental Health in British Columbia was revised, and Careers in
Mental Health was republished to meet the demand for copies. The departmental
exhibit in the B.C. Pavilion, Vancouver, was dismantled to make room for a physical
fitness display organized by Action B.C., which proved to be a highly successful
undertaking. Miscellaneous responsibilities included arranging press conferences;
the preparation of display advertisements for nurse recruitment; press releases and
feature articles; the monthly inservice publication, the Newsletter; correspondence;
news-clipping service; and editing the Annual Report. The Director continued to
serve as a member of the Forms Control Committee.
37
  COMMUNITY MENTAL HEALTH SERVICES
Mental Health Centres
mental
health
branch
  COMMUNITY
MENTAL HEALTH
SERVICES
During 1974, there was no expansion of services into new localities, but gains
of the previous years were consolidated. During the year, 20 psychiatric nurses
were added to the community programme, with particular emphasis on providing
community services to the type of adult psychiatric patient likely to require hospital
care. At the year-end these nurses were undergoing an intensive in-service training
programme to adapt them to work in the community. The recruitment of staff in the
far north and eastern Interior continued to be a problem. The array of services,
numbers served, and thrust of service, remained essentially the same as outlined in
the 1973 Annual Report. During the summer of 1974 mental health centre programmes were greatly enhanced by the addition of over 90 college students employed
under the student summer programme. They provided a wide variety of services,
including special assessment and treatment, to children, adolescents, and the
chronically disabled in boarding-homes, and also helped mental health centres
evaluate their own services to the community.
Mental health centre regional meetings were held during the year in Prince George,
Kelowna, Naramata, Port Coquitlam, and Victoria. The Vancouver Island meeting
(above) was held in Victoria in November and was attended by J. W. Mainguy, Senior
Consultant to the Minister; Dr. F. G. Tucker, Deputy Minister of Mental Health; and
Dr. G.  R.  F.  Elliot,  Deputy  Minister of Health.
41
 F 42 MENTAL HEALTH BRANCH REPORT,  1974
ABBOTSFORD
MENTAL HEALTH CENTRE
In October the Centre completed its first full year of functioning as a separate
Centre, after having been previously served by a travelling clinic from Chilliwack.
Services were provided by an Administrator/social worker, a half-time psychologist,
a sessional psychiatrist, a clerk-stenographer, and boarding-home staff shared with
the Chilliwack Mental Health Centre.
A variety of services and programmes emanated from the Centre during the
year, including direct therapeutic services to clients; consultation and conferences
with social, educational, correctional, and medical agencies; planning, co-ordinating,
and leading professional and public educational workshops; and participation on a
number of committees and projects in the interests of enhancing services and resources for community mental health. The Centre also provided field work opportunities for psychiatric nursing students of BCIT and social work students from
UBC.
An Open House held in conjunction with Mental Health Week drew public
attention to the presence of the Centre through the publicity of a Mental Health
Profile presented by the Centre. This consisted of a series of talks, demonstration,
discussion groups, and displays on two successive evenings, which drew approximately 100 people.
The boarding-home programme saw some expansion, with additional residences
being approved, and a greater increase of the utilization of the boarding-home programme from local referral sources. A varied and stimulating year-round activity
programme, highlighted by a summer outdoor camping experience for the boarding-
home residents, was the result of the energy and imagination of the boarding-home
social worker, the activity therapist, and community volunteers in the programme.
BURNABY
MENTAL HEALTH CENTRE
In 1974, vigorous growth and development of the range and extent of psychiatric services was provided to the citizens of Burnaby by the Mental Health Burnaby
organization. The programme's objectives were to provide the total spectrum of
necessary psychiatric treatment resources for adults, families, and children resident
in Burnaby, including out-patient assessment and treatment services, day programmes for adults and children, and an acute psychiatric unit for 24-hour short-term
in-patient care.
In-patient unit—On January 3 the short-stay in-patient unit opened in temporary accommodation with 12 beds on the lower level of the building. This was
an interim measure while renovations were being made on the main floor for a
much larger and better equipped facility, capable of accommodating up to 25
patients. Unfortunately, a construction industry strike, and difficulties in obtaining
delivery of equipment, delayed the move to the new quarters by the in-patient unit
until November. In the meantime, the capable and enthusiastic staff had provided
exemplary inpatient care in inadequate quarters, and together with the Community
Care Teams achieved an average length of patient-stay of less than 12 days in
the first nine months of operation.    This accomplishment occurred in spite of a
 COMMUNITY MENTAL HEALTH SERVICES
F 43
50 per cent turnover in nursing personnel, as well as a change of area clinicians
and occupational therapists.
Day programme—The existing 30-patient day-programme for adults and
adolescents continued during 1974, with the recruitment and training of two additional occupational therapists and two additional nurses. Plans to open a second
day-programme had to be postponed due to the delays in the in-patient unit moving
to its renovated space, but it was anticipated that a second adult day-programme
would be in operation early in 1975. During the year, three adult day-programme
workshops were held to assess and revise the present programme and to plan for
the new one. A new education and orientation programme for mental health
professionals and other interested persons, held the third Friday morning of each
month, was inaugurated, in addition to the work experience already offered for
new staff, as well as UBC and BCIT students. In view of the increasing interest in
the development of new day-hospital programmes throughout the Province, this
was a particularly timely and worth-while endeavour.
Building upon last summer's successful experience, a children's day-treatment
programme was operated during July and August, with a group of 3 to 7-year-old
children served in the mornings, and a group of 8 to 12-year-olds in the afternoons.
Additional personnel were available for this programme during the summer, through
the summer student employment programme, and the BCIT student nursing programme. Due to this successful experience, three child care counsellors were hired
to operate an ongoing programme for 3 to 6-year-old children in quarters vacated
by The Maples children's day programme, which was incorporated into the Greater
Vancouver Mental Health Service.
Outpatient programme—A dramatic improvement in the accessibility of adult
out-patient psychiatric evaluation and treatment was made, with the opening in
February of an office on East Hastings Street, and in May an office at Canada Way
and Edmonds Street. Additional recruitment of staff continued, as case loads
were building in the local teams, and it was gratifying to see referral networks
developing in each local area, involving the family physician, public health nurses,
community park and recreation personnel, the Human Resources Department, and
other interested individuals and agencies. Staff in the community clinics were
finding that it was a real advantage to have a definite geographic catchment area
within which to work, and an opportunity to have a more intimate knowledge of
that particular part of the community, as well as closer relationships with its resources.   Continued development of the teams was anticipated for 1975.
In response to ever increasing needs, the number of physicians on the Children's
Out-patient Services was increased, and a comprehensive plan for development to
meet this demand was developed.
Consultative and educational services—The active consultative and educational
services offered by Mental Health, Burnaby, were continued during the year. Training programmes for psychology, nursing, occupational therapy, and social work
students from UBC, Simon Fraser, and BCIT, expanded as new services developed
and more personnel became available. Psychiatric consultation service to Burnaby
General Hospital, and consultation and assistance to programmes such as the
SeCure Programme for agoraphobics, Burnaby Human Resources Department and
the Burnaby Family Life Institute, and the Burnaby Parks and Recreation Department, developed and expanded. An in-service education committee, chaired
by the Centre's senior psychologist, presented a programme of guest speakers and
many of the staff attended local seminars, workshops, and meetings.    Work also
 F 44 MENTAL HEALTH BRANCH REPORT,  1974
continued on the development of more efficient systems of record-keeping, and the
evaluation of treatment effectiveness. A special project in the latter was undertaken
during the summer, with assistance from the student summer employment programme, as was a project to develop video-taping material.
CHILLIWACK
MENTAL HEALTH CENTRE
The Chilliwack Mental Health Centre operated on an open referral system.
The underlying philosophy of this system was the belief that in order for a mental
health centre to be an integral part of the community it must be open, responsive,
and accessible to all members of that community. Its programmes cannot be ancillary to other agencies or isolated from the general public. It must be considered
a front-line community service if it was to have any significant impact in the community it serves.
The composition of the Chilliwack Mental Health Centre staff was as follows:
one Administrator/social worker, one psychologist, one mental health nurse, one
part-time psychiatrist, one part-time boarding-home social worker, two clerk-
stenographers, and one half-time clerk-typist. In August, sessional psychiatric
involvement at the Centre was reduced from eight sessions to six sessions.
The Centre served an area population of approximately 50,000, which included
an estimated 10,000 school-children. The Centre served the City of Chilliwack
and the Township of Chilliwhack, which included the towns of Rosedale, Sardis,
Yarrow, Greendale, Cultus Lake, and the Armed Forces Base; the City and Municipality of Hope; and the towns of Boston Bar and North Bend. The Municipality
of Kent, which included the towns of Agassiz and Harrison Hot Springs, also received mental health services from the Chilliwack Mental Health Centre.
During the year, 434 new cases were activated, which averaged out to 36 new
referrals being processed each month. Approximately 18 per cent of clients seen
at the Centre were direct referrals of individuals requesting mental health intervention. The largest percentage of the therapists' time was taken up in the provision
of direct services to clients.
The Centre provided basically five direct service programmes, which included
the following:
(1) A psychological testing programme of school-aged children manifesting behavioural and (or) learning difficulties primarily in the
classroom. Psychological tests were also administered upon request from Government agencies, such as the Department of Human
Resources, the Corrections Department, and from the Psychiatric
Ward of the Chilliwack General Hospital, and from private physicians.
(2) A psychiatric assessment and treatment programme. The psychiatrist also conducted transactional analysis groups.
(3) A family and marital counselling programme.
(4) An open referral system which results in a more or less basic intervention type of programme.
(5) A free pharmacy programme to those people who could not afford
to purchase their drugs and to those people who could afford to
 COMMUNITY MENTAL HEALTH SERVICES
F 45
purchase their own drugs but who, it was felt, would not do so if
left to themselves. These drugs were provided when prescribed by
the psychiatrist, and upon the request of the family physician.
Two Centre therapists, the psychologist and the social worker, were on the
Board of Directors of the community sheltered workshop. The social worker was
a standing member of the Mental Health Committee of the Chilliwack General
Hospital, and also acted as a programme consultant to the psychiatric ward of the
hospital. The mental health nurse was involved with a public health nurse in providing joint weekly informal counselling services to the senior high school in the
city. She also collaborated with personnel from the Community Services Centre
in providing weekly resocialization group meetings for long-term patients residing
in the community.
All Centre therapists were standing members of the School District No. 33
Action Committee, which was composed of representatives from the school, Public
Health, Department of Human Resources, and Mental Health.
The psychologist provided in-service training in behaviour modification for
the lay staff employed by the Sardis Hostel for Retardation. He was also a member of the Aid to Handicapped Committee, and a member of the Agassiz Liaison
Committee.
The Centre was approached by the Coqualeetza Society for the preservation
and promotion of Indian culture, and accepted their request in assisting them to
develop family life programmes.
It appeared that the more the Centre involved itself in indirect community
activities, the greater the request for direct services.
Since July the Centre experienced an acute staff shortage, which had an
appreciable effect on work output.
COURTENAY
MENTAL HEALTH CENTRE
In retrospect, 1974 appeared to be the year in which the local public more
fully recognized the role in community development which can be played by the
Mental Health Centre staff. Consequently, requests for community service increased.
The local Crisis Centre merged with the Family Services Group, and a more
comprehensive training programme for lay counsellors was developed in conjunction with staff members. Training involved 10 weeks of theory followed by an
eight-week experiential phase. Those who completed the course would be expected to provide at least one year of volunteer counselling services to the community.
A psychiatric wing was added to St. Joseph's General Hospital during the
year and Centre staff members co-operated in the development of this facility.
The boarding-home social worker was instrumental in assisting the local Upper
Island Mental Health Society in purchasing and developing a residence for those
patients who were discharged from the psychiatric wing and not yet ready to return
to their usual community environment. In addition, this residence would be used
as a preventative facility, with a full-time staff, and consultation provided by the
Centre staff. A co-operative venture between the Department of Human Resources
and Mental Health to provide treatment services to children in the Comox Valley
took place during the summer.    Many of the children in this programme were
 F 46 MENTAL HEALTH BRANCH REPORT,  1974
then assigned to a "special" school in the fall. The staffing, programming, and
evaluation of this school became a joint responsibility of the Department of Human
Resources, Mental Health, and the School District.
A series of "Living with Children" training courses, available to any interested North Island residents, was provided. Modified versions of these courses,
which promoted the utilization of social learning techniques, were also presented
to local boarding-home operators.
Research activities of this Centre involved evaluation of the previously mentioned special school. In addition, work continued on developing, in conjunction
with the Branch's consultant in psychology, a model for the delivery of comprehensive community services. It was expected that this model in manual form would
be useful to any community agency which was involved in the co-ordinating and
implementing of comprehensive community services.
During the year two new group homes were opened—one in Fanny Bay for
12 retarded men and women, and one in Merville for 10 men, most of whom were
from Riverview Hospital. It was doubtful that any more boarding-homes should
be opened in the Courtenay area, as the present boarding-home population allied
to that of Bevan Lodge constituted a weighty number for a community to support
in terms of its social, recreational, and health services. There was increasing talk
of unemployment in the area, and chances of rehabilitation into employment were
considerably lessened.
The picture was different in Campbell River and Powell River, as both these
areas required considerable development. A group home provided by a nonprofit
organization might be the best facility to provide for each one.
The opening of the Halfway House would relieve some of the pressure on the
psychiatric unit, and provide a much-needed community service. The amount of
community support and good will shown to the project was gratifying, and reflected
an increasingly responsible attitude toward mental illness and retardation.
Altogether, the year was a very busy and productive one, with improvement
in both quantity and quality of programme.
Changes and major developments in the Boarding-home Programme, from the
case aide's point of view, were as follows:
(1) Assessment forms—as of September 1, the boarding-home rates for
residents were individually assessed. Added to this new rate was
an assessment of the home. The latter assessment would hopefully
act as a financial stimulus with the boarding-home operators, as the
better their homes became the more money they were entitled to.
(2) In the assessment form for the boarding-homes money was available
for recreation. A few of the operators in the area used this money
to hire an activity worker, who went around to the different homes
and worked on arts and crafts with the residents.
(3) A fair number of the residents were going to the Opportunity Centre,
run by Bevan Lodge, that opened in Courtenay. This was proving
to be a productive venture for the residents, many of whom would
otherwise be unable to become involved in something outside their
homes.
(4) To supplement the work-type setting of the Opportunity Centre,
the Administrator of the Centre started a remedial learning class
for the mentally handicapped as part of the night-school programme
in Courtenay. Participants came from Bevan Lodge, as well as the
Boarding-home Programme, and response to the programme was
excellent.
 COMMUNITY MENTAL HEALTH SERVICES
F 47
CRANBROOK
MENTAL HEALTH CENTRE
During the year the Centre was staffed with a full-time social worker/Administrator until September 30, a part-time social worker, a temporary psychologist
for four months, a sessional psychiatrist from Calgary who made occasional visits
to the area, a full-time boarding-home case-aide, a part-time pharmacist, and two
clerical staff. Some consultation was provided by the Branch's Co-ordinator of
Adult Psychiatric Services. It was expected that the three full-time positions for
social worker, psychologist, and psychiatrist would be filled before the year's end.
The geographical area covered was the East Kootenay, with the exception of
Creston, which was transferred to the care of the Nelson Mental Health Centre in
March.  The population served was approximately 50,000.
The Centre's services consisted of direct treatment, consultation to other
agencies and groups, and involvement with community planning groups. Travelling
clinics were held in Fernie, Invermere, and Kimberley once a month. Golden was
visited during the summer months.
The psychiatrist, with some student staff, provided consultative services to the
local physicians, the 10-bed psychiatric unit in the Cranbrook Hospital, and the
various agencies. During the summer he began to visit the Invermere area and
would be closely involved in the operation of a local co-ordinating committee which
organized in the fall.
In Cranbrook the Centre helped to establish a Family and Marriage Counselling
Bureau of voluntary counsellors who had previous training and experience in counselling. The Bureau had been in operation since January, and a similar programme
was planned for Kimberley. During the summer four students were hired to work
in the Cranbrook and Kimberley Crisis Centres, where they made a significant
contribution.
The psychologist and social worker/Administrator provided consultation to a
planning committee in Golden, which was studying the community's needs and
resources.
The Centre's social worker/Administrator was on a committee of local professionals in Kimberley which had been working with the Development Group from
Victoria in planning the establishment of an integrated Community Health and
Human Resources Centre.
The boarding-home case-aide helped the operators to form their own local
Boarding-home Association. She also organized a very successful visit of the
residents to Expo in Spokane. Four residents were working in incentive programmes
financed by the Department of Human Resources.
While the heavy demand for direct treatment in the area continued, the mobilization of some of the communities to form planning and counselling groups would
help meet some of this demand, and would require the Centre to become more
involved in consultative and preventive programmes in the future.
DUNCAN
MENTAL HEALTH CENTRE
The Duncan Mental Health Centre continued to grow in terms of staff and the
range of programmes it was able to offer to the community. The staff consisted of
an Administrator/psychiatric social worker; two sessional psychiatrists; a full-time
 F 48 MENTAL HEALTH BRANCH REPORT,  1974
psychologist, and one psychologist part-time for children's services; a social worker
who was Regional Boarding Home Co-ordinator, a case aide, and an activity
therapist to the Boarding-home Programme.
In order to make its services as available as possible the Centre operated on an
open door policy, i.e., it was not necessary for an individual to be referred.
The greatest demand was for direct service, and with the addition of the two
psychologists, the Centre significantly increased its capability in this regard. An
art therapy programme was provided for children two or three days per week. This
programme was under the supervision of the Registered Art Therapist from the
Victoria Mental Health Centre.
During the summer, services were increased in several areas through the use
of the Provincial Government Student Employment Programme. The projects
carried out included an early intervention programme for pre-school children; a
summer camping programme for boarding-home patients; and community recreation and social service programmes. A summer student also served as Activity
Co-ordinator for psychiatric patients in the Cowichan District Hospital, and another as programme assistant to the Cowichan Opportunity Centre.
Direct service also took the form of group sessions in relaxation therapy, transactional analysis—adults and adolescent groups, and small group work with children.
The Boarding-home Programme, which supervised approximately 85 residents
in the Duncan and Nanaimo regions, underwent considerable change due to the
development of more psychiatric services in these communities. The addition of an
activity therapist to the programme proved to be most helpful.
Consultative services were provided to the Cowichan District Family Life
Association, the Cowichan District Hospital, the Cowichan Opportunity Centre
day-care and workshop programmes, the Lake Cowichan Activity and Resource
Centre, and the Regional District Activity Centre in Duncan.
Consultation with personnel within the school system and special education
programme was a regular function. Daily consultation was provided to the nursing
staff in the hospital's psychiatric unit, as well as working in close co-operation with
the medical practitioners involved.
Centre staff were active in a Regional District committee working toward the
development of a new in-patient and day-care centre for psychiastric patients under
the auspices of the Cowichan District Hospital.
Transactional analysis was used as a means of educating interested people in
other approaches to self-awareness and understanding. This took the form of
weekly group sessions, as well as one workshop programme. The Malaspina Adult
Education Programme was an effective way to reach out into the community with
educational and preventive mental health programmes.
During the year the Centre was a member of the Team Service Group in Lake
Cowichan. This team was made up of representatives from all agencies working in
the area and it met twice monthly. The result was an integrated service to the
people of this area, as well as the development of new services, such as day care,
Meals on Wheels, and a regionally funded activity centre programme.
The Centre was also represented on a Senior Citizens Advisory Council which
was formed through the concern for adult education programmes for senior citizens.
It expanded its focus and had the potential for integrating services to the senior
citizens, as well as facilitating integration of the senior citizen within the community
through a variety of programmes and activities.
