"61bdd976-8792-46ef-bbde-fce75d080a8c"@en . "CONTENTdm"@en . "MENTAL HEALTH BRANCH REPORT, 1967/68"@en . "http://resolve.library.ubc.ca/cgi-bin/catsearch?bid=1198198"@en . "Sessional Papers of the Province of British Columbia"@en . "British Columbia. Legislative Assembly"@en . "2018-04-12"@en . "[1969]"@en . "https://open.library.ubc.ca/collections/bcsessional/items/1.0365685/source.json"@en . "application/pdf"@en . " DEPARTMENT OF HEALTH SERVICES\nAND HOSPITAL INSURANCE\nMental Health Branch\nPROVINCE OF BRITISH COLUMBIA\nANNUAL REPORT\n1968\nPrinted by A. Sutton, Printer to the Queen's Most Excellent Majesty\nin right of the Province of British Columbia.\n1969\n To Colonel the Honourable John R. Nicholson, P.C, O.B.E., Q.C., LL.D.,\nLieutenant-Governor of the Province of British Columbia.\nMay it please Your Honour:\nThe undersigned respectfully submits the Annual Report of the Mental Health\nBranch, Department of Health Services and Hospital Insurance, for the year 1968.\nR. R. LOFFMARK,\nMinister of Health Services and Hospital Insurance.\nOffice of the Minister of Health Services and Hospital Insurance,\nVictoria, British Columbia, January 23,1969.\n Department of Health Services and Hospital Insurance,\nMental Health Branch,\nVancouver, British Columbia, January 23, 1969.\nThe Honourable R. R. Loffmark,\nMinister of Health Services and Hospital Insurance,\nVictoria, B.C.\nSir,\u00E2\u0080\u0094I have the honour to submit the Annual Report of the Mental Health\nBranch for 1968.\nF. G. TUCKER, M.B., B.S., C.R.C.P., M.Sc.\nDeputy Minister, Mental Health Branch.\n '\n\u00E2\u0096\u00A0$.\n/\u00C2\u00AB..\n'.if\nThe Honourable Ralph R. Loffmark, Minister of Health Services and Hospital Insurance.\n F. G. Tucker, M.B., B.S., C.R.C.P., M.Sc, Deputy Minister of Mental Health.\n TABLE OF CONTENTS\nPART 1.\u00E2\u0080\u0094GENERAL ADMINISTRATION\nReport\u00E2\u0080\u0094Deputy Minister of Mental Health\t\nReport\u00E2\u0080\u0094Comptroller of Expenditure\t\nPage\n9\n14\nReport\u00E2\u0080\u0094Departmental Personnel Officer 3 5\nReport\u00E2\u0080\u0094Co-ordinator of Mental Retardation Programmes 41\nReport\u00E2\u0080\u0094Social Service Consultant 42\nReport\u00E2\u0080\u0094Nursing Consultant 46\nReport\u00E2\u0080\u0094Statistician and Medical Records Consultant 49\nReport\u00E2\u0080\u0094Consultant in Sociology 52\nReport\u00E2\u0080\u0094Information Services 53\nPART II.\u00E2\u0080\u0094COMMUNITY MENTAL HEALTH SERVICES\nMental Health Centre, Burnaby 55\nSouth Vancouver Island Mental Health Centre, Victoria 61\nCentral Vancouver Island Mental Health Centre, Nanaimo 63\nSouth Okanagan Mental Health Centre, Kelowna\nWest Kootenay Mental Health Centre, Trail\t\nUpper Fraser Valley Mental Health Centre, Chilliwack.\nNorth Okanagan Mental Health Centre, Vernon\t\nNorthern Interior Mental Health Centre, Prince George.\n66\n67\n70\n73\n75\nStatistical Tables, Mental Health Centres 77\nPART III.\u00E2\u0080\u0094IN-PATIENT SERVICES\nReport\u00E2\u0080\u0094Director of Mental Health Services 81\nReport\u00E2\u0080\u0094Director of Nursing Education 88\nReport\u00E2\u0080\u0094Superintendent, Riverview Hospital 8 9\nReport\u00E2\u0080\u0094Superintendent, The Woodlands School 127\nReport\u00E2\u0080\u0094Superintendent, The Tranquille School 141\nReport\u00E2\u0080\u0094Superintendent, Geriatric Division 147\nReport\u00E2\u0080\u0094Executive Director, British Columbia Youth Development Centre,\nThe Maples, Burnaby 166\nCover photo by Ken Thompson, reproduced\nfrom mental health booklet \" When Things\nGo Wrong,\" published by the Canadian Mental Health Association.\n H\nPi\n<\nX\nu\nz\no\nH\n<\n<\no\no\nM\nU\n<\nPi\nm\n<\n<\nH\n2\nS2\nSE\nBE\n\"- _ _:_: E\t\nI _\n\u00C2\u00A3f>e>\ncj\"\u00C2\u00BB -_r.-_So =\ns\n11-3,5\n\u00E2\u0080\u0094 \u00C2\u00AB.2o.2\nSSI\nE_\no a\nOJ\n__:\nH\n Report of the Mental Health Branch\nApril 1, 1967, to December 31, 1968\nPART I.\u00E2\u0080\u0094GENERAL ADMINISTRATION\nREPORT OF THE DEPUTY MINISTER OF MENTAL HEALTH\nF. G. Tucker, M.B., B.S., C.R.C.P., M.Sc.\nI hereby submit for your consideration a report on the activities of the Mental\nHealth Branch covering a period of 21 months from April 1, 1967, to December 31,\n1968. Future Annual Reports will be based on the calendar year, thereby permitting an up-to-date presentation of the operation of this Branch to the Legislature.\nIt is only right that this Report should commence by paying tribute to Dr. A. E.\nDavidson, who retired on March 31, 1967, after 38 years of service dedicated to the\nmentally ill of this Province. For eight years, as Director and Deputy Minister, he\nsteered the Mental Health Branch through a period of expansion and through the\nmany problems which are inevitable in periods of transition. Among his many\naccomplishments he will be remembered as the author of the Mental Health Act,\n1964, and for the number of major projects which he initiated, including the Eric\nMartin Institute, the British Columbia Youth Development Centre in Burnaby, and\nThe Glendale Hospital, all of which are now drawing to completion or are well\nunder way. In his new post as Mental Health Consultant to the Federal Government, Dr. Davidson will bring his long experience to bear upon the broad aspects\nof mental health at the National level.