 COMMUNITY MENTAL HEALTH SERVICES
F 49
The Centre continued its involvement in the Community Options Society,
which attempted to provide and (or) promote a range of alternative programmes
for adolescents. One of the basic aims of the Society was to stress the need for the
community to assume responsibility for its own children. In general, the community
seemed more than willing to do this, but in the case of acting-out adolescents, the
test was more than they bargained for. It would appear that this would continue
to be an area of difficuty for all concerned.
Centre staff looked forward to continual development and broader involvement
in the community during the coming year.
FORT ST. JOHN
MENTAL HEALTH CENTRE
The Centre commenced operations in February with the arrival of the psychologist. The active monthly case load increased from 12 to 56, at which point
it became too heavy for one therapist. The psychologist's wife, a psychiatric nurse,
joined the staff in July, and during the remainder of the year they travelled extensively as a team.
Clinics were held in Dawson Creek, in the Public Health Unit, each Monday
and Tuesday, with an approximate case load of 110. On Fridays they alternated
between Fort Nelson and Chetwynd. Wednesday and Thursday was spent in Fort
St. John, with an estimated case load of 141. Various types of counselling were
provided, with emphasis on marital and adolescent problems, and four group
sessions were held each week.
The Centre's relationship with outside agencies continued to improve throughout the year.
KAMLOOPS
MENTAL HEALTH CENTRE
The population served by the Centre continued to grow at an estimated rate
of 5.5 per cent, making the current population an estimated 89,000, according to
the Thompson-Nicola Regional District. The number of new referrals increased,
although the complement of staff was reduced. The Centre received four hours of
psychiatric consultation a week, which did not adversely affect the number of
physician referrals which had shown considerable growth. Less desirable was the
effect on long-term psychiatric patients, who were required to attend general practitioners for the supervision of their medications. The long-term psychiatric patient
typically cannot cope with the appointment routine of a busy family practice, and
often needs more visits and more time than the physician has available. However,
the Centre's mental health nurse did a commendable job of working with physicians
for the provision of medical services to these patients, as well as maintaining contact
with many others through a weekly drop-in programme. The long-term patient was
also served by the boarding-home programme, and approximately 80 patients were
housed in a total of 35 boarding-homes. Seventy per cent of these patients had
employment or were working in the workshop. All residents were encouraged to
participate in a number of recreational programmes, which were given tremendous
support through a community-sponsored Local Initiatives Project during the winter.
At the year-end the Centre's staff included a half-time occupational therapist.
 F 50 MENTAL HEALTH BRANCH REPORT,  1974
The Centre provided psychiatric social work services, in the form of crisis and
ongoing counselling, for individuals, couples, and families. There was a particularly
notable increase in the demand for marriage counselling, with more referrals of this
nature coming from physicians. A new programme developed for the Centre by the
psychologist commenced in October offering full treatment of emotional and
behaviour disorders in children of the seven to nine age-group. Ten children were
enrolled in the programme, which was carried out by four staff, in addition to
mental health personnel. The School Board and the Department of Human
Resources were both contributing staff positions.
Centre staff worked closely with voluntary agencies including the Family Life
Association and the Crisis Line service, the Canadian Mental Health Association,
the Homemakers, the Youth Resources Society, the Retarded Children's Association
and the Sheltered Workshop, the Child Development Centre and the Community
Resource Board. These agencies carried a great deal of the load, enabling the
Centre staff to cope with the high growth rate in Kamloops. However, it was
becoming more difficult for the staff to cope with demands for increased service in
the outlying communities.
Staff once again enjoyed the vitality and enthusiasm of the student participation
in Centre programmes, both from the summer employment opportunities and as
part of Cariboo College training. 1974 was a rewarding year for staff, especially
in the growth of support services in the private sector. For the coming year it was
hoped that a psychiatrist would move to the area and assume the Centre's allotment
of sessions.
KELOWNA
MENTAL HEALTH CENTRE
During 1974 there continued to be a considerable demand for direct services,
and much staff time was utilized in this way. Many individuals, couples, families,
and groups received service in their community and were able to maintain family,
friend, and employment ties to complement their therapy. Many times interagency
co-operation was required to make the service effective.
Education and prevention also ranked high on the priority list, and courses and
seminars were presented to the general public, and consultation was made available
to a variety of professional people.
Several students worked on research projects during the summer. Centre staff
attached considerable value to research on a local level, and would like to see more
work of this nature throughout the Province.
The Kelowna Addiction Treatment Centre continued to operate successfully.
An operating grant was received from the Drug, Alcohol, and Tobacco Commission
which permitted the employment of a co-ordinator, a counsellor, and the rental of
office space.
An occupational therapist joined the staff to work on the Boarding-home Programme, and she was instrumental in initiating a number of programmes to enhance
the lives of boarding-home residents.
For the first time the Centre had a psychology resident, for four months during
the summer. He was working on his doctorate in psychology, and spent time with
all major agencies in the community, gaining invaluable field experience.   The
 COMMUNITY MENTAL HEALTH SERVICES
F 51
Department of Psychology, University of British Columbia, was extremely pleased
with this programme, and wished to see it established on a permanent basis. The
Centre endorsed the proposal and supported a continuation of field placements.
In the coming year the Centre looked forward to closer involvement with other
agencies and professionals, in meeting the needs of local citizens.
LANGLEY
MENTAL HEALTH CENTRE
During 1974 the Langley Mental Health Centre completed its first year of
operation in an ever-increasing catchment area which was estimated to be 44,000
as of September. Staff members included a social worker who served as the Administrator, a clerk-stenographer, a sessional psychiatrist, a half-time psychologist,
a part-time pharmacist, a boarding-home social worker, and a part-time case aide
for the boarding-home programme. Also, the occupational therapy co-ordinator
for the boarding-home programme spent several hours a week providing direction
and support to volunteers and boarding-home operators regarding activities for
residents. A result of this was a weekly "drop-in centre" for a group of elderly
individuals from several of the boarding-homes.
Despite a reduced staff ratio to population served, the Centre remained very
busy in the field of direct service as demand was relatively high. This was largely
due to the fact that treatment resources were practically nonexistent in the community. The system of referral was open, and besides taking referrals from individuals and families, the Centre accepted referrals from physicians, the school
district, Human Resources, public health, probation, and several voluntary services.
There was an over-all average of 26 cases activated per month. Average waiting
period for direct service was approximately two to three weeks. An average of
six admissions or readmissions to Riverview took place each month, and the sessional pyschiatrist spent three out of six sessions at Riverview dealing with admissions (including Abbotsford) and discharges. In this regard, a fair amount of
follow-up and after care was also provided by the Centre. The pharmacist provided service to clientele attending the Centre, boarding-homes, and community
physicians, and filled an average of 70 prescriptions per month. The boarding-
home programme was extended to include approximately 30 intermediate care beds
at Langley Lodge, a modern high-rise senior citizens facility with a total capacity
for 176 residents. One special means of direct service was in provision of full-
team assessments for children and their families. This was done particularly in
cases where no previous psychiatric, psychological, and social work-ups had been
conducted. Also, a weekly drop-in was held at the Centre for ex-Riverview patients,
their relatives, and friends.
Co-operation and communication with local agencies and groups serving
people in need of help developed increasingly during the year. Consultations,
letters of support, meetings, as well as talks to several groups of school principals,
were ways which contributed to closer working relationships. Also, staff were
active in community development and organization to augment present services
and programmes. A successful Open House was held during Mental Health Week
and there was excellent coverage by the press and radio. As an elected board
member the Administrator was involved with the newly formed Langley Community Services Resource Society.   The prime function of this service was to establish
 F 52 MENTAL HEALTH BRANCH REPORT,  1974
an umbrella organization in the community which would co-ordinate and integrate
the delivery of initiated services to people. The Administrator was also involved
in an advisory capacity on the Alternate Learning Environment Project, which was
established to assist youths who for various reasons were not fitting into the regular
school programme. Experience had shown that, given an alternate school environment, abilities and talents had developed in a manner which fostered growth
of a positive self-concept. The Centre's psychologist was also involved on the
Board of Family Life Services, with the anticipated hopes of jointly planning programmes regarding the recruitment and training of volunteers as lay counsellors.
MAPLE RIDGE
MENTAL HEALTH CENTRE
Direct services involving the care of acute and chronic psychotics continued to
be the Centre's principal field of endeavour. There were 768 active cases on the
case load as of the end of September, and an average of 30 new cases were seen
each month.
The involvement of the community in social services and self-help groups increased during the year. This appeared to be part of a growing social awareness in
communities, and the Centre, mainly through its social workers, became involved
in the network of social services in the community.
Interagency meetings with case discussions on the local level took place in
Haney and Mission. The regional social worker was involved with the Community
Services Council, in the local Crisis Centre, and Neighbourhood House, including
assisting in the training of volunteers. He also participated in a survey of community needs under the sponsorship of the Community Services Council. The
Centre was active, in conjunction with the Port Coquitlam Mental Health Centre,
in the planning of a Mental Health Centre Youth Camp at Harrison Lake.
As an outcome of much combined effort by Government agencies in Maple
Ridge, a Youth Centre was established under the direction of Central City Mission.
Staff included 15 child care workers, and at the year-end 87 Maple Ridge children
were receiving services. The Centre's psychologist played a considerable part in
establishing the Youth Centre, and served on the Board. It was planned to have
an extension of a live-in group care home under the auspices of the same agency.
The class for emotionally disturbed children which was set up in the Mental
Health Centre last year, in conjunction with the School Board, proved extremely
rewarding in terms of accelerating academic achievement of the children and improved behaviour. Consequently, the concept of this "attainment class" was extended by two additional classes to which Centre staff provided medical and assessment services. The mental health nurse and the psychologist also saw the children
in play therapy, in small weekly group. The mothers of these children frequently
became involved in an 8 to 10-week class on parental management conducted by
the nurse.
An attempt was made to follow up alcoholics seen by Centre staff, who were
residents of the local Halfway House. It appeared that the needs of the alcoholic
were being met in a piecemeal way. A multidisciplinary unit for short-term active
treatment and extensive follow-up, and the use of hostels for long-term care of
those socially isolated alcoholics requiring rehabilitation, appeared to be indicated.
 COMMUNITY MENTAL HEALTH SERVICES
F 53
One of the summer students compiled a list of books, films, and other materials
which could be used by various agencies in town as part of a Family Life Education
Programme which the Centre proposed to initiate within the community.
A psychiatrist joined the Mental Health Centre staff during the year, and it
was anticipated that her services in caring directly for the patients in the Centre's
catchment area, i.e., Maple Ridge and Mission, would lead to continuity of care.
The expansion of this continuity was further anticipated by the addition of two community psychiatric nurses to the establishment. In November the nurses began a
four-month course in orientation in community psychiatry, and by giving more extensive follow-up to discharged patients and assessing emergency situations with
the community, it was hoped they would prevent and reduce the number of hospital
in-patient admissions.
Permission was given for a 10-bed psychiatric unit in the local Maple Ridge
Hospital, with provision for day care, and discussions with the architect were under
way at the year-end.
There had been a great thrust forward in the Boarding-home Programme in
the last few years, and this continued through 1974. The rehabilitative aspects of
the Boarding-home Programme were being stressed, and the residents were encouraged, through self-improvement, social, education, and work groups, to improved their self-esteem and utilize their potential.
A survey of Maple Ridge secondary students and drop-outs was completed
in regard to their sexual attitudes and involvement in drug taking. A comparison
of findings in regard to drug taking, including tobacco, alcohol, soft and hard drugs,
was made between Maple Ridge in 1973, Vancouver in 1970, and six British Columbia school districts in 1969. There was no great difference between the Vancouver and Maple Ridge survey results. The use of alcohol, marijuana, and heroin
was a little higher in Maple Ridge in 1973 than it was in Vancouver in 1970. The
use of LSD was considerably lower, which was anticipated in view of the reported
concerns over the adverse effects of LSD among drug users. All the rates of use
were higher for Maple Ridge than for the students of the six districts surveyed in
1969. Surveys of this kind were extremely important in indicating to the proper
authorities what types of drugs were being used in the teenage population and where
the focus of prevention should be placed.
In all surveys, illicit (under-age) use of alcohol represented by far the most
common use of drugs, followed by smoking and the experimental use of marijuana.
The slight increase in heroin use was a matter for concern.
The survey of sexual attitudes highlighted the need for sexual education in the
schools, and the apparent lack of responsibility of the young male in regard to
sexuality. The local School Board expressed considerable interest in these findings
and a summary of the findings was prepared at the request of the School Board for
the information of administrative and school personnel. The findings were also
published in summary form in the local newspaper. Contrary to the expectations
of the School Board there was no public outcry about such knowledge being disseminated, and it did not appear that there would be any active resistance among the
parents to a more widespread dissemination of knowledge. The main anxiety
appeared to lie with the educators, who anticipated adverse criticism from parents regarding family life education and, in particular, education for sexuality, within the
school system.
 F 54 MENTAL HEALTH BRANCH REPORT,  1974
NANAIMO
MENTAL HEALTH CENTRE
The full-time staff of the Nanaimo Mental Health Centre consisted of an
Administrator/social worker, a clinical psychologist, a psychiatric social worker, a
medical records receptionist, and a stenographer. The Centre continued to utilize
the services of a part-time pharmacist, who dispensed psychotropic medication on
referral from physicians and private psychiatrists. A part-time social worker attached to the Boarding-home Programme was available one day a week. The
psychiatric consultant position was vacant during the year. A psychiatric nurse,
following a training period, was to commence work in March of 1975. It was
expected that she would be working in close collaboration with the Public Health
Unit, in efforts to maintain the chronic population within their own community.
The Centre's catchment area extended from Qualicum to Ladysmith, encompassing a population of approximately 58,000. Interdisciplinary travelling clinics
were held on a weekly basis in the Parksville and Qualicum area. Due to the large
proportion of retired families in the Parksville area there was an increase in the
provision of broad psychogeriatric services to individuals over the age of 70.
Community consultation to agencies which related to community mental health
programmes continued as a priority of the Centre, which was represented on such
groups as Malaspina College, Family Division Committee, Advisory Committee for
Guthrie Centre, Canadian Mental Health Association, Nanaimo Association for
Retarded Children, Parents Without Partners, Parksville Interagency Committee,
Family Life Association, Steps to Maturity, and the Nanaimo Association for Intervention and Development, and Nanaimo Neurological and Cerebral Palsy Association. Many of these agencies assisted the Centre in providing supportive mental
health services within the framework of prevention.
During the year the Centre was active in the development of the Nanaimo Community Resource Board, which culminated in the early summer with the appointment
of Board members by the Nanaimo Regional District. At the year-end the Resource Board was in the process of forming a society which would hopefully enable
the orderly development of both statutory and nonstatutory agencies.
The Centre was also involved in the development of an analogous structure, the
Nanaimo Justice Council, initiated by the Department of the Attorney-General.
The Centre was represented on the steering committee of this organization, which
enabled staff to provide input in an effort to integrate all levels of the judicial systems,
and link allied supportive and consultative services.
During the year the Centre, in co-operation with the Canadian Mental Health
Association, was in the process of expanding the Nanaimo Contact Programme.
This outreach service was designed to provide services on two major fronts—a
drop-in clinic for parents of children up to 5 years of age, and an activity programme for people of all ages who were experiencing emotional difficulties. Two
activity aides employed by the programme were based in the psychiatric ward of
the Nanaimo Regional Hospital, facilitating the interchange of patients between
hospital and community. Application was made for increased funding through a
number of sources, including LIP. This programme had also been utilized as a
field-work placement for students from Malaspina College, and as a training experience for teacher aides.
The Centre provided direct treatment services to individuals and families within
the catchment area, either on referral from community agencies, physicians, or on
a self-referral basis.    Treatment may take the form of marital counselling, child
 COMMUNITY MENTAL HEALTH SERVICES
F 55
management at home and at school, family therapy, group therapy, or individualized
supportive services.
The Centre experienced a 33-per-cent increase in referrals for direct treatment
services over the same period last year, and attempted to meet this growing demand
through an expansion of group therapy programmes, and an increase in training
and consultative services.
Centre staff continued to provide liaison between the Nanaimo Regional Hospital and the Provincial institutions, specifically Riverview and Valleyview Hospitals.
Pre-admission assessments were being performed on a routine basis in an attempt
to develop alternatives to hospitalization.
NELSON
MENTAL HEALTH CENTRE
The year 1974 was a busy one in all fields of direct therapy, consultation to
agencies, educational programmes, and a wide variety of community development.
The normal staff complement of four was reached for the first time since the Centre
opened four years ago. Despite this, the demands for direct therapy increased
measurably. Additional staff, such as a special needs child care worker provided by
the Department of Human Resources, helped to relieve the growing load to some
extent. In addition, the unique and large-scale use of child care assistants used by
the psychologist enabled treatment of more cases of special needs children than
could possibly have been accommodated by the present staff.
The Centre's load and commitment were further increased by the inclusion of
the total School District No. 86 in the catchment area. Creston and area was a
more than average intensive need area, i.e., social assistance cases in Creston alone
were double those in either Nelson or Trail, which had three to four times the
population base.
The Centre continued with the aim of primary prevention in community mental
health. Over a protracted period involved deliberations took place in the community, as it sought the total integration of social and health services. However,
this failed due to the lack of positive support.
The Nelson Community Service Centre, whose presence materially reduced the
Centre's emergency case load, continued with an expanding programme. The
Nelson Youth Activity Society's Programme, and the Kootenay Society for the
Handicapped Workshop, also involved the Centre's personnel to a considerable
degree. A great deal of time was spent in the development of the Community
Resources Board of Nelson, which was adequately funded, functioning, and effective
by the year-end.
The Centre was also involved in maintaining programmes to volunteers; student
summer programmes; presenting papers to various commissions and hearings, such
as the Family Court hearings; and in providing counselling services (staff were involved in single parent groups, panels on child care, the emotional effects of overeating, etc.).
Psychiatric services were available with a sessional psychiatrist serving the
Centre. The Kootenay Lake District Hospital opened a psychiatric wing to serve
this catchment area.
The Boarding-home Programme continued to grow slowly in numbers and in
programme content.   There must, however, be better service provision for the needs
 F 56 MENTAL HEALTH BRANCH REPORT,  1974
of the chronically ill who have been discharged from Riverview but who periodically
become acutely ill, thus putting a strain on community health services that are not
designed or prepared to cope with them.
There was a continuing need to develop an accurate and effective case finding
system at the pre-school and school level.
During October, Centre staff attended a mental health centre regional meeting,
which proved its value and effectiveness in the sharing of centre programme content,
and in improved relationships both between centres, and between centres and senior
officials.
NEW WESTMINSTER
MENTAL HEALTH CENTRE
The Centre continued to utilize other community services to meet mental health
needs in the area, and accepted for direct patient service only those who appeared
most clearly to be otherwise unattended. This was reflected in the statistical trends
for 1974 compared with 1973; requests for service showed an increase, whereas
direct service showed a decrease, and community service involvements for promotion
of mental health proliferated. The majority of direct service concerned adult care,
and the average waiting period was one week or less.
The Mental Health Centre staff participated in a broad range of community
service activities.
Centre staff were involved with the formation of a day-care society for the
establishment of centres for children under three years.
Participation with the United Good Neighbour Board of Directors continued
and included work with the Allocations Committee, the Membership Committee,
and toward the year-end, a Committee for expansion of the Community Information
Service Bureau.
During 1974, staff were on the local YM/YWCA Board of Directors and
Community Development Committee, Committee for Aid to the Handicapped, and
represented the Centre regularly at meetings of the City Council's Health and
Welfare Committee.
Quarterly joint staff meetings with the Public Health Unit and separately with
the Social Services Department were initiated by the Centre to encourage communication efforts. Meetings with the latter department partly prompted establishment of a local Family Development Service (funded through Human Resources),
to specialize in family therapy and family life education.
Regular consultation was made available to elementary school teachers through
one staff member visiting local schools on a rotating schedule.
A programme of regular consultation with the counselling department of the
local secondary school resulted in the formation of two counselling groups for
students appearing at psychosocial risk.
As in the previous year, the Centre continued to advocate strongly the establishment of psychiatric facilities in the Royal Columbian Hospital. Staff were persistently involved with mobilizing meetings regarding the issue, and in formulating
recommendations for various aspects of the major services anticipated, namely day
hospital, in-patient, and emergency care. As a result, the day hospital is expected
to materialize in early 1975.
 COMMUNITY MENTAL HEALTH SERVICES
F 57
Centre staff regularly reviewed the patients in the Boarding-home Programme
associated with the Centre, the majority of such boarding-home residents being
located in the Coquitlam section of the catchment area.
Staff were significantly involved in the development of a local Activity Centre
(Sha-Sha Club) for the handicapped. The Activity Centre was sponsored by the
local branch of the Canadian Mental Health Association, and accommodated an
average of 25 people per month from the registry of the Mental Health Centre, and
another 55 potential clients.
Various Centre staff were engaged with the local Detached Youth Programme
on a variety of levels, including the Detached Youth Programme Advisory Board,
community committees, and conjoint family counselling.
The Lifeline Crisis and Information Centre received continuing consultation
from mental health staff by means of introductory sessions for volunteers, workshops
for phone counsellors, back-up professional contact regarding specific individuals,
and programme advisory group membership.
The Centre offered several other consultation programmes for the benefit of
staff from other services, such as Douglas College, Public Health, and Human
Resources.
The Centre assisted Canada Manpower and other agencies in developing a
local workshop ("Incentive Crafts") for the encouragement of adults who would
otherwise have difficulty in producing marketable craftwork.
Interaction with Riverview Hospital improved and some staff were appointed
to the Centre and to Centre Lawn Unit; some Riverview staff became more available
to the New Westminster community, and communication improved with the Riverview Psychology Department's behaviour therapy service. Two community psychiatric nurses joined the Centre staff and commenced in-service training in November.
Three other nurses from the same training programme were field-placed with the
Centre.
On request of the B.C. Alcohol and Drug Commission the Centre agreed to
serve as a liaison between Commission and community.
Working closely with other community agencies the Centre actively encouraged
multiagency efforts to explore and deliver human services.
The Centre served as field placement for three sets of B.C. Institute of Technology students in psychiatric nursing, and as a summer placement for two students
through the Provincial Government's student summer programme.
Near the end of 1974 the Centre co-sponsored, with school personnel in
counselling and remediation, a brief workshop for 20 elementary school teachers,
focusing upon classroom behaviour management methods. This was expected to be
the first of a series of such workshops.
Staff paid increased attention to developing methods to more accurately outline
current services, priorities, and to chart the Centre's plan for subsequent, local
community mental health programming.
PENTICTON
MENTAL HEALTH CENTRE
In 1974, the third complete year of the Mental Health Centre's operation, the
community saw the completion of the Retirement Centre complex to serve the
large retirement population in Penticton and surrounding districts. The complex
is a testimony to the high-level co-operation of the whole community to achieve a
 F 58 MENTAL HEALTH BRANCH REPORT,  1974
specific goal for its residents. The hazard in the past had been factionalism,
fragmentation, and duplication. Achievement of a common goal in the magnitude
of the Retirement Centre complex was significant for the future of other services in
Penticton.
Stimulated by the numerous official reports (CELDIC, Hastings, Foulkes), the
community continued discussions to ascertain how much co-ordination and integration was possible and realistic. A community workshop in March, at Naramata,
for 126 representatives of the public, institutions, agencies, and associations, provided information as to present services, and discussion concerning future organization of service, for example, a community resources board. A Carry-On Committee
to assess feasibility and methods was elected, with respresentatives from the lay
public, professionals, and significant groups who had spearheaded much of the
community action. A community resource board may be inevitable through legislation, before sufficient consensus is obtained through group process.
The local Health and Welfare Association, operating as the interim co-ordinator of nonstatutory services, prepared a global budget for Government approval,
and provided a local information services centre and a regional directory of health,
welfare, and recreational services, plus extended volunteer services.
A Penticton-based professional advisory committee responsible to the Okanagan Similkameen Society for Community Mental Health, a regionally represented
body to participate in ascertaining mental health needs and assist in programme
planning, asked five major groups to review its function and role in the current
facets of the community's development.
Professionals and lay members greatly benefited from an information sharing
Community Liaison Committee meeting once monthly, which was begun approximately one year ago.
In such a context, the role of Centre staff remained primarily as enabling and
low-profile. Meaningful support was given through direct service, consultation and
education to the Retirement Centre, the community workshop, and the five groups
served by one professional advisory committee (the Administrator of the Mental
Health Centre, two psychiatric consultants and the head nurse of the psychiatric
unit were also on this committee) as well as the whole community and region at
large.
Staffing remained the same, though the Mental Health Centre's staff involvement increased. Princeton and Oliver each asked for a full-time mental health
worker. Service to date included direct service on a partial basis in Princeton,
Oliver, Keremeos, and Cawston, with principle emphasis on consultation. Princeton also met with SPARC personnel, and began plans to expand the present health
unit office into a small community Health and Human Resources Centre.
Within the network of local psychiatric services the Penticton Regional Hospital day-care programming (for 20 spaces) began in September, in temporary
quarters within the hospital. Plans included an intensive treatment programme, a
support programme, and part-time services for individuals able to receive psychiatric care on a day-care basis.
The Mental Health Centre shared summer student staff with the Penticton
Regional Hospital Psychiatric Unit, and the South Okanagan Human Resources
Centre, to jointly sponsor a summer recreational programme for children and
adolescents who found it difficult to relate to others, and needed to learn to structure a day with meaningful activity.
The Mental Health Centre staff prepared an Advanced Skills Training Course
for Child Care Counsellors and paramedical personnel within the community.   The
 COMMUNITY MENTAL HEALTH SERVICES
F 59
purpose was to provide in-service training for permanent staff and new staff members which would assist in their helping roles. The course consisted of three hours
per week for 15 weeks. An independent evaluator from the School of Social Work,
University of British Columbia, was selected to evaluate the programme. At the
year-end preparations were under way to having the course administered through
the Penticton Campus of the Okanagan College.
Parenting sessions during the year were under the auspices of the local Canadian Mental Health Association, with the assistance of the staff of the Naramata
Centre for Continuing Education.
The Centre's psychologist participated in a two-month "wilderness project"
funded by the Department of Human Resources, sponsored by the South Okanagan
Human Resources Centre.
The Group Living Home Society for Handicapped Citizens, formed one year
ago, obtained a building with space for 19 persons, which would provide halfway
house accommodation and boarding-home type accommodation for mentally and
physically handicapped adults in the region. It was expected to be ready for
occupancy by the year-end.
Last year the Penticton Training Centre extended its services to encompass
a work-assessment and work-training for mentally handicapped and physically
handicapped persons, and during October it was able to place a trainee in full-time
employment in the community.
Centre staff and one of the psychiatric consultants participated in a newly
organized support ministry to clergy and their families through consultation, assessment and treatment, thus enlarging the network of mental health services available
to clergy and their families in British Columbia.
In the fall, Penticton and Summerland were funded through the Education
Department and the Department of Human Resources for special rehabilitation
classes for school dropouts.
In all of these significant major developments in 1974, staff members provided
leadership, support, consultation, and education. The future of the Mental Health
Centre will be dependent on developments inherent in the reorganization of the
Health Department in providing adequate health services to the community and
region.
PORT ALBERNI
MENTAL HEALTH CENTRE
As a result of almost two years' work the Centre accumulated a "population"
of chronic patients in 1974 who required long-term management. These patients
needed many services and a pattern was emerging of partnership between the Mental
Health Centre, the family doctor, the Department of Human Resources, Probation
Services, Homemakers', Family Guidance (including alcohol counselling), the
schools, the courts and the RCMP, as well as the employers of many of these
patients.
Hospital consultations gradually increased and numbered between 200 and
250 per year. Most of these were consultations in which the general practitioner
continued to care for his own patient while in the hospital.
In the area of forensic psychiatry, slow but steady progress was made and the
Centre was consulted a number of times on the management of people with psychia-
 F 60 MENTAL HEALTH BRANCH REPORT,  1974
trie problems.    Active and direct liaison with the Probation Service continued
during the year.
The free medication programme operated very smoothly, due to the excellent
services of the hospital administration and the pharmacist. Approximately 420
prescriptions were issued under this service.
The psychiatrist and the psychologist attended meetings of the Aid to Handicapped, a committee which provided valuable services to many of the Centre's
clients in return for periodic psychiatric consultation. During the summer, under
the special arrangements of the Department of Human Resources, the Centre acquired the services of a home-visitor. She worked directly under the psychiatrist
and was of great help in the management of more difficult patients, particularly
the older patient, and the chronic depressed younger housewife and mother. This
activity continued, on a limited basis, during the winter through the use of a work
incentive programme. The Centre required more space in order to introduce group
activity programmes involving various type of therapy, particularly art, and the use
of relaxation and exercise techniques.
A psychiatric nurse was expected to join the staff in March 1975.
The case load for children consistently increased during the year, with heavy
demands for both therapeutic and diagnostic services. In as many cases as possible,
the children were referred back to the school counsellor, the Probation Officer, a Big
Brother, the foster parents or Human Resources, for care, with the psychiatrist or
psychologist acting as consultant. There still remained, however, a hard-core group
of children who demanded consistent therapeutic intervention and management by
Centre staff. Because of the staff shortage services were very limited for the Tofino,
Ucluelet, and Franklin River areas.
During the summer eight students worked with 47 children under an activity-
oriented therapy programme. These children were placed in small groups and seen
daily throughout the summer. In addition, 17 youngsters were seen on an individual
basis by these students. This programme was very beneficial for the children in
terms of the feedback from parents and teachers. Some techniques in bioenergetics
were introduced with these groups with surprisingly beneficial results.
The psychologist did a considerable amount of follow-up work regarding
patients of the Port Alberni area who attended the Nan-Wah-Kawi summer camp.
During the year Centre staff were involved in consultative and seminar-type
meetings with the Interagency Committee, Family Guidance, Human Resources,
school counsellors, civil groups and sororities, Mental Health Association, personnel
officers and management. Mental health administration served on the steering
committee for studying the creation of the Human Resources Board. The Administrator served on the Interagency Administrative Group involving Family Court,
Board of Education, Human Resources, and Probation Service, which met once a
month to co-ordinate existing programmes and to plan new ones relating to children
and adults with varied needs in the Alberni Valley. Such programmes as the Gill
School Session, or "Project 70-74," originated from these community-oriented meetings. The psychiatrist and the psychologist attended the bimonthly meetings of the
Inter-agency Committee where individual cases and family situations were discussed
with the participating agencies; school counsellors, public health nurses, teachers
Human Resources, the social workers and, in some instances, the family doctor.
A large group of citizens, as well as agency representatives in the area, met in
May to discuss boarding-home problems and ways in which the community could
help.
 COMMUNITY MENTAL HEALTH SERVICES
F 61
PORT COQUITLAM
MENTAL HEALTH CENTRE
During the year the Centre provided service to a catchment area with a population of over 100,000. The majority of staff time was spent in providing direct
service to clients, in the forms of individual therapy, group therapy, family therapy,
and play therapy for children.
The boarding-home activity therapist ran a creative activities programme for
boarding-home residents and others with chronic mental illness who were unable to
use other community facilities. The boarding-home social worker and her case aide
were successful in helping boarding-home residents move into independent living
situations.
The sessional psychiatrist and one of the mental health nurses succeeded in
integrating more adult psychiatric services into the community, and made Riverview
more accessible to local physicians and Centre staff.
The Centre ran a residential summer camp for emotionally disturbed children,
and accepted children from Burnaby, Maple Ridge, and New Westminster, as these
centres contributed to the staffing and organizing of the camp.
In the community, time was devoted to developing a full-time sheltered work
shop and activities centre for the chronically mentally ill. The psychologist developed a preventive consultative service in one of the senior high schools.
Two new positions were added to the Centre during the year, one social worker
and one psychiatric nurse. The social worker enabled the Centre to provide ongoing
groups for pre-teens and adolescents, and the psychiatric nurse increased the service
to the chronically mentally ill.
All Centre staff were involved with field students in psychiatric nursing from
BCIT, social work students and psychology students from UBC, and were also
involved in the new in-service programme for psychiatric nurses entering community
mental health.
POWELL RIVER
MENTAL HEALTH CENTRE
This Centre continued to operate in a flexible manner with a core staff of a
psychiatrist and a social worker. In addition, in July the Centre obtained the part-
time services of a psychometrician, who proved invaluable as an incisive diagnostic
aid.
The Special Services to Children Programme offered by the Department of
Human Resources enabled the Centre to further enlarge its service of in-depth
assessment and treatment, particularly to multiproblem families. The use of this
programme enabled the staff to provide individualized back-up services in the areas
of parent effectiveness, behaviour modification, and tutoring of emotionally difficult
children.
The biggest expansion during the year was the Centre's increased involvement
in community development, and many new programmes were established through
the direct participation of staff. An alternative school for drop-outs was started,
designed to reach the potentially, as well as already academically alienated students.
Assistance was given a local Drug and Alcohol Council in funding, selecting,
and hiring a Family Counsellor, specifically for families with a chemically dependent
member.   The Centre provided ongoing help in the form of direct case consultation.
 F 62 MENTAL HEALTH BRANCH REPORT,  1974
The establishment of a Children's Committee composed of Centre staff and
representatives from Human Resources, probation, the school, public health, and
the Sliammon Indian Band home-school co-ordinator, proved a boon in joint
decision-making process. It not only served as a clearinghouse for deciding which
agencies could offer the most effective help in individual situations, but also as a
vehicle for development of innovative programmes.
The Centre played a significant part in the difficult task of mobilizing public
support for a Community Resource Board. This effort was rewarded at the year-
end by the establishment of the Powell River Community Resources Society. This
was a major landmark in working toward a more cohesive health and social services
network, with priorities expressed at the local community level.
PRINCE GEORGE
MENTAL HEALTH CENTRE
The Prince George Mental Health Centre served an area from the Alberta
border in the east to Granisle in the west, and from Hixon in the south to Pine Pass
in the north.   The 1974 population figure for the area was approximately 100,000.
Early in the year the Centre was also responsible for the Peace River area,
which had a population of approximately 50,000. This area was transferred to
the Fort St. John Mental Health Centre, after a pyschologist was recruited in February.
At the year-end the Centre's staff included one mental health nurse, two
social workers (one the Administrator), one psychologist, and one boarding-home
social worker.
During 1974 the Centre maintained a balance between direct and indirect
services. In the area of direct services more emphasis was placed on working with
groups, and the mental health nurse and the social worker were most active, creating and maintaining groups for adolescents, women and parents, and children.
Indirect services were continued, with consultation to all public and private community agencies, and representation on various community organizations.
The Centre maintained its open door policy, which continued to be met with
wide community approval.
With regard to outlying areas the Centre maintained its policy of visiting on
request, primarily for consultative and educative purposes. The Centre also was
continuing to provide pharmaceutical services to the Granisle area, until that new
establishment gets organized.
In February the Centre contracted to the Prince George Regional Hospital to
handle Centre medications. This improved service tremendously, and completely
eliminated the problems inherent in the previous system of part-time pharmacists.
The Centre worked in close co-operation with public health to interest other
agencies—for example, Human Resources, schools, probation, Alcoholism Foundation, Community Resources Board—in possible involvement in sharing space in
the proposed new health building, which was tentatively slated for completion in
the summer of 1976.
The Boarding-home Programme continued to provide an active service to
the community. There were eight unlicensed and one licensed home, providing
care for 22 patients.
 COMMUNITY MENTAL HEALTH SERVICES
F 63
PRINCE RUPERT
MENTAL HEALTH CENTRE
The Prince Rupert Mental Health Centre completed its first full year of operation on October 5. The staff consisted of the Administrator/social worker and a
clerk-stenographer. The Centre's catchment area included not only Prince Rupert,
but also the Queen Charlotte Islands and as far south at Ocean Falls, with an overall population of approximately 27,000.
A total of 316 adults and children used the Centre for direct patient service
in the 12-month period. The Centre endeavoured to meet a variety of problems,
including drug abuse, alcoholism, marital breakdown, and trouble families. The
active case load at the year-end was approximately 170. The Centre operated on
an open referral system and referrals came through most of the established agencies,
along with a high proportion of self-referrals. The model of treatment included
psychotherapy, joint marital counselling, and family therapy. A heavy demand
for direct patient services continued through the year.
Educational services included two sessions on effective parenting involving
34 families. There appeared to be a high interest for this kind of service, and
under the auspices of the Adult Education Programme of the school board district
it reached a number of people who benefited from the courses. The Administrator
gave talks to elementary and high school students on some basic mental health
concepts. In-service training seminars were also held with medical, social, and
child care workers.
The Administrator endeavoured to provide a variety of consultation services
to other health and social workers, as well as teachers within the school system.
He acted as a consultant to a study group seeking to implement a family life education course on the Queen Charlotte Islands. Monthly visits were made to the
islands. Other consultation services were carried out with other agencies, including Public Health, Department of Human Resources, Family Court Division, probation services, schools, and medical practitioners.
The Administrator acted as a consultant to a steering committee endeavouring
to set up an Activity Centre for the mentally and socially handicapped. He also
served as a Director of the Friendship House Association, an agency that provided
accommodation for transient men, and other vital social and educational services.
Pharmaceutical services were successfully negotiated with the pharmacist of
the Prince Rupert Regional Hospital to provide for distribution of psychiatric drugs
to patients. This also provided a greater liaison with the local hospital and medical practitioners.
The Centre employed two summer students who carried out a research project in regard to the high drop-out rate among high school students.
As the year progressed it became more apparent that the Centre was taking
on the role of a crisis centre involving short-term treatment. This role would seem
to be quite appropriate in an area noted for a very high turnover of people.
At the end of October a team from Riverview Hospital, consisting of a psychiatrist, a psychologist, a social worker, and a public health nurse, arrived to
initiate the first of regular monthly services to Prince Rupert. Prior to their visit
a questionnaire was circulated among the medical professionals, to gain some information concerning their expectations in the form of service that they wish to see
provided.
 F 64
MENTAL HEALTH BRANCH REPORT,  1974
Prince Rupert continued to expand in industrial and economic forms, as well
as increase in population. The Centre endeavoured to keep up with these demands,
and at the same time provide a variety of services that would keep people within
the community and treat them with whatever resources were available.
SAANICH
MENTAL HEALTH CENTRE
The Saanich Mental Health Centre continued to operate in its Royal Oak
location, and served the same region as in previous years. Staff members worked
in close collaboration with the public and private agencies serving the area, and
the Centre provided direct treatment and assessment services to individuals and
families.
The Centre had teams, or staff members, visit Ganges, Sidney, and Brentwood
to serve people who, for valid reasons, could not attend the Centre. The visits
helped the Centre to establish closer contact with these communities, and helped
in assessing community needs.
The Centre worked closely with projects initiated by laymen who were interested in developing a healthier community. The Citizens Counselling Centre in
Victoria was very active in training volunteers in marriage counselling. It also
conducted seminars to promote healthier family life. The Centre also worked
closely with the Saanich Peninsula Guidance Association, which was developing a
service similar to the Citizens Counselling Centre in the Sidney area. The Cornerstone Project, a resocialization and rehabilitative programme developed jointly by
the Canadian Mental Health Association and the Cordova Bay Irregulars (a citizens' group in Cordova Bay), continued to give active service to people residing
in boarding-homes, and also to members living in the community. The Centre
also provided leadership to indigenous citizens' groups who were trying to improve
housing, legal services, welfare, employment, and day-care centres.