\nIn April, 1967, the Honourable Wesley D. Black, Minister of Health Services\nand Hospital Insurance, appointed a committee to review the organization and\nfuture role of the Mental Health Services Branch. As a consequence of these deliberations, the Minister made the following statement, which perhaps best summarizes\nthe principles upon which the operation of the Mental Health Branch will be based\nin the foreseeable future and the reorganization necessary to achieve these aims:\u00E2\u0080\u0094\n\" The Mental Health Branch is undergoing a major reorganization to\nmeet the changing patterns of care for the mentally ill and retarded. It will no\nlonger be primarily ' service ' oriented, but will assume increased responsibility for\nthe over-all aspects of mental health planning in order to facilitate the decentralization and regionalization of mental health programmes throughout the Province.\n\" The positions of Deputy Minister and Director have been separated, and the\nDirector of Mental Health Services, Dr. H. W. Bridge, will be located in the Vancouver area, having as his responsibility the management of all mental hospitals and\ninstitutions providing in-patient care, as well as the Mental Health Centre in Burnaby. The Deputy Minister, Dr. F. G. Tucker, will be located in Victoria and will\nhave a staff of professional consultants whose task it will be to co-operate with local\nauthorities, mental health professionals, universities, public and private agencies,\nas well as with other Government departments in the development of community\nprogrammes.\n\" Particular emphasis will be placed upon providing professional counsel for\nthe development of community-based psychiatric programmes, facilities and services\nfor mental retardates, comprehensive programmes for emotionally disturbed chil-\n L 10\nMENTAL HEALTH BRANCH REPORT, 1967/68\ndren, integrated services for the aged mentally ill, and for the provision of forensic\nclinics. Special epidemiological and sociological studies will be undertaken; emphasis will be placed on the collection, analysis, and interpretation of essential statistical data; ongoing programmes will be continually evaluated; any required regulations, standards, etc., will be developed; in-service training, liaison with universities, organization of seminars, institutes, and workshops for professional groups will\nbe promoted; and clinical research will be facilitated.\n\" It will be appreciated that in a period of rapid change and development it is\nnot possible to provide a detailed blueprint for the future and that the primary\ncharacteristics of all such planning must be flexibility and the continuing evaluation\nof programmes. However, it can be assumed that future programmes will be based\nupon the following:\u00E2\u0080\u0094\n\" Decentralization and regionalization will be emphasized and a wide\nrange of new programmes will be developed to meet local needs . . .\n\" The existing division in the care of physical and mental illness will gradually lessen and largely disappear . . .\n\" The larger centralized facilities will be adapted to meet current demands\nfor psychiatric services to the mentally ill and retarded in such a way\nas to facilitate modification to meet changes in requirements occasioned by the development of other regionalized and decentralized\nprogrammes . . .\n\" The recruitment and training of new professional staff will receive a\nhigh priority due to the anticipated continued shortage of mental\nhealth professionals. In-service training and retraining will be advanced and special programmes developed to meet staffing requirements . . .\n\" Increasing emphasis will be placed upon prevention, thereby requiring\nmore precise problem identification and definitive planning . . .\n\" The improvement and evaluation of treatment methods will require continuing research at the clinical level.\n\" In summary, the reorganization will result in the broadening of the Mental\nHealth Branch from that of a ' service' organization to one which will be\ninvolved in all aspects of mental health through involvement, integration, co-operation, and liaison with all those who are concerned in the mental welfare of the Province, the objective of which will be the decentralization and regionalization of mental\nhealth programmes.\"\nOn August 1, 1967, Dr. F. G. Tucker was appointed Deputy Minister of the\nMental Health Branch; Mr. A. Porteous, Assistant Deputy Minister; and\nDr. H. W. Bridge, Director of Mental Health Services. Steps were immediately\ntaken to establish and recruit the positions necessary to effect the organizational\nchange in the administration to relocate the headquarters Branch office in Victoria,\nand the efforts of the Branch were increasingly focused on community programming.