Consultation was given to the Boarding-home Programme for former mental
patients, and also to the Springwood Training Centre, a residential training facility
for mentally retarded young people. These programmes were of a high calibre
because of well-trained able operators. The summer students were a real asset
to these programmes.
The goals for 1975 will be to continue the existing programmes, with particular
emphasis on co-operation with other agencies to find ways and means to develop
stronger and healthier family units, which is the key to good mental health.
SECHELT
MENTAL HEALTH CENTRE
The Sechelt Mental Health Centre completed its first full year of operation
serving the Sunshine Coast. The Centre very quickly became an active segment of
the rather sparse services in this area, which tended to guard its individuality, and
only reluctantly used the more centralized services of the Vancouver metropolis.
This attitude led to considerable interest in community development and optimism
that comprehensive services could be developed by active citizen involvement.
 COMMUNITY MENTAL HEALTH SERVICES
F 65
Despite this feeling, it was apparent that the community was not a homogeneous one,
but rather was made up of a core of permanent residents and a large, more transient
group, who sought to solve their problems by retreating from the urban areas to
what they hoped was a less artificial life of living close to nature. A large influx of
summer people occurred annually, but did not seem to make very significant demands on the health and social agencies.
The staff of the Centre consisted of one full-time Administrator/psychologist,
weekly psychiatric sessions, and one part-time clerical staff. Approximately 75
open cases were carried monthly, by the year-end. An open referral policy operated
successfully, with the majority of referrals coming from the physicians in private
practice. The schools made considerable demand for service, as the school system
did not have a psychologist on staff, although some consultation services were
available through UBC. A relationship was maintained with the Squamish Mental
Health Centre, and while this was considered valuable for consultation, the two
Centres functioned separately and the staff did not give direct patient service in the
alternate area.
The majority of time was spent in direct patient service. The demands were
great but service was provided on a very immediate basis. Staff were available to
be called in on cases handled by the other community agencies, and worked closely
with public health, Human Resources, RCMP, probation and the local general
hospital. The hospital asked for considerable consultation, as there were many
occasions when the hospital handled patients with psychiatric problems, although
there were not any psychiatric beds.
Through the hiring of a summer student it was possible to offer a recreation
programme for youngsters with social and emotional problems. The programme
served 19 children from the primary schools, and also served as a good learning
experience for the Centre in the problems of operating a community-wide programme
in a very widespread area. The availability of volunteers to supply transportation
was extremely helpful.
There was a great deal of involvement by the Administrator in the development
of improved community services. Much time was devoted to the newly formed
Community Resource Society, which, within its first year, had planned and obtained
funding for two vital community services. Staff were also instrumental in developing
regular inter-agency meetings through which problems were shared in providing
co-ordinated services on a case level, as well as communication on new and planned
modifications within the various agencies.
A major area of concern in the area was service for geriatric patients. The
elderly made up an unusually large percentage of the population, and more services
were necessary for this group. While there were senior citizens' housing and
extended-care beds in the local hospital, there were no boarding-homes or nursing-
home facilities in the area. The Centre had been involved in exploring suitable
facilities and more efficient access to the facilities outside the geographic area, but
it became evident that this need would have to be met locally, and at the year-end
staff were involved with other agencies in promoting this service.
This first year saw the Mental Health Centre become a meaningful part of the
Sunshine Coast health service. The increasing demands for service meant continued
and expanded involvement in a large number of new community projects.
 F 66 MENTAL HEALTH BRANCH REPORT,  1974
SQUAMISH
MENTAL HEALTH CENTRE
The prime focus of the Squamish Mental Health Centre in 1974 was to mobilize
the professional community to co-ordinate their services, and thereby facilitate the
better use of the Centre as an educational, consultative, and treatment resource.
This proved to be a difficult task, due to the Centre's close proximity to Vancouver.
The constant flux of professionals, coupled with the lack of direction from supervisory staff based outside the community, also led to a lack of knowledge of community problems and (or) the authority to bring about changes.
In January, a survey to discover what services the professionals wished the
Centre to provide, showed that treatment services and assistance in studying community problems received highest priority. Since that time, there was an increase
in requests for consultation both on an individual and agency-group basis. Several
conferences were also held, to discuss mental health cases involving several agencies.
Monthly meetings of professionals, instigated by the Centre, continued throughout the year. The purpose of the meetings was to study resources within the community and subsequently define gaps in services, and act in an advisory capacity
to the Community Resource Board once this was established. As a direct result of
these meetings, a Homemakers Service was established in August, which was instrumental in setting up a sheltered workshop for the handicapped in September.
The Squamish Mental Health Centre continued to remain active on the committee for "Special Services for Children," organized in March under the direction
of the Department of Human Resources. A directory, outlining the resources available for children in the Britannia and Squamish areas, was compiled.
A good liaison with Riverview Hospital, and Lions Gate Hospital psychiatric
unit in North Vancouver, was established, with the Centre attending patient conferences and providing family counselling while patients were still hospitalized.
There was evidence that admissions to Lions Gate Hospital were considerably reduced, and admissions to Riverview were almost always from the single, transient
population.
There continued to be an increasing demand on the Centre to provide direct
treatment services and consultation to the Squamish and Mount Currie Indian
Bands. This proposed a real challenge, as problems referred were chronic, cultural,
and often demanding of time and energy, in spite of the excellent co-operation
received from Indian health workers.
During the year a High School Student Counsellors' Programme was set up
by the Centre to assist in social rehabilitation of children, ages 4 to 10 years. In the
summer months, a university student was employed to supplement this programme
through play therapy.
SURREY
MENTAL HEALTH CENTRE
During 1974 the Surrey Mental Health Centre catchment area grew to an
estimated 125,000 people. Approximately 68,000 of these lived in the Delta area,
and the remainder resided in the South Surrey and White Rock areas. Activations
and reactivations in the Delta area were significant and represented a great demand
from that area.
 COMMUNITY MENTAL HEALTH SERVICES
F 67
Centre clients in 1974 participated in various individual therapy groups as well
as Adolescent Growth Groups, Adult Therapy Groups, Child Management Groups,
Play Therapy, and Marriage and Family Therapy Groups. There were always at
least four full-time members on staff to provide these services. There were approximately 140 residents in regional boarding-homes, who received consistent group
and individual therapy, and medical supervision from the Centre.
Among the community projects which involved Centre staff were the submissions of an extensive project proposal through the Family Life Association to
the Surrey Social Services Department and which involved the following: Extension
of a summer project ("Tuning In"), which offered "Big Brother" type service to
delinquent adolescents in the catchment area; the provision of several free public
education courses on Child Management, Child Development, and Growth in Marriage, as well as continued legal forums (in co-operation with the Vancouver
People's Law School); the contribution of major efforts which culminated in the
establishment of regional councils for residents and operators of regional boarding-
homes; and expansion of services to the retarded, involving an infant stimulation
pre-school programme.
Centre staff supervised and provided fairly extensive field placement experiences for three graduate students from the University of Western Washington (all
studying on the Masters Programme in psychology). These three students participated in therapy sessions with staff, in consultation with educators, and provided
some psychometric services to clients of the Centre. One of these students acted
as co-ordinator of the summer programme sponsored by the Centre, which involved
working on a recreational-based programme with delinquent adolescents from the
catchment area.
In addition to direct service to clients, consultation with community groups, and
helping to develop much needed services for adults and children, the Centre established a general liaison with the staff of the Peace Arch and Surrey Memorial Hospitals, as well as an improvement in relationships with Centre Lawn staff at Riverview.
It was recognized that more should be done in terms of improving the total
delivery of community mental health services to residents of the area, but the dramatic increase in the size of the catchment area placed excessive demands on the existing staff.
TERRACE
MENTAL HEALTH CENTRE
The Terrace Mental Health Centre continued toward the development of comprehensive mental health services both on a community and regional level. A
number of forward moves were made in this direction. This was particularly evident in areas of boarding-home facilities and in co-ordination of services with other
agencies.
The area the Centre covered geographically was extremely large, and included
that of the Skeena Health Unit, other than Prince Rupert, Ocean Falls, and Queen
Charlotte Islands. The furthest north that the travelling clinic went during the
year was Telegraph Creek. There was a regular travelling clinic to Kitimat, Hazelton, Smithers, and Houston.
Staff members included a social worker, a psychiatric social worker, a part-
time psychiatrist, a part-time pharmacist, a paediatrician on a sessional basis, and
 F 68 MENTAL HEALTH BRANCH REPORT,  1974
two stenographers. Staffing was a problem because it was difficult to recruit qualified professional people.
The total number of activations and reactivations of files from October 1973
to October 1974 was 420. This number was not truly reflective of the need for
mental health services, due to the difficulties encountered in providing an adequate
service in a large geographic area.
During the year there was a major expansion of the boarding-home programme. Skeenaview Society purchased two homes to provide boarding-home
facilities to 20 people. These homes would work in conjunction with other facilities,
such as the Three Rivers Workshop, Mills Memorial Hospital, and the Northern
Training Centre.
The expansion of services to outlying communities was given priority, and was
evident in the time spent in communities such as Kitimat and Smithers. The increasing of the time of the consulting psychiatrist was of particular importance.
Consultation and in-service education for professional and lay personnel also
received a great deal of attention. This service was particularly important in the
northern area of the Province due to lack of qualified people. The co-ordination
of resources was also of great importance.
The upgrading of existing resources, as well as the establishment of new ones,
required a great deal of time from personnel at the Centre. For example, the research and planned establishment of a Child Development Centre in Terrace was
a combined effort between a number of agencies, as well as the involvement of
local volunteers and paediatricians.
The goals for 1975 would be continued expansion of services to areas such
as Kitimat and Houston, and the continuing effort to develop a closer liaison with
other agencies and community people.
TRAIL
MENTAL HEALTH CENTRE
The year 1974 was marked by the increasing growth of mental health services
in this region. With a focus on consolidation, integration, and prevention, Centre
staff were actively involved in a wide range of programmes. There were many
social and health developments which had a significant mental health component,
and Centre staff provided consultation and advisory direction.
In the area of direct services, over 200 individuals and their families were
provided with counselling, follow-up, placement, and psychological assistance.
This included child guidance, marital counselling, individual therapy, group work,
and family therapy.
The boarding-home programme continued to expand with an increase from
31 to 45 people in residence. Through the initiative of the boarding-home social
worker, many residents took part in social activities, travelled to Expo '74, and
participated in sheltered workshop activities.
Community development functions of staff members included active advisory
roles in such groups as the Canadian Mental Health Association, the Trail and
District Association for Community Planning, Big Brothers, Kootenay Society for
the Handicapped, Union Board of Health, Rossland Integration Project, Trail
Methadone Clinic, Youth Liaison Committee, Trail Group Home Society, and the
Aid to the Handicapped Committee. Indirect consultative functions were provided
to such programmes as the Weekend Attendance Programme, Alternate Education
 COMMUNITY MENTAL HEALTH SERVICES
F 69
Programme, Grand Forks Community Human Resources and Health Centre,
Grand Forks Society for the Handicapped, and the Youth Hostel Society.
Community education and information programmes involved staff in panels,
radio talks, a Centre "Open House," Family Life groups, and workshops for professionals and volunteer groups. Staff were directly involved in an advisory, student
supervision, and educational function for the Nursing and Social Service Aide programmes at Selkirk College.
To increase its consultative effectiveness the Centre continued to provide
travelling clinic services to the Grand Forks and Castlegar areas. Fewer and more
intensive interagency case conferences, particularly in regard to school-children,
were arranged to provide greater assistance to teachers and other agencies, which
provided needed service to individuals and families with special or severe problems.
Three programmes of special interest were developed during the year. The
mental health nurse worked closely with volunteers, Public Health, the hospital's
psychiatric unit, and other professional staff, toward the development of a comprehensive programme for persons with long lasting emotional problems. This involved putting together a Community Resources Folder for discharged patients;
screening, selection, and orientation of CMHA volunteers for hospital and home
visitings; group work with several people after discharge; and interagency meetings
directed toward continued improvement of follow-up services.
A second programme involved three summer students who worked with some
35 children in therapeutic, recreational, and camping activities. The fourth student
completed the revision of a Community Services Directory, as well as the development and distribution of a community questionnaire which assisted in determining
attitudes and suggested directions for the further development of mental health
programmes. Subsequent to these, arrangements were made to employ three
child care workers through the Department of Human Resources "Special Services
to Children" Programme. This co-operative endeavour was begun in order to
extend the summer programme, under the supervision of the Centre psychologist.
Centre staff were very active in working with different community groups
toward the development of integrated services at the local level. With a long history
of co-operation, co-ordination, and communication between community, professionals, and agencies in the area, staff were hopeful that a truly integrated and
accessible social and health service system could become a reality in the near future.
Administratively, the development of new programmes and greater community
involvement increased the work load significantly. The considerable assistance of
the clerical staff in these areas made it possible to avoid a large decrease in the
maintenance of client and consultative functions.
The Centre's goals through the next year included—expansion of the boarding-
home programme to maintain the emphasis on decreased institutional care, with
a particular need to develop personal care homes in the Grand Forks and Trail
areas; continued development of follow-up and volunteer programmes; maintenance of limited but stable and effective direct services; increased services to children with special mental health needs, in order to prevent the development of more
serious disorders; focus on meaningful integration of local services; and more effective consultation and education at the professional and community level with the
introduction of programmes primarily preventive in nature. With a small staff of
four professional workers, the Centre has been fortunate to work in an area where
the potential for the development of volunteer and other lay groups made it possible
to extend mental health services to a wider range of people than might otherwise
be expected.    While there were many areas of unmet needs, it was hoped that
 F 70 MENTAL HEALTH BRANCH REPORT,  1974
professional manpower could gradually be increased and, with the further development of effective co-ordination between community groups, the mental health programmes would reach a point where the majority of people within the region would
have access to these services.
VERNON
MENTAL HEALTH CENTRE
In 1974 the Vernon Mental Health Centre attempted to continue to service as
comprehensively as possible the mental health needs of the North Okanagan community. Consultation and education programmes were greatly expanded, in spite
of the very heavy demand for direct treatment.
The boarding-home programme took care of approximately 260 patients and
was functioning well with the addition of a second boarding-home social worker
during the year.
Team members included a psychologist, a mental health nurse, a psychiatrist,
two social workers in charge of the boarding-home programme, a full-time case aide
for the boarding-home programme, two full-time stenographers, a part-time typist,
and a social worker/Administrator. There were also five summer students employed
for a period of four months.
The Centre continued with a variety of treatment programmes, including
reality-oriented brief service, behaviour modification, marriage and family therapy,
and group therapy, and also medical supportive care for chronic patients.
A specific programme was developed in consultation with the elementary
schools, involving acting-out children. This programme diminished the need for
direct treatment of school-children from Grades I to VII. The programme involved
a conference between all the school personnel involved with a child, and two staff
members from the Centre. Sometimes the parents of the child were included in
the conference. A specific programme was worked out with the school, to make it
virtually impossible for the acting-out child to interfere with the teacher's freedom
to teach, and other students' freedom to learn. The success rate in this programme
(about 11 or 12 conferences) has been 100 per cent. Schools were being encouraged to use the Centre's services for elementary children.
The other service that was greatly expanded was in the field of Parent Education. The Centre provided "Parent Effectiveness Training" courses and approximately 400 parents took advantage of these. This programme was expanded to
"Teacher Effectiveness Training," in which all the staff at two schools participated.
These principles were also used in consultation with other agencies, especially for
example, Human Resources.
During the year Centre staff provided travelling clinic services twice each month
to Salmon Arm and Revelstoke. Consultation and education programmes were
being applied in these communities as well.
Staff also gave a good deal of time to new services in the community, including
Mara House, an assessment and planning centre for children from the ages of 6 to 16.
The Centre's psychologist was on the professional advisory board and a number of
staff gave a lot of time to staff training, as well as weekly consultations. There was
a new pediatric extended-care unit, and the psychologist provided instruction in
behaviour modification, which formed the basis of their programme. This same
programme was soon to be added to the adult extended-care unit.
 COMMUNITY MENTAL HEALTH SERVICES
F 71
Perhaps the greatest unmet need in the community was the lack of another
psychiatrist. The psychiatric ward of the Vernon Jubilee Hospital received only an
hour or two of consultation a week from the Centre's psychiatrist, because of the
other pressures on her time.
The Centre's goals for 1975 were to increase the consultation and education
programmes, which would eventually reduce the demand for direct treatment.
VICTORIA
MENTAL HEALTH CENTRE
During the year the Centre experienced rapid change within its catchment area,
and there was a resultant need for evaluative practice in all areas of service delivery.
With the development of the Integrated Services Project into a functioning reality,
the project staff moved from the Mental Health Centre into their own accommodation. The removal of the responsibility for services to children enabled the Centre
to work toward achieving its goal of developing a more comprehensive service to
adults.
There was also a need to shift and devise new patterns of service delivery as
the result of changes in the administration of the Department of Human Resources
and of Public Health. The development of district neighbourhood offices by the
former, and the incorporation of the latter into the Capital Regional District,
presented an opportunity not only to develop co-operative planning with those
major organizations, but also to achieve flexibility in meeting the changing needs
in the community.
The Boarding-home Programme, despite staffing vacancies, was able to accomplish a degree of integration of services in relation to both community agencies and
to the Eric Martin Institute of Psychiatry, Royal Jubilee Hospital. The Boarding-
home Programme provided not only a basic model of service, but the imaginative
beginnings for the development of a comprehensive community programme for the
psychiatrically disabled in the Capital Region.
The year was one of greater involvement with students, through summer employment in the Boarding-home and the Art Therapy Programmes. In both areas,
valuable contributions were made by the students to the Centre's services. There
was an expansion of co-operative efforts with the University of Victoria, in that
students from both the Department of Psychology and the Department of Education
were given an opportunity to gain practical experience in a community mental
health centre. This programme was broadened with the beginning of the fall
term, by giving students more training in intensive therapy techniques, through working with patients of the Centre.
A closer working relationship was developed with the Eric Martin Institute of
Psychiatry, with the Centre becoming more actively involved in the referral of
patients from emergency, and in developing responsibility for more active participation in follow-up care on referral from the Institute.
Consultative services were continued, mostly in areas of community planning
(in conjunction with other community agencies). The greatest demand for service
was, however, for direct patient treatment. It was foreseen that consultative services may be more in demand, as the community achieves its goal of integrated
neighbourhood services, and this Centre was ready to meet that need.
 F 72 MENTAL HEALTH BRANCH REPORT,  1974
Throughout the year, staff participated in educational programmes at the
community level; talks, lectures, and participation in symposiums were carried out
in conjunction with community agencies and private groups.
During the year the groundwork was laid for what was anticipated to be a
better integration of service in the area of mental health service delivery, and for the
establishment of district service through miniclinics, in conjunction with the Department of Human Resources and Capital Regional District Health Services. It was
hoped that staffing will allow for the provision of teams to serve such a programme.
The Art Therapy Programme developed into a successful treatment facility,
and expanded its programme to include the training of art therapists from other
areas of the Province and from the University of Victoria. The Art Therapy Programme, beginning in September, was providing a training centre for students who
will eventually graduate with a degree in art therapy.
This Centre's interest in forensic psychiatry remained unabated and, in the late
fall, plans were completed for assisting in assessment and treatment of offenders, as
part of the Alternatives to Gaol Programme.
WHALLEY
MENTAL HEALTH CENTRE
During the year the Centre carried between 350 and 450 cases per month.
Two hundred and seventy-eight new cases were activated during the first 10 months
of 1974. These figures did not include 42 boarding-home cases which were also
carried by the staff of the Whalley Mental Health Centre.
Generally, the services offered by the Centre could be classified as follows:
The encouragement of self-help groups and organizations within the community, with staff participation in community educational projects.
Early intervention of child management problems.    Staff provided consultation and guidance to parents and worked in co-operation with
schools, public health, social service, and others who were involved
with the child.
Diagnostic and therapeutic service to adults with acute adjustment problems and psychological disturbance.    The Centre provided counselling and medication during periods of crisis.    Staff helped clients
to clarify their adjustment problems, and to make decisions which
would relieve their distress.   Clients were directed to other resources
as necessary.
The establishment, co-ordination, and supervision of services to chronically disabled persons.   Rehabilitation was most likely to be required
by persons who were retarded or who suffered from chronic disorders.
Centre staff participated in the development of a psychiatric "day hospital"
service at Surrey Memorial Hospital, and continued in their consultative roles to the
Surrey Rehabilitation Workshop, the Special Teacher Programme, Crisis Centre,
Douglas College, and Surrey Centre Youth Workers. Centre personnel also assisted
community groups at organizational meetings and in the provision of services, while
still maintaining a productive working relationship with the Surrey Social Service,
the Probation Department, the schools and public health.
 COMMUNITY MENTAL HEALTH SERVICES
F 73
WILLIAMS LAKE
MENTAL HEALTH CENTRE
During the first six months of the year the Mental Health staff continued to
provide service to the Cariboo and Chilcotin areas. The emphasis was on the consultative and public education approaches, with limited direct service offered in
Williams Lake only.
There was an increasing number of requests for consultation from 100 Mile
House and from Quesnel. Accordingly, more staff time was spent in these two
communities. However, the demand for service continued to increase, and this was
particularly noticeable in Quesnel.
The staff became involved in the local Civil Liberties Group and the Cariboo
Indian Friendship Society. They participated with the Probation Department in
100 Mile House in setting up an Attendance Centre, a receiving-home for children
waiting for a court decision on their future. Staff were also involved in helping the
community plan for the establishment of a community resource board. As a result
of the efforts of the centre staff, a co-ordinator of counselling services for the area
around 100 Mile House was appointed.
In July the Mental Health staff resigned. In September a psychologist joined
the staff, followed by a psychiatric social worker in October. This new team spent
time getting to know the area, the programmes and the other professionals, and
taking travelling clinics outside of Williams Lake as far as Bella Coola. Activity
consisted of some direct treatment, assessment, consultation, and involvement in
planning with local community groups such as the Canadian Mental Health Association and the Cerebral Palsy Association. The psychologist was on the advisory
board of a proposed Child Development Centre, to be operated under the auspices
of the Cerebral Palsy Association.
At the year-end plans were being made to move out of the local health unit
building because of space limitations.
  IN-PATIENT SERVICES
A
mental
health
branch
  IN-PATIENT
SERVICES
RIVERVIEW HOSPITAL
GENERAL COMMENTS
At the beginning of the year it was anticipated that the study of Riverview
Hospital undertaken by the Core Committee, established by the Deputy Minister
of Mental Health, would recommend the general form the hospital should take in
its reorganization to five major programmes. The prime sources of input for the
committee came through the Interim Programme Advisory Committees, composed
of the majority of disciplines in patient care, administration, and services. Such
committees were of inestimable value to the Core Committee in its meetings,
deliberations, and conclusions. The Core Committee's Report was completed and
forwarded to the Deputy Minister in August.
The Minister's Conference on reorganization of the Department of Health was
held in the Education Centre, October 1 and 2, and the general plans indicated new
directions, relationships, and roles for Riverview Hospital.
During the year the Vancouver Psychiatric Service Programme, identified as
Programme 1 for the Core Committee, continued to function and work in close
association with the Greater Vancouver Mental Health Service. This was assisted
by the ongoing activities of the Joint Steering Committee, with representatives from
Riverview Hospital and the Vancouver-based programme.
The Out-patient Service programmes were not altered in any particular respect,
as the Vancouver Psychiatric Service Programme did not, in effect, diminish to any
marked degree the operation of the hospital's outpatient services, which continued
to meet needs of former in-patients from the Greater Vancouver area. In April a
special meeting of the Joint Steering Committee and senior personnel from the
Out-patient Services was convened for the purpose of considering the development
of a Day Hospital Programme for Vancouver. The proposals were for such a
programme to be maintained and operated at the Out-patient Services, and this
recommendation was forwarded to the Deputy Minister.
In 1974, physical changes at Riverside Unit were completed, which provided
very considerable improvements. It was disconcerting to note that patients continued to escape from the Riverside Unit and that nurses were held responsible in
large measure for the security, although they were not trained for these purposes.
The provision of the new recreational unit was one of the major achievements for
Riverview Hospital. The new facility came into being late in the year, and the
Recreational Therapy Department and related services were confident that this
building would serve a most important recreational need.
Most of the changes that were necessary for Residences 6, 7, and 8 were
accomplished, and Residence 7 remained unoccupied during the year. Residence 8
was named "Sunnyside," and accommodated 40 female patients in the preliminary
stages of returning to society. Residence 6 was occupied during the year by the
Dental Services and Transport Services. Additional physical changes were needed
in order to accommodate business office personnel.
Improvements were made in administrative and organizational functions which
facilitated patient interviews, expedited the completion of patients' records, and
77
 F 78 MENTAL HEALTH BRANCH REPORT,  1974
improved the preparation of patients to commence treatment. The Riverview
Hospital Pharmacy received some physical improvements which permitted more
accurate and rapid dispensing of drugs for the individual patients, and for supplying
the pharmacy cupboards in the buildings and ward stock.
The Operant Conditioning Programme which was begun in 1972, continued
to be of great value and every effort was made throughout 1974 to provide good
support for this programme. It was unfortunate that staff shortages continued in
the early part of the year and during the summer, so that at times the Operant
Programme did suffer from inadequate staffing.
One of the consistent aims in the area of treatment services was the improvement of the quality of care given to patients in the hospital, and a special study group
was established for this purpose in the Department of Nursing at North Lawn. The
Nursing Staff Development Programme was the basis for the improvement of nursing
care in Riverview Hospital.
Due to the physical inadequacies, the C side of West Lawn Unit was closed
during the year. Fifty of the patients, with appropriate staff, were transferred to
Valleyview Hospital, another 50 patients were sent to East Lawn, and the remainder
were placed in suitable wards on the A side of West Lawn.
Very useful functions were provided, and services maintained or improved, in
the areas of podiatric services, optometric services, patients' education, barber and
beauty services, and in pastoral care services. The Roman Catholic chaplain was
transferred from the hospital and his lack of replacement placed a burden on the
Protestant chaplain and the part-time clergy personnel who visited Riverview
Hospital from their local church communities in the Greater Vancouver area.
During the year a new type of Review Panel was introduced under section 24
of the Mental Health Act. The panel's structure was diversified, to include physicians, psychiatrists, and other concerned persons, which enabled patients to be
assessed rapidly, carefully, and with some degree of community approach. The
Panel commenced its functions in January, and approximately one-third of the 70
patients reviewed were recommended for discharge from the hospital.
Legislation was also introduced to establish the Forensic Psychiatric Services
Commission, charged with the total responsibility of forensic care programmes and
activities in British Columbia. This will entail new directions for the operation of
Riverside Unit and for the care of Order in Council patients throughout Riverview
Hospital.
The Joint Steering Committee continued to meet so that Riverview Hospital
and the Greater Vancouver Mental Health Service could work together for the
citizens of the selected Vancouver health regions.
The Riverview Hospital Advisory Board met twice in the year, and once as
Joint Conference Committee. Proposed medical staff by-law changes were not
approved, pending changes in the reorganization of Riverview Hospital.
Staff shortages experienced during the summer were partially offset by an
additional 30 summer relief positions, and 75 summer students taken on by the
nursing department. The average monthly vacancies January to September were
94. The recruitment programme from the United Kingdom provided almost half
of the total graduate nurses recruited in the first eight months of the year. This,
plus an extensive use of on-call staff, enabled the hospital to provide coverage of
its programmes over the summer.
It was clearly evident that there was an increasing need for additional administrative staff at senior and business office levels, as the planning, executing, and
assessing of hospital functions became more demanding.
 "Talking" books were added to the patient's
library in 1974.
RIVERVIEW HOSPITAL
|   Physiotherapy was an important part of the
treatment programme for many patients.
"
 F 80
MENTAL HEALTH BRANCH REPORT,  1974
TREATMENT SERVICES
The major changes in treatment programmes developed in the hospital during the year were to accommodate a changing patient population. New psychotherapeutic agents were incorporated in the treatment programme. Behaviour
modification programmes in the form of an Operant Conditioning Programme on
Ward D5, and aversive conditioning in the Psychology Department, were continued,
and a research project in biofeedback techniques was developed.
The changes in the patient population were a reflection of a change in the
characteristics of the newly admitted patients, and the increasing age of the long-
stay patients in hospital. Many persons voluntarily seeking treatment obtained it
in psychiatric units in general hospitals, or in some other community teams, while
the more seriously disturbed patients were referred to Riverview for admission.
In order to meet the needs of these patients, the operations of the Intensive Psychiatric Care Unit in the Crease building were modified to accept seriously disturbed
patients from all areas of the hospital, for a short intensive course of treatment on
a closed nine-bed ward. A second ward in the Crease building was developed as
a closed ward, with emphasis on behavioural modification for patients requiring
this type of approach over a longer time interval. In both instances, however, staff
shortages have hampered the development of these programmes.
Since in-patient treatment in Riverview Hospital was only one phase in the
over-all treatment programme for most patients, close liaison with other treatment
facilities was imperative. This was established with the local regional mental health
centres through joint staff meetings, and through psychiatrists who had joint appointments at Riverview Hospital and the relevant mental health centres. These
psychiatrists provided the in-patient treatment at Riverview Hospital to all patients
admitted from that particular community. Five psychiatrists had such an appointment. Teams of psychiatrists, social worker, and nurse visited the more distant
communities, including Prince Rupert, Smithers, Prince George, and Vancouver
Island. Liaison was established with the Greater Vancouver Mental Health Service, through the formation of the Joint Steering Committee.
The Out-patient Department located at 96 East Broadway, continued to be
a very active resource, carrying an average case load of 755 patients.
Special treatment programmes were developed for certain groups of patients,
such as those suffering from organic brain syndrome or those admitted under some
provision of the Criminal Code.
The Organic Brain Syndrome Project came into being at the beginning of the
year in a 42-bed ward in the North Lawn Unit. At the time the project was started
the waiting list for patients suffering from chronic organic brain syndrome exceeded
80 patients. During the first 10 months of the year 33 patients were admitted. Because of the great demand for this service, combined with a low recovery rate, the
waiting list was again in excess of 80 persons at the year-end.
During the course of the year, steps were taken to develop the Riverside Unit
into a specialized forensic service. Female patients could not be housed in the
Riverside Unit, but were provided psychiatric treatment in the East Lawn Unit
by the services of the forensic psychiatrists, who also tended out-patients at the
Forensic Clinic. Ninety-two nonforensic patients were transferred out of the
Riverside Unit to other areas of Riverview Hospital. An additional 25 patients
had stays of proceedings entered into their cases, and were transferred to other
areas of Riverview Hospital, or discharged. As part of this programme, the Riverside Annex was closed, being considered no longer suitable for patient occupancy.
 RIVERVIEW HOSPITAL:     p   ,$
XJ)
Classes in handicrafts were
popular' with the patients
and assisted in their rehabilitation.
Musical sessions, under the
guidance of a trained therapist, played an important
role on the road to recovery.
 F 82
MENTAL HEALTH BRANCH REPORT,  1974
The "potentially dangerous patient" continued to be of concern, and a committee studied the problem. An Assessment Committee was established to assist
in the evaluation of risk in such patients, and in reviewing treatment and rehabilitation plans. Specific recommendations were made for the modification of certain
areas of the hospital for this purpose, such as the development of a closed area in
the Centre Lawn Unit.
The Medical Staff Organization and its various committees continued actively
throughout the year. The Credentials Committee maintained its requirements for
physicians to be fully registered in the practice of medicine in British Columbia,
before it would recommend a medical staff appointment. With the exception of
two physicians previously appointed on temporary registration, all medical staff
were fully registered in British Columbia. The Psychiatric Audit Committee continued to review individual patterns of practice, individual treatment problems, and
made a full-scale review of the Out-patient Department and the Operant Conditioning Project. At the year-end this Committee was considering a review of the
patterns of suicide.
By the end of October, 10 physicians had been granted a medical staff appointment during 1974, and 13 had resigned. As of October 31, eight medical staff
positions were vacant.
The average age of the in-patient population increased with the corresponding
increase in the number of patients with physical infirmities. To meet the specific
needs of these patients, some of the larger wards were divided into small infirmary
areas. Six medical staff positions were set aside for general practitioners to provide general medical care for such patients. A part-time specialist in physical
medicine was granted a staff appointment to work closely with the consultants in
surgery and internal medicine, as well as with the Department of Physiotherapy
and Occupational Therapy, and Recreational Therapy. A full-time speech therapist
was available early in the year; however, due to her resignation, this position was
vacant at the year-end.
A former nurses' home was renovated, and utilized as a special facility for
preparing long-stay female patients for return to sheltered accommodation in the
community.
With the changed methods of remuneration of physicians, the provision of
night-duty doctor coverage for the hospital became more difficult, with a smaller
group of salaried physicians providing all this coverage. Specialist consultation at
night was available in all specialties, except psychiatry.
Formal affiliation with the University of British Columbia was obtained early
in the year. Several of the hospital psychiatrists had university appointments.
Residents in psychiatry from the University of British Columbia received training
experience at Riverview Hospital. The hospital continued to be active in the affiliation with various educational institutes, such as the B.C. Institute of Technology
and Simon Fraser University, in the training of laboratory technologists, psychology,
nursing, and social work students.
Research activities in the hospital were hampered by the large and urgent needs
for direct patient care. However, research continued in the following: The biochemical basis of schizophrenia, drug research, and research in the biofeed-back
mechanisms. The hospital was very active with various research projects underway at the University of British Columbia, including the biochemical factors of
schizophrenia and Huntington's Chorea.
 IN-PATIENT SERVICES
F 83
ITEMS OF INTEREST
Included in the year's accomplishments were the provisions of Patients' Comfort Allowances with increases; the daily cleaning of buildings by the building
service workers; an increase in production in the Industrial Division of useful items
for patients' needs; and a special study to improve drug handling and distribution
by the Pharmacy.
The Transport Service moved to Residence 6 from its old office in the transport
garage area, which resulted in very definite improvement and operation of that
service.
Food Services provided 1,891,724 meals during the year, of which 15 per cent
required special diets of a therapeutic nature.
Improved methods of handling patient statistics in ward, unit, and Out-patient
Services were developed, and were being implemented and placed into a computerized system at the year-end.
The Department of Rehabilitation played a very special role in Riverview
Hospital in providing effective services for work placement, including effective
follow-up on work performance and guidance for the ex-patient. Forty-six patients
were transferred to Venture and Vista.
There was a great need for a modern sheltered workshop, as well as for more
personnel and increased efforts at work planning, work placement, and worker
supports.
Miss M. L. Carmack, Director of Nursing, resigned September 15 to accept
employment with the Registered Nurses' Association of British Columbia, after 12
years' exemplary service.   An Acting Director was appointed immediately.
A thorough study of safety conditions at Riverview Hospital was made in
April and recommendations for improvements were presented for study.
The survey of the Canadian Council on Hospital Accreditation took place
November 4 to 6.
Contractual agreements with certified groups of employees were completed,
resulting in very marked increases in paper work and necessitating unexpected
clerical staff and personnel staff increases. In addition, because of certain clauses
in agreements, considerable changes in work scheduling had to be undertaken.
Approximately 250 volunteers, under the auspices of the Canadian Mental
Health Association (B.C. Division), provided 19,000 hours of service. Their
"Gift of Hope" project received 7,000 donated items, which were gift wrapped as
Christmas presents and distributed to every patient in hospital. The CMHA station
wagon logged 10,000 miles in transporting patients to volunteer programmes outside
the hospital grounds.
Under the Legal Assistance Programme, 117 patients received legal counselling, of whom 53 were referred to the Legal Aid Society of British Columbia for the
appointment of a counsel.
 VALLEYVIEW HOSPITAL
During the year, Valleyview Hospital provided 726 beds to serve the psychiatric needs of persons 70 years of age and over. Many of the elderly suffer a form
of mental deterioration from physical processes connected with aging. Those who
developed behaviour or habits which could not be tolerated in community-care
settings were accepted for care at Valleyview.
Admissions to Valleyview showed a slight drop from last year. This was the
result of a deliberate reduction in the rate of admissions during January, February,
and March, made necessary by a shortage of both nursing and medical staff. The
resulting reduction in population allowed one ward to be evacuated. However, at
the beginning of July this was reopened to receive 50 patients from Riverview Hospital, along with a suitable complement of nursing staff. Death rate and discharge
rates showed little change from last year.
The Minister of Health, the Honourable Dennis Cocke, made an official visit
to the hospital in July. He spent a half-day touring the premises and talking with
staff, which was very much appreciated.
CLINICAL SERVICES
The pre-admission screening programme was expanded by the addition of an
experienced psychiatric nurse and social worker. This allowed better assessments
to be made and it became possible to help the referring doctor find alternative community residential care in those cases where it was considered that admission of the
patient to Valleyview was not necessary. This resulted in a significantly higher
proportion of rejections for admission, which in turn meant a smaller waiting list.
In 1974 the longest wait was five weeks, and this was for males only.
One of the hospital's two positions for psychiatrists remained vacant, due to
the difficulty of recruiting psychiatrists who were interested in working solely in
the geriatric field. The four physician positions remained filled, but because they
had to cover all night and week-end duty for the hospital without help from Riverview medical staff, their compensatory repayment of time resulted in a 20 per cent
reduction in daytime medical staff, which was a continuing handicap.
Nursing Division staff continued to give excellent service to the patients, and
the good reputation of this hospital was largely based on their efforts. However,
it was an ever-increasing struggle to maintain the level. Recruitment of nurses
continued to be below the requirements, so that the ratio of nurses to aides was at
a critical level throughout the year. Aide recruitment was also difficult at times,
and to compound the difficulties the rate of turnover of all nursing staff was rapidly
rising. Greater use of on-call staff prevented a serious reduction of service. The
general health of the patients was good. A continuing problem was to prevent
confused, elderly, unsteady walkers against accidental injury to themselves, but still
keep them as active as possible. Sickness and accidents amongst the ward staff
continued at a very high level and greatly concerned the administration and the
Safety Committee.
The reduction of admissions rate referred to previously permitted a change
in location of the rehabilitation ward. The former ward had three levels and
patients had to be able to negotiate the stairs. Since anyone needing rehabilitation
who could not use the stairs was denied the benefit of this programme, it was considered advantageous to have it transferred to a single-level ward.    Other ward
84
 IN-PATIENT SERVICES
F 85
changes were also initiated. The only male infirmary ward was integrated to a
combined male and female ward. The activation ward was also integrated, to
allow a more centralized physiotherapy programme.
An in-service education department was instituted late in 1973 under the
direction of a former instructor in the Education Department at Riverview Hospital.
Two additional nursing instructors were added later. This department was responsible for organizing all forms of in-service education required for all categories of
staff. A good start was made with the development of orientation courses for new
staff, initial or refresher short courses for aides, as well as brief sessions for housekeeping staff and a one-day session on telephone answering for clerical staff. This
was an important innovation for Valleyview, which could be expected to pay dividends in the future.
The Social Service Department had its six professional positions filled throughout the year and they maintained a good level of work, with some evidence of improved quality.
Occupational and Recreational Departments were an important part of the
programme for patients. Over the past few years proportionately more of the
patients were physically infirm. Easier means of transportation to the Occupational
Therapy Department, as well as more ward-based programmes, were required but
would not be possible until additional personnel and proper equipment for transport could be acquired. The Recreational Department was handicapped through
most of the year by the continued serious illness of the director. Fortunately, summer students were able to help. Though lacking in knowledge or experience they
supplied plenty of enthusiasm and energy which were very appropriate and useful
to this area of service.
Volunteer services continued to expand, and provided varied kinds of personal
attention and service to patients which could never be rendered by regular staff.
Their presence was very much appreciated by patients and staff alike.
During the year a second beautician was added to the staff, and this expanded
service was very popular with patients and their families.
The dentist carried on his regular work and also found time for a repeat survey of all patients in the hospital, which showed some degree of improvement in
oral hygiene, a result of his educational efforts with ward staff.
The Radiology Department and the Pathological Laboratory continued to
maintain a high standard, and provide a most necessary and valuable service.
Another service essential to the elderly patients was provided by the Physiotherapy Department. A second physiotherapist was appointed during the year,
which gave a considerable boost to the work and improved the quality of the reactivation service. More visits to the outside wards also became possible, and this
was important for direction and support to nursing staff.
A very important service was also provided by the podiatrist, who worked
part-time at Riverview Hospital.
ADMINISTRATIVE
Unfortunately, the Business Manager, A. I. Smith, had to go on sick leave in
May and was not able to return before his retirement took effect in November.
Mr. Smith had a firm and knowledgeable hand on the reins for almost 15 years and
under any circumstances his departure would be significant. The problem was
compounded with the initiation of union contracts in mid-summer. Fortunately,
a capable personnel officer was obtained who was able to help cope with the new
personnel practices.
 F 86
MENTAL HEALTH BRANCH REPORT, 1974
Anticipating Mr. Smith's retirement, a major administrative change was initiated, whereby a qualified hospital administrator (nonmedical) would be sought
and the present medical director would then confine his responsibilities to the direction of medical staff and the medical work of the hospital. This was being finalized
at the year-end.
Housekeeping services continued with no significant change during the year.
Dietary standards were maintained at their previous high level, and an additional
dietitian was provided, resulting in improved efficiency.
During the year a variety of building problems was reviewed by the architect
from Public Works and a capital study was initiated. It was expected that work
on the most urgent needs would commence next year.
 DELLVIEW HOSPITAL
The philosophy of the hospital during the year was to foster and maintain the
social and cultural conditions which were an integral part of the patient's way of
life. The purpose of the hospital was to provide care, treatment, and rehabilitation
for the elderly who suffer mental, emotional, or behavioural disturbances associated
with the aging process.
During the year many changes and innovations took place in the Nursing
Department. In November 1973, 12 temporary assistance staff had been hired,
which permitted many additional nursing care hours. In February 1974, an in-
service education position was assigned to the hospital, which resulted in a comprehensive orientation programme for new staff being developed, together with a
programme of ongoing education for all other staff.
The integration of male and female patients was tried in a small way during
the year. Fourteen female patients were integrated into the male ward, which reduced overcrowding in the female ward and resulted in improved behaviour from
integrated patients. At the same time, 18 male patients were transferred to an
unused nurses' residence, providing greater freedom, privacy, and independence for
the patients. The improvement in these patients was dramatic; undesirable behaviour almost disappeared, personal hygiene improved, and withdrawn patients
started to take an interest in their surroundings again.
There were no serious staff problems during the year. The recruitment of
graduate nurses was good, and all nursing position vacancies were filled.
Staff work loads continued to increase. Approximately 50 per cent of all
patients were nonambulatory, and an additional 20 per cent were semiambulatory.
Medical services continued to be provided on a part-time basis, with psychiatric
services of one hour per week being provided through the Vernon Mental Health
Centre.
A dentist attended one morning each week, with all services performed in Dell-
view's dental suite. Miniature chest X-ray services were provided by a volunteer
technician, with all film developed by the Willow Chest Centre, Vancouver. Approximately 1,300 plates were taken.
Physiotherapy services were contracted through Vernon Jubilee Hospital on a
half-time basis commencing in July. This programme provided a much needed
service. In addition to direct patient service, the physiotherapist assisted with
staff training.
An In-service Education Co-ordinator was added to the establishment early in
the year, and newly developed programmes included an orientation programme,
tours for the visiting public, and staff immunization programmes. A volunteer
programme was also started, attended by 11 candy stripers through Vernon Jubilee
Hospital, 40 students from the Clarence Fulton High School, and eight psychology
students from Okanagan College.
On May 4, Dellview Hospital hosted its first Open House held in conjunction
with Mental Health Week. Approximately 350 visitors toured the hospital. On
May 23 the Vernon Medical Association held their regular medical staff meeting at
Dellview, with 18 doctors in attendance.
During the last week of September a Safety Week was held, with 16 resource
speakers providing 35 various programmes attended by 433 staff. The programme
was attended by a Safety Officer from the Public Service Commission, Victoria, with
87
 F 88
MENTAL HEALTH BRANCH REPORT, 1974
all other speakers from the local community. Fire drills, films, posters, and a
safety quiz contributed to make it a very successful undertaking.
Under the student summer employment programme Dellview employed 12
students, who contributed to improving dietary and housekeeping standards of
service. The six psychiatric aide positions allotted to Nursing Service enabled the
development of innovative patient programmes. These included the participation
of some 60 patients in various undertakings, such as three-day camp-outs, swimming,
boating, sing-songs, wiener roasts, cherry-picking, scenic drives to local orchards,
tours of local tourist spots, and a number of fishing trips to local trout lakes.
Regional laundry services provided a regular and adequate supply of linens.
The Dellview Linen Advisory Committee developed, in co-operation with regional
laundry, a number of improved clothing and linen designs to facilitate and improve
patient care.
The Dietary Department continued to provide excellent service to all patient
areas. Some difficulties were experienced in the summer when the supply of meat
products was restricted by a labour strike.
Several staff members participated in continuing educational studies during the
year. Courses included "Hospital Organization and Management," "Nursing Unit
Administration," "Hospital and Health Care Administration," and a two-week
seminar on "Basic Instructional Techniques" at BCIT. One member attended a
one-week B.C. Safety Council seminar at UBC. Four staff attended a four-day
Labour Relations Seminar held at Valleyview Hospital, and a further 12 were
scheduled for a similar course early in 1975.
Additional personnel were approved during 1974 for a total of 20 positions,
and at the year-end approval was received for 29 more positions.
 DELLVIEW:
Staff held several picnics for the residents during the summer. This one took place at
lovely Mara Lake.
Approximately 350 visitors attended Dell-
view's first Open House, held in May. This
group was photographed as they entered the
male patients' annex.
5 &09f
Patients considered this trip to the Okanagan
Game Farm to be one of the highlights of
the year.
 SKEENAVIEW LODGE
The basic element at Skeenaview during the year was that of change, involving
both improvements and difficulties. Coping with this change occupied the majority
of staff time since the beginning of the year.
The general objectives continued to be the maximization of the independence
of the individual resident and the creation of a normal environment. The commitment on the part of the staff to the objectives and the over-all improvement of care
standards, on an individual and group basis, was one of the few constants.
On May 1, Skeenaview Society assumed responsibility for the operation of
Skeenaview Lodge for a trial period of one year. The maximum bed count was
170 and funding was provided through the Department of Human Resources rather
than the Mental Health Branch. Applications for admission continued at an increasing rate, and from September on were not below 15. One of the problems was that
there were few, if any, facilities for the aged north of the Interior. The Lodge
continued to admit only men because to admit women the patient count would have
to drop to 150 in order to enable the hospital to convert a dormitory to female use.
Treatment services underwent major changes. Staffing increased considerably
and a number of new nurses, primarily from Saskatchewan, were recruited.
The fundamental alteration was a conversion to team nursing. Concurrent
with this was a mixing of levels of care on the wards. In order to complement this
system three other changes were made:
(1) The capacity of the Occupational Therapy Department was increased
by moving it to one of the out-buildings;
(2) A rehabilitation unit, consisting of a nurse, a physiotherapist and an
aide, was established to provide more intensive therapy where
required; and
(3) Medical services of an acute nature were provided through a small
clinic, rather than designating a ward to extended and acute care.
This system, while increasing the therapeutic capacity of the facility, increased
demands on the part-time medical staff and the local acute care hospital.
This conversion made greatly increased demands on an inadequate physical
plant. Some improvement was being made with additional furnishings and equipment.
Administrative and other services also went through extensive change, primarily
in response to reorganization. The demands of a society operation and collective
bargaining made the greatest demands on clerical staff. In the dietary area, the
move toward greater normalization required increased flexibility in the dining area.
Meal hours were extended to two hours, and residents came for dinner when they
wished during that period. This was much improved over the more regimented
system of ward designation.
In general, reorganization created some problems, however, most of the changes
brought about improvement in the level of resident care.
90
 WOODLANDS
Over the past decade Woodlands fulfilled a supportive role to the growing network of community services for the retarded. The main determinant for admission
to Woodlands in 1974 was that the individual's behaviour was so disturbing that he
could not be handled by the family, the school, the workshop, the group living
home, or other community resource providing for his needs. It was for this reason
that the residential population of Woodlands included retarded persons of all ages,
all degrees of retardation, who were often multihandicapped. As well as providing
diagnostic treatment, training, and educational services to prepare residents for
return to the community, there was a more intense involvement of staff during the
year in innovative and viable service programmes that would strengthen community
resources.
The objective to reduce the overcrowding of Woodlands to the approved
residential count of 983 was not obtained in 1974. The resident population remained
steady at approximately 1,100 for the past three years. Admissions for 1974 to
November 1 totalled 48, as compared to 70 for the same period last year. During
1974 the waiting-list varied between 14 and 26. For the last several months of
19*74 the waiting-list was static at 14, 12 of whom required an extended-care type
of accommodation. Up to November 1 the deaths for 1974 were 13. Included in
this number were several who were in community resources but still "on leave"
from Woodlands. The Shigella epidemic, which started in 1973, was not controlled
until July 1974, and involved nine out of the 34 wards at Woodlands. Additional
nursing, laboratory, and housekeeping staff had to be hired in order to control the
epidemic. The Public Health Officer made several recommendations in the hope
of preventing a similar occurrence.
The most constructive role for Woodlands was that of a Community Resource
Centre for the retarded rather than a Holding Centre. To meet this objective there
had to be a close working relationship with the community, an adequate quantity
and quality of staff, adequate physical facilities, and appropriate and specialized
equipment.
The number of staff on establishment increased very little in 1974, but assistance
in developing and operating innovative programmes for the residents was provided
by many summer students, an LIP Project and an OFY Project centred at Woodlands, and by many dedicated volunteers. The In-service Education Department
was increased to five staff during 1974, but in order to provide the variety of
training programmes required in such a complex operation as Woodlands, the
department utilized the competency of other Woodlands staff, as well as making
maximum use of the Staff Development Fund, which provided more group and
individual upgrading courses than in any previous year. Many staff enrolled in
community college, technical school, or university courses, to improve their knowledge and skills in their work. A restructuring of the Accident Prevention Committee
has placed an increased emphasis and awareness on the role of safety.
Labour difficulties and slowness in delivery of equipment delayed the completion of McBride Centre, a large building previously used as a nurses' residence,
intended for use for school, workshop, and activity areas; volunteer programmes;
and many offices. Overcrowded ward situations, with a lack of many basic facilities,
was a major concern to all staff at Woodlands. Many minor improvements
involving programming, safety, and comforts for residents were made by the public
works staff.
91
 F 92 MENTAL HEALTH BRANCH REPORT,  1974
Some of the specialized equipment purchased during the year included a
defibrillator and monitor to be used during general anaesthesia in the Dental Department. An ultra-violet visible spectrophotometer purchased for the laboratory
permitted closer monitoring of treatment for epilepsy, as well as the performance
of the majority of biochemical tests that are part of the evaluation of etiological
factors in mental retardation.
TRAINING, EDUCATIONAL, AND TREATMENT SERVICES
The reorganization of Woodlands into five programme units, which was
instituted in 1973, progressed slowly in 1974. Senior administrative and supervisory responsibility continued to be shared among the limited number of staff,
until the required establishment of programme co-ordinators and assistant directors
of nursing could be approved. The year saw a working-out of lines of responsibility
and the means of co-operation and co-ordination to best meet the needs of retarded
children and adults at Woodlands through programme planning and budgeting.
The Health Care Programme unit consisted of children and adults who were
physically handicapped, with the majority meeting the BCHIS criteria for extended-
care. This programme unit also provided the acute medical and nursing care for all
residents at Woodlands. In the pediatric extended-care ward extra programmes
were introduced to improve motor skills, eye and hand co-ordination, and speech
stimulation. There was a growing number of brighter but physically handicapped
Woodlands residents who were regularly travelling to Vancouver, New Westminster,
Surrey, and Coquitlam, to take part in educational training and recreational programmes.
Staff from Woodlands worked closely with the New Westminster and District
Society for the Retarded to develop a special community training home that would
meet the need of children resident in the Developmental Opportunity Programme
Unit. The proposed 20-bed units with a centralized learning centre located in a
nearby community, would hopefully help to rehabilitate the children at Woodlands.
The Intermediate Care Preparation Programme Unit consisted of six wards
and Alder Lodge, with a resident population of 218 children and adults. Within
this programme unit staff continued their preparation of Woodlands residents for
placement into regional boarding-homes. Many of the children at Alder Lodge in
Coquitlam attended community school facilities, and a few adults attended local
community sheltered workshops.
One of the most significant evidences of community involvement was the
Matsqui-Woodlands Project, which involved the Intermediate Care Motivation
Programme Unit. Fifteen residents spent three days a week at Matsqui Prison,
where they received training, stimulation, and education from a group of specially
selected prison inmates. There was a noticeable benefit to both Woodlands residents
and the Matsqui inmates from this project.
The Life Education Programme Unit consists of seven wards and the Halfway
House, with a resident population of 200 children and adults. The Academic School
at Woodlands catered primarily to this group of residents. The children were usually
very disturbed and the majority had been excluded from community schools because
of behaviour. The adults could not benefit from vocational services or earn their
own living. Programming for these residents was a combination of psychiatric
treatment; behaviour modification; and educational, vocational, and general learning
skills for life adjustment.
Medical care for residents of Woodlands continued to be of a high standard.
Liaison was maintained with the Department of Paediatrics and the Department of
Psychiatry at UBC. The Medical Director was appointed a member of the Faculty
  F 94 MENTAL HEALTH BRANCH REPORT, 1974
Residency Committee, UBC Faculty of Medicine. Special dietary preparations and
general supervision of treatment for children diagnosed in British Columbia as
Phenylketonuric and Homocystinuric was provided by the Provincial Government
through Woodlands and co-ordinated by the Medical Director.
There were a number of staff changes in the Social Service Department during
the year. Five students from the UBC School of Social Work received their field
placement at Woodlands.
A special project staff completed all the social assistance applications for
residents over 17 years, as well as the majority of the nonward admission documentation of children under 17 years. This was part of the procedure required when
Woodlands came under the Department of Human Resources.
During the year there was considerable development and restructuring in the
Psychology Department, and there was intense involvement by the psychology staff
in innovative and viable service programmes, both within and outside Woodlands.
One of the psychologists had primary responsibility for developing, co-ordinating,
and monitoring the Home Management Programme, which, after a year of preparatory work, commenced active service in August and became a most valuable
extension of the Out-patient Department services.
The Director of the Training and Education Department was on extended
educational leave in order to complete her doctoral thesis. The four department
heads under her direction, that is, Occupational Therapy, Recreational Therapy,
School, and Vocational Department, rotated administrative responsibility. The continuous school-year introduced in August 1973 generally proved to be beneficial for
the pupil. This was one way of making maximum use of classrooms and equipment.
Involvement with community school programmes was utilized whenever possible. It was anticipated that Jericho Hill School would assume responsibility for
at least 28 of the deaf pupils. Planning with Jericho Hill also involved many of
Woodlands' blind pupils, who could benefit from their specialized services. Early
in the year a film titled "Play-to-Learn," was released by the National Film Board.
This was based on one of the teachers and his novel approach to teaching moderately
and severely retarded children.
The Head of Recreational Therapy co-ordinated British Columbia's involvement in the Special Olympics held in Winnipeg, and accompanied the 18 residents
from Woodlands who took part. He also negotiated an exchange programme
between a group of residents from an institution in Ontario and a group from Woodlands. The camp programme at Gold Creek consisted of the usual day and overnight
busy schedules, but also saw the start of a semipermanent group of eight, who
showed remarkable progress under this scheme.
Through planning and organization of the Vocational Department, 34 adults
residing at Woodlands had the opportunity to be enrolled in community workshop.
Approximately 230 residents per month enrolled in programmes supervised by the
Vocational Services Department.
It was, again, hard to estimate the magnitude of contribution in time, funds,
and goodwill provided through volunteer services at Woodlands. The increase of
student volunteers, who frequently came as part of classroom assignment, would
have a secondary benefit in future recruitment of staff.
PERSONNEL
In June a personnel officer was appointed at Woodlands. The last six months
were especially busy with the introduction of Master Contracts and Component
Agreements which would cover all but 15 of Woodlands employees. The staff
establishment for Woodlands increased from 973 to 995 in 1974. With temporary
appointments, there were usually no less than 1,100 people on staff.
 WOODLANDS:
Residents enjoyed a five-day camp  at Otter
Lake through an LIP grant.
Clowns, refreshments, and excitement were all
part of the annual visit to the Pacific National
Exhibition.
Youngsters' birthday parties, with all the trimmings, were celebrated throughout the year.
 TRANQUILLE
Tranquille, a residential facility for the mentally retarded of all ages, provided
accommodation for 494 beds, plus 10 sick-bay beds. Administrative and operational responsibilities were transferred to the Department of Human Resources
in July 1974.
Living in Tranquille were long-stay patient-trainees who were mentally retarded without the need for active nursing and medical care, and those who were
extended-care patients in a 100-bed unit known as the Greaves Building. There
were also a large number of children, mostly housed in the Sage Building, with
some older ones living in Century House. From time to time there were numerous
short-stay patient-trainees. The emphasis in Tranquille was placed on preparing
the patient-trainees for gradual easement into community living.
Kamp Kiwanis continued to function, though it was difficult to know what
its exact status would be in the coming year due to difficulties of staffing, together
with the change in population of Tranquille. Fitzwater School, the Pleasant Services
Workshop, and other regional resources for the retarded could possibly utilize
it throughout the year.
Some patient-trainees were also sent to Camp Winfield, as had been done in
previous years.
Pine Park was developed for the use of the patient-trainees. It was possible
to use this on a day-to-day basis, and patient-trainees could return to Tranquille
within a few minutes after leaving the park.
TREATMENT SERVICES
During the year treatment services continued on a collegiate basis. The two
psychologists took part in the active management of cases and in providing consultative advice to nursing and other staff. Much of their philosophy was oriented toward
behaviour modification and neuro-psychology. A good deal of emphasis was also
placed by the medical, social work and psychology staff on group procedures, and
several groups were in progress, led by various staff members.
During the summer there was some interruption in the medical service due
to the resignation of one physician, a psychiatrist, who left to go to Australia. This
work was taken over by the Executive Director but with the arrival of new medical
staff the great pressure of work abated, and the former again acted in a consultant
capacity.
Much use was made of the extramural consulting medical staff, and many
patient-trainees were referred to these people for consultation and possible treatment.   Outside doctors co-operated magnificently with the physicians at Tranquille.
Nursing staff still seemed to be spread somewhat thinly, possibly due to the
fact that nurses substituted for a lot of other professionals when these were not
available. The position of Director of Training was still vacant at the year-end
and the department was being supervised by the senior psychologist on a pro tem.
basis.
Out-patient Department—An Out-patient Department was functioning, although there was no specific building to accommodate the various people needed
for an outpatient assessment.   Plans for such a building were still under way.
Group living homes and jamily extension services—A group living home was
established at Tranquille for younger patient-trainees, who lived in a family situa-
96
 ANQUILLE:
A staff member talks to a group of visitors
during the Open House programme held in
May.
■,- iv^s
-1£! l "IpJglB'
IW jH5 BP '"'W |
'\i
i!>w mm
Tranquille's beautifully landscaped grounds
were put to good use by the residents during
the summer.
Occupational therapy was an important part
of the treatment programme for patient-
trainees.
 F 98
MENTAL HEALTH BRANCH REPORT,  1974
tion with nursing staff. It proved to be a popular resource, especially for those about
to go into the community.
It was still hoped that a halfway house could be established in the community
itself, so that those who required further socialization in this manner could proceed
from the group living home at Tranquille to a facility in the community.
At the year-end a second residence at Tranquille was about to be used as a
family living home for small children, largely on an experimental basis.
A residence for families who come to stay at Tranquille as part of a therapeutic programme involving their children was also maintained.
New units—The five 20-bed units, which had been under construction during
the past two years, were completed. It was anticipated that these new buildings
could be placed in use early in 1975. They would have a great impact on the
training facilities of Tranquille.
At the end of 1974, Tranquille had admitted 26 regular patient-trainees and
15 temporary admissions, together with one transfer, making a total of 42 in all.
Boarding-home placements numbered 32.
ADMINISTRATIVE SERVICES
The positions of Business Administrator, Chief Housekeeper, and Director of
Training were vacant at the year-end.
During the year new contracts with the Nursing Association and the B.C.
Government Employees' Union came into being, and a tremendous amount of
administrative staff time was required to deal with these.
The Executive Director and many of the staff participated throughout the
year in numerous community activities with a view to furthering community interest in Tranquille. Radio and television broadcasts were made, and talks and
lectures given to various bodies, while there was a continuing association with the
Cariboo College Departments of Nursing, Psychology and Social Work. Staff
members attended the meetings of the local Society for the Mentally Retarded, and
many conferences were held with these people.
Throughout the year, meetings were held between the administration and the
two unions to discuss matters other than bargaining arising from contracts. These
were held on a monthly basis and proved a valuable vehicle for management and
the unions to evaluate each other's positions, and work together on a co-operative
basis.
The Executive Director met weekly with the senior management personnel,
and on a monthly basis with all departmental heads. The medical staff met once
a week and their discussions were mostly of a clinical character, though some
administrative matters were discussed.
 BRITISH COLUMBIA
YOUTH DEVELOPMENT CENTRE
THE MAPLES
The following reorganizational changes took place during 1974:
The Board of Management was dissolved June 30.
The Family and Children's Clinic was seconded to the Greater Vancouver
Mental Health Services July 1.
RESIDENTIAL TREATMENT UNIT
Staffing, programme, and intake changed during the year, in order to provide
improved treatment and service, focusing on severely disturbed adolescents under
psychiatric direction. A third new cottage was opened, staff were specifically
trained, and a more-structured programme was organized to handle this segment
of the population. Within two months of its opening, the third cottage admitted
10 adolescents. The remaining two cottages were left as more open settings, to
deal with children suffering with more socially oriented and acting-out difficulties.
Actual treatment focused on family, milieu, and intense interactional modalities.
This treatment was carried out by cottage personnel consisting of child care staff,
social workers, and the consulting psychiatrist. The main source of referrals came
from special placements, which was discontinued following the reorganization of
the Department of Human Resources. The Residential Unit was relatively successful with most referrals because of its policy of maintaining a balance between the
psychotic, withdrawn, and acting-out child. Because of the nature of their problems,
many of the acting-out adolescents required containment, which was not available
in the cottages. As an alternative a camping programme was used successfully for
three months, and provided services for six severely delinquent boys, aged 14 to 17.
Another facet of the programme was the Day Centre, located in the community. It continued to provide treatment to a specialized group of teenagers who
had severe problems, but not of such magnitude as to require residential treatment.
These adolescents came to the Day Centre on a daily basis, but remained living at
home. Families of these children received family therapy during the length of time
their child attended the Day Centre programme.
Teachers were also added to the staff and formed a Maples Educational Team,
which increased the availability of academic work for the children. To facilitate
individualized programmes for each adolescent, treatment goals meetings were individually organized. These meetings consisted of the adolescent's social worker,
teacher, programme co-ordinator, child care counsellor, and consulting psychiatrist.
An Alumni Programme was maintained in order to ensure continuity of treatment by providing follow-up care and services. This programme was open to any
discharged adolescent, and emphasized dealing with problems that the child had
encountered after discharge.
In-service training for staff provided new skills in the area of basic child care,
family dynamics, growth and development of children, handling of difficult children,
first aid, gym, camping, and swimming skills. All staff were required to complete a
two-year programme before receiving an in-service certificate from the Department
of Health.
99
 F 100 MENTAL HEALTH BRANCH REPORT,  1974
In July the Residential Unit reorganized. The reorganization called for the
unit to continue under the auspices of the Mental Health Branch; to be under
psychiatric direction; to be affiliated with the Department of Psychiatry, UBC, in
order to offer a training facility for professional and nonprofessional personnel; to
engage in the care and treatment of severely disturbed adolescents, age 12 to 17; to
offer diagnostic assessment and short-term therapy for these children; and to
affiliate and liaise with other existing community treatment services for adolescents.
Four psychiatrists, working both part- and full-time, were appointed, including a
psychiatric director. To facilitate implementation, and to provide additional services in teaching, training, and diagnostic areas, some administrative changes were
proposed which would allow for five distinct treatment units to be established.
These included an Out-patient Programme with an assessment and diagnostic
unit, which would be headed by a psychiatrist and staffed by a social worker and
two child care counsellors. The major responsibility of this department would be
to screen all referrals, to assess each applicant and his family from a psychiatric,
social, and interpersonal standpoint. Once assessed, the child would either be
admitted to The Maples Residential Treatment Programme, referred to the Day
Programme, continue as an out-patient at The Maples, or be re-referred to other
appropriate community agencies.
Also included was a Day Centre Programme which would be headed by a
psychiatrist and staffed by a social worker and four child care counsellors. Their
responsibility would be to organize and implement a programme designed to meet
the needs of those children who, although disturbed, did not require 24-hour
in-patient care. Another function of this department would be to receive those
children who have been in residence, but were not fully rehabilitated, and could
benefit from a transitional programme from cottage to community.
The Residential Cottage Programme would consist of three residential cottages,
comprising those adolescents who suffer from significant and severe psychopathol-
ogy, each cottage headed by a psychiatrist. The staff would consist of a social
worker, and a supervising child care counsellor with a staff of child care counsellors.
Treatment would include individual, group and family therapy concepts. Each
child's parents, whenever possible, would be actively involved in the treatment
process. To facilitate normalization and re-entry into community and family life,
the child, while in residence, would be engaged in age appropriate activities such
as school, recreational and occupational endeavours. An education co-ordinator
would be responsible for liaising with area school boards, in order to provide credit
and certification for school work done by the children while in residence.
PSYCHOLOGICAL EDUCATION CLINIC
The Psychological Education Clinic had a successful year of operation in 1974.
The programme was stabilized with two components, namely the school and the
out-patient department.
The school programme consisted of six classrooms, with about 50 students,
ranging in age from 5 to 13 years. It was a highly specialized programme for
children with emotional difficulties and concommitant learning disabilities. It was
designed for those children in the school system who were unable to cope. The
mornings were assigned primarily to academic pursuits and remediation of the
specific learning disabilities, while the afternoons were more for social interaction
and learning interpersonal coping skills. The families were seen on a regular basis
whenever possible, and continual contact was maintained between the psycho-
educational treatment staff and the psychotherapeutic staff.   The average length of
 IN-PATIENT SERVICES
F  101
stay of a child in the programme was about a year. Any follow-up would last as
long as necessary. Taking the children to a camp for a week at a time was another
important aspect of the programme as the experience proved to be invaluable to
them. There had been concern in the past about the amount of regression that
seemed to occur during the two summer months, so this year a summer programme
was held for 28 children, and found to be very therapeutic. The staff for this
programme was provided through the Government's student employment programme, and it was hoped that it could be continued again next year. Another
dimension to the school programme was the continual training of existing staff,
both within the programme and within the neighbouring school districts. An ongoing arrangement with the Burnaby School District provided two teachers, through
a grant from the Department of Special Education, who were seconded to the programme for one year at a time. They return to the Burnaby school system following
their year of placement, and use their knowledge both in their own class and to
assist other teachers. The training component will be increased in 1975, and
teachers will be accepted from around the Province, to be placed in the programme
for a limited period of time.
The other aspect of the total operation was the Out-patient Department, conducted by the five psychologists on staff. Frequently children were referred to the
clinic and it was found, after investigation, that it was not necessary to remove the
child from his school, provided the teacher was willing to accept assistance in designing a different approach for the child. In these instances staff went to the school
and helped the teacher to reorganize her understanding of the child, and to provide
a more relevant educational experience. In these instances staff offered family
and (or) marital intervention, so that the total treatment of the child, his family,
and the environment could be worked with at the same time. A travelling clinic
service was provided to some areas within the Province on request, to offer workshops, consultation, and assessments. Psychology students were placed in the programme as an adjunct to their clinical training.
The main thrust of the programme was to enter into preventive programmes,
and become involved as early as possible prior to the very serious problems developing. This was done by setting up special programmes in schools, consulting to
specialized operations such as the Granville Centre, and working with individual
referrals, in the hope that most of the problems could be dealt with in this manner.
However, it was found that there were a resistant few for whom the existing school
system was inappropriate, no matter how flexible and adaptive it became. For
these children it still seemed necessary to have a special centre where they leave their
own community and enter a programme such as that provided by the clinic. Another aspect to this approach the clinic would like to have developed in the future
would be a small residential facility which could handle about four to six children
for short stays only.
FAMILY AND CHILDREN'S CLINIC
On July 1, 1974, the staff, and vacant positions, of the Family and Children's
Clinic were "seconded" to the Greater Vancouver Metropolitan Board of Health and
were incorporated in the developing Greater Vancouver Mental Health Service.
The team which had been working in South Vancouver continued, as a nucleus of
a Community Care Team, to provide services to families and children, and planned
to operate out of newly constructed offices on Fraser Street. The Day Centre for
young children was relocated in a house on Blenheim Street. The staff provided
morning programmes for the children in two groups, and treatment for their families.
 F 102
MENTAL HEALTH BRANCH REPORT, 1974
Treatment for families of younger children not in the day programme, consultation
to community agencies, and educational programmes were also maintained.
Eight vacant positions were divided among the Community Care Teams, to
employ workers with a special interest in children and their families.
It was hoped that the dispersal and decentralization of the staff of the Family
and Children's Clinic would represent a new impetus to the further development of
relevant and effective services to the children of the Greater Vancouver area.
 CONSTRUCTION AND
MAINTENANCE REVIEW
A
mental
health
branch
  CONSTRUCTION AND
MAINTENANCE REVIEW
Riverview Hospital, Essondale
A new dental department was completed in March.
Renovations to the pre-release centre (formerly Nurses' Homes 6, 7, and 8)
were completed in September.
Phase I of the Riverside Building, involving urgent repairs, was completed in
October, and Phase II, involving over-all improvements, was in the programme stage at the year-end.
Major renovations to Wards C2 and C4 in the Crease Unit were out-to-tender.
Renovations to the canteen in Pennington Hall were expected to be completed
in December.
The Regional Laundry was still in the planning stage and a new site was chosen,
north of the North Lawn Building.
Fire-alarm installations, and general electrical work, were completed, and the
installation of fire escapes continued.
Valleyview Hospital, Essondale
Working drawings were under way for renovations to the 100 bed units, and
the Valleyview Building.
Skeenaview Lodge, Terrace
Replacement of this hospital was in the planning stage.
Dellview Hospital, Vernon
Working drawings were under way for general renovations, and the proposed
new 75-bed unit was at the programming stage.
Woodlands, New Westminster
A contract was awarded for improvements to the Dietary Department in the
Fraserview Building and work was expected to be completed by February
1975.
Major renovations to the Fraserview Building were in the planning stage.
Phase II, which involved improvements to the activity and academic building,
was expected to be completed by the year-end.
Working drawings were under way for improvements to the roads and parking facilities.
Tranquille, Tranquille
Construction of the five new 20-bed units was expected to be completed early
in 1975.
Work on the fire-alarm system and general electrical services was completed
during the year.
105
  PATIENT MOVEMENT
A
mental
health
branch
  PATIENT
MOVEMENT
TRENDS, SEPTEMBER 1974
PATIENT
MOVEMENT
TRENDS
Yearly Sum of Entriesi From—
Resident or Case Load
Facility
Oct. 1971
to
Sept. 1972
Oct. 1972
to
Sept. 1973
Oct. 1973
to
Sept. 1974
End of
Sept. 1972
End of
Sept. 1973
End of
Sept. 1974
10,589
3,349
3,059
2,487
39
11,976
2,650
2,480
1,911
37
14,542
2,823
2,682
2,024
43
110
505
413
72
20
141
92
49
11,719
9,610
253
807
412
243
117
291
107
350
464
235
398
327
419
222
261
482
319
259
188
234
242
128
69
278
401
194
759
535
31510
285
16
492
95
20
152
22
48
274
279
178
185
215
149
12,025
4,785
3,207
2,100
26
14,017
4,583
3,033
1,976
23
1,034
656
T80
198
1,550
1,099
451
9,434
8,175
15
567
465
126
144
315
74
343
399
17,102
4,152
2,657
Residential programmes. 	
Riverview   	
1,643
17
Burnaby In-patient unit 	
10
533
442
76
15
290
214
76
7,240
6,363
532
421
86
25
170
121
49
9,326
8,120
15
524
527
331
157
264
93
330
328
1,081
655
214
212
1,578
1,097
481
7,240
6,097
987
645
174
Skeenaview...	
168
1,495
1,083
412
Woodlands 	
Out-patient programmes	
12,950
11,108
Abbotsford (Sept. 1973)2	
231
537
387
301
382
189
142
274
330
576
384
172
332
199
119
227
350
776
333
281
Cranbrook	
Duncan      	
Fort St. John...	
Kamloops-	
Kelowna	
Langley (Jan. 1974)2...	
63
523
199
392
634
210
371
180
152
168
223
476
224
267
265
201
417
263
320
121
72
304
371
160
246
136
171
687
296
471
263
241
247
210
294
133
66
458
768
447
672
258
260
Port Alberni (Nov. 1972) 2           	
286
Port Coquitlam	
Powell River (Jan. 1972)2	
283
120
138
178
94
129
230
366
257
Prince Rupert (May 1973)2 	
149
301
444
512
Sechelt (Oct. 1973)2..	
Squamish (Jan. 1974)2    	
Surrey  	
74
58
166
353
207
486
507
388
385
226
628
613
227
147
198
601
520
411
124
218
733
605
535
202
Trail	
225
Vernon	
Victoria 	
VISC3 (August, 1974)2    .
Whalley   	
Williams Lake (Oct. 1972)2	
1,097
374
287
166
357
24
557
114
35
278
52
52
118
116
258
12
773
114
11
229
26
7
99
398
11
406
68
28
276
57
42
821
54
15
221
31
1
709
54
15
B.C. Youth Development Centre	
104
14
3
247
Mount Pleasant Community Care Team*5	
150
142
145
Kitsilano Community Care Team9 	
West Side Community Care Team9     	
156
	
	
103
i Includes permanent transfers, admissions from community, and returns from leave and escapes.
2 Month Centre/Department commenced reporting.
3 VISC—Integrated Services for Child and Family Development.
4 Nine patients active in the Riverview Hospital Centre Lawn out-patient case load are not included.
f> March 1973.        0 October 1973.        t November 1973.        8 December 1973.        8 February 1974.
io Two hundred and sixty-five cases transferred from Victoria Mental Health Centre.
109
 DATA,  1974
PATIENT
MOVEMENT
DATA
Entries
Exits
Facility
Total
c
.2
ll
.3-u
Q<!
>
CS
ii
did.
u u
go
2 <8
Is
Total
U
M
ra
Xi
u
•ft
s
u
S «j
u J~
d u
E c
62
Mr*
Vi
(9
U
0
2,918
2,784
2,034
42
165
543
435
82
26
134
82
52
14,790
2,468
2,359
1,724
39
165
431
349
70
12
109
61
48
383
360
310
3
47
22
12
13
23
19
4
67
65
65
64
1
2
2
3,308
3,101
2,403
51
125
522
385
84
53
207
110
97
10,456
1,679
1,618
1,366
47
125
80
69
2
9
61
33
28
1,120
1,005
872
4
129
101
24
115
62
53
71
70
69
1
1
1
1
Residential programmes	
438
408
Riverview	
Youth Development Centre.
96
Geriatric facilities	
312
215
57
Skeenaview	
Facilities for the mentally retarded
40
30
14
16
Out-patient programmes	
12,322
10,036
228
968
413
247
126
289
190
342
452
294
367
334
441
237
251
472
324
240
186
233
233
146
86
300
421
186
785
531
394
300
20
499
97
23
134
21
54
286
306
199
212
269
186
8,777
7,153
46
759
539
92
176
96
91
326
265
31
344
148
119
256
277
445
289
188
68
183
206
68
14
132
314
169
453
827
35
178
19
580
128
11
330
24
45
124
157
43
50
73
59
Abbotsford (Sept. 1973)2	
Burnaby    ~	
Chilliwack	
Courtenay	
Fort St. John	
Kelowna	
Langley (Jan. 1974)2	
Penticton (Oct. 1971)2	
Port Alberni (Nov. 1972)2
Powell River (Jan. 1972)2....
Sechelt (Oct. 1973)2	
Squamish (Jan. 1974)2  .
Trail - 	
Victoria 	
VISO (August 1974)2	
Whalley    	
Williams Lake (Oct. 1972)2
Riverview Out-patient
Departments^	
Woodlands Out-patient
Tranquille Out-patient
B.C. Youth Development Centre.
West End Community Care Team^..
Mount Pleasant Community Care
Strathcona Community Care Team*5
Richmond Community Care Team?.
Kitsilano Community Care Teams...
West Side Community Care Teams..
1 Table compiled from actual data through September 1974, and projected for the remainder of year. (Note—
In case of centres/departments opened in 1974: Table compiled on basis of available data for 1974 and projected
for remainder of year.)
2 Month Centre/Department commenced reporting.
3 About 205 patients active in the Riverview Centre Lawn Out-patient area case load are not included.
i March 1973.    5 October 1973.    6 November 1973.    7 December 1973.    8 February 1974.
0 V1SC—Integrated Services for Child and Family Development.
110
 FINANCIAL STATEMENTS
1
A
mental
health
branch
  FINANCIAL
STATEMENTS
FINANCIAL TABLES
Table A—Showing the Average Number of Patients in Residence Each Year, the
Total Amounts Spent for Maintenance, and the Gross Yearly and Daily per
Capita Cost, 1964/65 to 1973/74.
Institution
Average
Number in
Residence
Maintenance
Expenditure
Yearly
per Capita
Cost
Daily
per Capita
Cost
1964/65
Crease Clinic	
Provincial Mental Hospital, Essondale
The Woodlands School, New Westminster
227.59
2,740.84
1,31420
512.79
753.91
234.70
290.44
$
1,573,366.00
8,054,536.00
4,501,364.00
1,509,947.00
2,351,885.00
553,985.00
510,679.00
$
6,936.16
2,938.71
3,425.17
2,944.57
3,119.58
2,360.40
1,758.29
$
18.94
8.05
9.38
8.07
Valleyview Hospital, Essondale r
8.55
6.47
4.82
Totals for the year	
6,074.47        |         19,055,762.00
3,137.02        |          8.59
1965/66
2,797.80        |        10,230,637.00
1,291.27                  4,981,190.00
562.37 1           1,876,093.00
763.44                   2,510,228.00
227.35                       595,532.00
295.38 551,447.00
1
3,656.67        i        10.02
The Woodlands School, New Westminster
3,857.59                10.57
3,336.05                  9.14
Valleyview Hospital, Essondale	
3,288.05                  9.01
2,619.45                  7.18
1,866.91                  5.11
5,937.61        |        20,745,127.00
3,493.85        |          9.57
1966/67
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
The Woodlands School, New Westminster
The Tranquille School..	
11.27
10.31
9.61
7.95
5.68
5,934.38                  22,699,611.00
3,825.10                10.48
1967/68
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
12.18
The Woodlands School, New Westminster
12.78
11.64
Valleyview Hospital, Essondale	
10.66
9.12
2.296.17
6.27
5,925.25                  25,276,134.00
4,265.83        |        11.66
1968/69
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
The Woodlands School, New Westminster
13.58
13.00
Valleyview Hospital, Essondale	
11.62
9.82
7.18
5,816.80        |        27,203,688.00
4,676.74        |        12.81
1969/70
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
The Woodlands School, New Westminster
The Tranquille School..	
16.41
16.18
14.25
11.21
8.65
5,567.14
31,986,308.00
5.745.55         1         15.74
113
 F 114
MENTAL HEALTH BRANCH REPORT,  1974
Table A—Showing Average Number of Patients in Residence Each Year, the Total
Amounts Spent for Maintenance, and the Gross Yearly and Daily per Capita
Cost, 1964/65 to 1973/74—Continued.
Institution
Average
Number in
Residence
Maintenance
Expenditure
Yearly
per Capita
Cost
Daily
per Capita
Cost
1970/71
Riverview Hospital, Essondale.  _	
The Woodlands School, New Westminster
The Tranquille School.	
Valleyview Hospital, Essondale	
Dellview Hospital, Vernon	
Skeenaview Hospital, Terrace	
Totals for the year	
1971/72
Riverview Hospital, Essondale	
The Woodlands School, New Westminster
The Tranquille School _	
Valleyview Hospital, Essondale....	
Dellview Hospital, Vernon	
Skeenaview Hospital, Terrace	
Totals for the year	
1972/73
Riverview Hospital, Essondale	
The Woodlands School, New Westminster
The Tranquille School	
Valleyview Hospital, Essondale	
Dellview Hospital, Vernon      	
Skeenaview Hospital, Terrace	
Totals for the year...	
1973/74
Riverview Hospital, Essondale	
The Woodlands School, New Westminster
The Tranquille School    	
Valleyview Hospital, Essondale	
Dellview Hospital, Vernon 	
Skeenaview Lodge, Terrace _ -	
Totals for the year 	
2,510.44
1,279.60
579.15
685.33
225.60
254.28
5,534.40
2,363.70
1,216.51
548.76
669.84
227.41
233.91
5,260.13
2,131.45
1,112.34
485.53
660.32
210.44
212.16
1,910.58
1,099.25
453.83
630.25
183.25
197.08
4,474.24
16,186,488.00
8,168,889.00
3,787,785.00
3,824,163.00
974,623.00
865,471.00
33,807,419.00
17,393,443.00
8,745,677.00
4,149,495.00
4,203,564.00
1,055,612.00
941,455.00
36,489,245.00
18,757,094.00
9,574,840.00
4,460,869.00
4,512,183.00
1,175,207.00
998,938.00
4,812.24        |        39,479,131.00
21,243,294.00
11,044,517.00
5,492,463.00
5,478,345.00
1,482,160.00
1,241,613.00
45,982,392.00
$
6,447.67
6,383.94
6,540.25
5,580.03
4,320.04
3,403.61
6,108.60
7,358.55
7,189.15
7,561.58
6,275.47
4,641.88
4,024.85
6,936.95
8,800.15
8,607.84
9,187.63
6,833.33
5,584.52
4,708.41
11,118.76
10,047.32
12,102.46
8,692.33
8,088.18
6,300.04
10,277.14
$
17.66
17.49
17.92
15.29
11.84
9.32
16.74
20.11
19.64
20.66
17.15
12.68
11.00
18.95
24.11
23.58
25.17
18.72
15.30
12.89
8,203.89        |        22.47
30.46
27.52
33.15
23.81
22.15
17.26
28.15
 FINANCIAL STATEMENTS
F 115
Table B—Summary Statements Showing the Gross and Net per Capita Cost of
Patients in All Mental Health Institutions for the Year Ended March 31, 1974
Gross operating costs— $
Riverview Hospital, Essondale  21,243,294.00
The Woodlands School, New Westminster  11,044,517.00
The Tranquille School  5,492,463.00
Valleyview Hospital, Essondale  5,478,345.00
Dellview Hospital, Vernon  1,482,160.00
Skeenaview Lodge, Terrace  1,241,613.00
Less collections remitted to Treasury
Daily average population	
Gross per capita cost, one year
Gross per capita cost, one day .
Net per capita cost, one year .___
Net per capita cost, one day ____
45,982,392.00
2,244,988.00
43,737,404.00
4,474.24
10,277.14
28.15
9,775.38
26.78
 F 116
MENTAL HEALTH BRANCH REPORT,  1974
Table C-
-Expense Statement of Riverview Hospital for the Fiscal Year Ended
March 31,1974 (Including 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,
1973
Less on Hand
March 31,
1974
Cost of
Operation
$
16,951,007
52,158
33,360
19,169
729,050
1,423,645
30,860
37,654
3,124
37,346
32,586
653,777
19,061
18,570
388
6,782
81,838
670
$
$'
$
$
16,951,007
52,158
Travelling expense 	
Office furniture and equipment	
33,360
19,169
147,286
281,049
595,287
1,423,645
30,860
27,654
Patients' library: .'.	
Maintenance and operation of equipment
Transportation.  	
3,124
37,346
457,749
32,586
127,500
323,528
19,061
18,570
388
6,782
81,838
670
Buildings and grounds	
1,533,468
210,000
1,743,468
Less—
Increase   in   inventory,   institutional
20,131,045
114,827
4,676
41,784
5,920
1,533,468
484,786             738,798         21,410,501
Inventory adjustment, $82,016)
1                         1
                 144.827
4,676
41,784
	
5,920
19,963,838
1,533,468
484,786
738,798
21,243,294
Yearly pi
r capita cost-
     8,8
$
72.18
46.58
es	
    2,2
11,118.76
 FINANCIAL STATEMENTS
F 117
Table D—Expense Statement of The Woodlands School for the Fiscal Year
Ended March 31,1974
Salaries, Supplies, and Operating
Expenses
Vouchered
Expenditures
Services and
Supplies
From Public
Works
Department
Inventory Adjustment
Actual
Plus on Hand
March 31,
1973
Less on Hand
March 31,
1974
Cost of
Operations
S
9,256,225
13,213
11,293
4,785
240,045
648,800
66,195
14,693
399
8,919
3,114
283,945
7,183
6,947
3,813
8,248
33,251
$
$
$
$
9,256,225
13,213
11,293
Office furniture and equipment	
4,785
38,210
59,326
218,929
648,800
66,195
14,693
Patients' library	
399
8,919
3,114
283,945
7,183
6,947
3,813
8,248
33,251
Buildings and grounds.	
526,377
526,377
Less—
Increase   in   inventory,   institutional
10,611,068
61,514
9,920
378
526,377
38,210
(Inventory adju
59,326
stment, $18,35'
11,116,329
)
61,514
9,920
	
378
	
10,539,256
526,377
38,210
59,326
11,044,517
Yearly per capita cost— $
Salaries      8,420.49
Expenses     1,626.83
10,047.32
 F 118
MENTAL HEALTH BRANCH REPORT,  1974
Table E—Expense Statement of The Tranquille School for the Fiscal Year
Ended March 31,1974
Salaries, Supplies, and Operating
Expenses
Vouchered
Expenditures
Services and
Supplies
From Public
Works
Department
Inventory Adjustment
Actual
Plus on Hand
March 31,
1973
Less on Hand
March 31,
1974
Cost of
Operations
$
4,000,605
11,638
9,938
2,698
81,819
390,080
16,953
11,600
148
6,669
384
177,358
12,150
2,172
1,886
6,122
15,783
3,100
$
$
$
$
4,000,605
11,638
Travelling expense	
9,938
2,698
81,819
12,268
13,268
389,080
16,953
11,600
Patients' library	
Maintenance and operation of equipment....
148
6,669
384
General supplies	
Occupational and recreational therapy—	
62,741
63,741
176,358
15,150
2,172
1,886
6,122
15,783
—
3,100
784,368
784,368
Less—
4,751,103
12,465
28,543
784,368
75,009
77,009
5,533,471
12,465
28,543
4,710,095
784,368
75,009
77,009
5,492,463
$
...    8,815.20
Expenses      3,287.26
Yearly per capita cost—
Salaries 	
12,102.46
 FINANCIAL STATEMENTS
F 119
Table F—Expense Statement of the British Columbia Youth Development Centre
for the Fiscal Year Ended March 31,1974
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.
Mental
Health
Centre,
Burnaby
Forensic
Clinic
Family
and
Children's
Clinic
Psychological
Education
Clinic
Residential
Unit
Total
$
74,751
$
$
61,021
$
29,747
148,740
6,865
43,478
$
147,824
513,495
23,341
93,362
$
313,343
56,139
4,882
278,410
3,814
38,138
996,784
Temporary assistance	
1,526
40,428
174,978
76,277
28,699
61,021
381,383
19,132
228,830
28,699
778,022
114,794
1,525,533
191,324
	
Totals...
104 976     1     61021
400,515
257,529
892 816     1     1.716.857
Table G—Expense Statement of the Valleyview Hospital, Essondale,
for the Fiscal Year Ended March 31,1974
Salaries, Supplies, Buildings, Grounds, and
Operating Expenses
Net Vouchered
Expenditure
Services and
Supplies From
Public Works
Department
Actual
Cost of
Operations
Salaries  	
Travelling expense	
Office expense _	
Office furniture and equipment.
Medical care	
Dietary 	
Laundry..
Gratuities to patients	
Patients'library	
Maintenance and operation of equipment.
Transportation  ...	
General supplies _	
Occupational and recreational therapy	
Audio-Visual _	
Patients' education..	
General expense	
Burials  	
Buildings, grounds, etc	
Less—
Increase in inventory for Institutional Stores..
Board  	
Adjusted expenditure	
4,551,371
6,454
13,920
3,251
149,845
403,841
35,266
2,017
642
2,551
28
173,010
2,023
1,214
26
4,085
80
5,349,624
28,707
21,200
178,628
178,628
4,551,371
6,454
13,920
3,251
149,845
403,841
35,266
2,017
642
2,551
28
173,010
2,023
1,214
26
4,085
80
5,299,717        |        178,628
5,528,252
28,707
21,200
5,4787345"
Yearly per capita cost— $
Salaries   7,221.53
Expenses   1,470.80
8,692.33
 F 120
MENTAL HEALTH BRANCH REPORT, 1974
Table H—Expense Statement of the Dellview Hospital, Vernon,
for the Fiscal Year Ended March 31,1974
Salaries, Supplies, and
Operating Expenses
Vouchered
Expenditure
Services and
Supplies From
Public Works
Department
Inventory Adjustment
Actual
Plus on
Hand
March 31,
1973
Less on
Hand
March 31,
1974
Cost of
Operations
$
1,004,514
2,245
4,643
26,287
452
116,632
72,565
65
280
230
55,186
2,356
195
2,970
460
$
$
5,728
4,437
12,685
$
6,728
5,437
13,685
$
1,004,514
2,245
4,643
25,287
452
Dietary  —~
115,632
72,565
65
Maintenance and operation of equipment	
280
230
-
54,186
2,356
195
2,970
460
203,419
203,419
Less—
1,289,080
1,586
5,753
203,419
	
22,850
25,850
1,489,499
1,586
Board _	
5,753
1,281,741
203,419
22,850
25,850
1,482,160
Yearly per capita cost—
Salaries ~ 	
Expenses   _	
$
5,481.66
2,606.52
8,088.18
 FINANCIAL STATEMENTS
F ,121
Table I—Expense Statement of Skeenaview Lodge, Terrace,
for the Fiscal Year Ended March 31,1974
Salaries, Supplies, and
Operating Expenses
Vouchered
Expenditure
Services and
Supplies
From
Public Works
Department
Inventory Adjustment
Plus on
Hand
March 31,
1973
Less on
Hand
March 31,
1974 '••
Cost of
Operations
$
851,250
1,609
2,258
1,328
22,103
126,193
5,305
64
306
728
2,252
53,723
5,627
1,431
4,681
2,350
1,603
$
$
''$'
$
851,250
1,609
2,258
	
1,328
22,103
14,714
15,714
125,193
5,305
64
306
Maintenance and operation of equipment
728
....
15,154
2,252
	
14,154
52,723
5,627
-
1,431
4,681
General expense.	
2,350
169,777
1,603
169,777
Less—■
1,082,811
3,216
5,759
169,777
28,868
30,868
1,250,588
3,216
5,759
Adjusted expenditure	
1,073,836
169,777
28,868
30,868
1,241,613
Yearly per capita cost— $
Salaries   4,319.31
Expenses   - 1,980.73
6,300.04
.'
.
 122 MENTAL HEALTH BRANCH REPORT, 1974
Table J—Expense Statement of the Community Services for
Fiscal Year Ended March 31,1974
Mental Health Centres—
Burnaby. Nelson. Terrace.
Chilliwack. New Westminster. Trail.
Courtenay. Penticton. Vernon.
Cranbrook. Port Alberni. Victoria.
Duncan. Port Coquitlam. Whalley.
Fort St. John. Powell River. Williams Lake.
Kamloops. Prince George.                 Boarding-home care—
Kelowna. Prince Rupert. Abbotsford.
Maple Ridge. Saanich. Langley.
Nanaimo. Surrey. Sechelt-Squamish.
$
Training programmes  6,364
Assistance for retarded        71,507
Operation of Glendale Hospital          66,885
Development of new patient-care programmes  1,199,424
Mental health care      282,735
Salaries  :  2,237,515
Office expense  27,497
Travelling expense  76,854
Office furniture and equipment  39,094
Medical care  269,860
Dietary  13,746
Laundry  236
Maintenance and operation of equipment  17,455
Transportation    1,568
General supplies   18,002
Occupational and recreational therapy  3,791
Patient education    1,114
Motor-vehicles and accessories  23,793
General expense  13,834
4,371,274
Less salary adjustments      160,056
4,211,218
 FINANCIAL STATEMENTS F 123
Table K—Expense Statement of General Administration for
the Fiscal Year Ended March 31,1974
$
Salaries   668,225
Office expense  16,531
Travelling expense  40,084
Office furniture and equipment  4,517
Grant to Trustees of Patients' Comfort Fund  12,000
Printing and publication  9,106
Grant to UBC research  30,000
Audio-Visual   21
General expense  2,197
Administration of Psychiatric Nurses Act  1,824
Stores equipment  3,081
787,586
Less salary adjustments     69,162
718,424
Table L—Expense Statement of the Department of Nursing Education for
the Fiscal Year Ended March 31,1974
$
Salaries   338,617
Office expense  3,135
Travelling expense  85
Medical care  377
Dietary  2,731
Laundry  382
General supplies  5,687
General expense ..  86
Affiliate and postgraduate training  5,288
Bursaries for psychiatric nurses  229,146
585,534
Less salary adjustments     37,896
	
547,638
 F 124 MENTAL HEALTH BRANCH REPORT,  1974
Table M—Institutional Stores
$
Net undistributed stores as per Public Accounts      380,010
Adjustment re farm profit  9,029
389,039
Inventory adjustment, plus on hand March 31, 1973      657,059
1,046,098
Less on hand March 31, 1974      841,050
... , , 205,048
Disposition of increase in inventory by vouchered expenditures:
Per Cent
Riverview Hospital    56        114,827
The Woodlands School  30 61,514
Valleyview Hospital  14 28,707
205,048
Reconciliation With Public Accounts, 1973/74
Table K—General Administration
$ $
Salaries         668,225
Expenses         119,361
787,586
Deduct salary adjustments  69,162
As per Public Accounts        718,424
Table L—Department of Nursing Education
Salaries         338,617
Expenses         246,917
585,534
Deduct salary adjustments  37,896
As per Public Accounts        547,638
 FINANCIAL STATEMENTS F 125
Table J—Community Services
$ $ $
Salaries  2,237,515
Expenses  2,133,759
4,371,274
Deduct salary adjustments        160,056
4,211,218  ■
Add inventory adjustment  808
As per Public Accounts     4,212,026
Table C—Riverview Hospital and Out-patient Services
Salaries..._.... =_-.  16,951,007
Expenses     4,292,287
Vouchered expenditure  21,243,294
Deduct—
Buildings and grounds   1,533,468
Salary adjustments  1,425,072
 2,958,540
18,284,754
Add—
Sundry adjustments, board, etc.     167,207
Inventory adjustment      171,996
        339,203
As per Public Accounts  18,623,957
Table G—Valley view Hospital
Salaries „    4,551,371
Expenses        926,974
Vouchered expenditure     5,478,345
Deduct—
Buildings and grounds      178,628
Salary adjustments      393,648
 572,276
4,906,069
Add—Sundry adjustments, board, etc.  49,906
As per Public Accounts     4,955,975
 F 126 MENTAL HEALTH BRANCH REPORT, 1974
Table H—Dellview Hospital
$ $
Salaries    1,004,514
Expenses    477,646
Vouchered expenditure       1,482,160
Deduct—
Buildings and grounds      203,419
Salary adjustment         87,600
       291,019
Add—
Sundry adjustments, board, etc. 7,339
Increase in inventory  3,000
1,191,141
10,339
As per Public Accounts     1,201,480
Table I—Skeenaview Lodge
Salaries        851,250
Expenses          390,363
Vouchered expenditure     1,241,613
Deduct—
Buildings and grounds      169,777
Salary adjustments        65,304
       235,081
Add—
Sunday adjustments, board, etc. 8,975
Inventory adjustment  2,000
1,006,532
10,975
As per Public Accounts     1,017,507
 FINANCIAL STATEMENTS F  127
Table D—The Woodlands School
$ $ $•
Salaries     9,256,225
Expenses     1,788,292
Vouchered expenditure  11,044,517
Deduct—
Buildings and grounds      526,377
Salary adjustments      791,472
     1,317,849
9,726,668
Add—
Sundry adjustments, board, etc.       71,812
Inventory adjustment  2,762
  74,574
As per Public Accounts     9,801,242
Table E—The Tranquille School
Salaries     4,000,605
Expenses     1,491,858
Vouchered expenditure     5,492,463
Deduct—
Buildings and grounds      784,368
Salary adjustments      365,292
     1,149,660
4,342,803
Add—
Sundry adjustments, board, etc.       41,008
Inventory adjustment  2,000
  43,008
As per Public Accounts     4,385,811
 F 128 MENTAL HEALTH BRANCH REPORT,  1974
Table F—B.C. Youth Development Centre
Salaries     1,477,623
Expenses ,        174,978
Vouchered expenditure     1,652,601
Deduct—Salary adjustments        127,068
As per Public Accounts     1,525,533
Table M—Net Undistributed Stores        380,010
Special Warrants 6 to 77—Treatment Resources Act        297,514
Special Warrant 19—Summer Employment Programme—
Temporary salaries        355,285
Travelling expense  3,475
        358,760
Total expenditure as per Public Accounts  48,025,878
Printed by K. M. MacDonald, Printer to the Queen's Most Excellent Majesty
in right of the Province of British Columbia.
1975

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