\nAs this year draws to a close, I am pleased to report that in accordance with\nthe above recommendations the following progress has been made:\u00E2\u0080\u0094\nI. The headquarters Branch office was established in temporary quarters in\nVictoria in November, 1967, and will move to its permanent quarters in January,\n1969. The Branch has been reorganized so that it now consists of two main components under the over-all direction of the Deputy Minister. The Mental Health\nServices Division, under the Director of Mental Health Services, is now responsible\nfor providing the bulk of direct treatment through the various in-patient facilities.\nThe Community Psychiatric Programmes Division, which will be directed by Dr.\n GENERAL ADMINISTRATION\nL 11\nR. Congdon (who will be joining our staff in January, 1969), will be made up of\nthe regional mental health centres and will concern itself particularly with the coordination and development of regional mental health programmes. Its primary\nfunction will be one of consultation, education, the development of special programmes, and limited direct community-based services.\nNeither of these positions can function effectively without adequate planning,\nprogramme evaluation, and an efficient business and fiscal administration. The\nnecessary positions to carry out these important functions have therefore been established in the Branch office as outlined in the organizational chart which accompanies\nthis Report.\nII. Decentralization and Regionalization.\u00E2\u0080\u0094For the purpose of mental health\nplanning, the Province has been divided into eight regions based upon clusters of\nhealth units. As the basic unit of these regions is the school district, rigid adherence\nto the proposed boundaries is not essential should change be considered desirable\nin the future. During the coming years the mental health needs and resources of\nthese individual regions will be studied, and it is hoped that, in co-operation with\nthe appropriate groups and agencies, a co-ordinated programme for the mentally ill\nand the retarded will be developed.\nThere are now 10 mental health centres established in this Province, and I am\nhopeful that a further two out of the remaining six will be in operation shortly.\nHowever, the shortage of professional staff willing to work in the smaller rural communities renders recruitment a matter of continuing concern. The reports of these\ncentres is detailed elsewhere in this Report.\nI am particularly pleased with the close working relationship that has been\nestablished with the Department of Social Welfare during the past year. As an\nexample of this co-operative effort, I would draw attention to the Bevan Lodge Association in Courtenay. In conjunction with the Department of Social Welfare and a\ngroup of interested and hard-working citizens, we have been able to set up an intermediate-care facility for 70 moderate to severe adult retardates. This will be administered by a non-profit society\u00E2\u0080\u0094the Bevan Lodge Association. I believe this\nprogramme will not only be beneficial to the trainees concerned, many of whom will\nbe closer to their homes, but will free urgently needed beds at The Woodlands School\nand The Tranquille School.\nIII. Changing Patterns of Care. \u00E2\u0080\u0094 A comprehensive regional mental health\nprogramme must include the following broad categories of care: Acute care, intermediate care, extended care, and chronic care, together with supporting services.\nIt is envisaged that the acute psychiatric patient will in future be admitted to\nthe psychiatric ward of the general hospital as these facilities become available.\nThe expansion of these specialized facilities throughout the Province therefore is of\ngreat significance.* Unfortunately a shortage of acute psychiatric beds continues\nin the Greater Vancouver area (Fraser-Burrard region), and for this and other reasons we are presently investigating the possibility of declaring at least part of the\nRiverview Hospital an \" open \" hospital, thereby allowing suitably qualified physicians to admit, treat, and bill their own patients.\nThe provision of extended care has long been a major responsibility of the\nMental Health Branch, and at the present time over 1,100 in-patients fall within this\ncategory. These individuals suffer primarily from a physical disability, with mental\n* A. Total number of existing psychiatric beds\nB. Total number under construction \t\nC Total number\u00E2\u0080\u0094advanced planning \u00E2\u0080\u0094\nD. Other planning stages \t\n149\n285\n84\n313\nTotal\n831\n L 12 MENTAL HEALTH BRANCH REPORT, 1967/68\nillness or retardation a secondary component of the over-all illness, and, therefore,\nthey would be more appropriately placed in future in the expanded extended-care\nfacilities within their own communities. Only those requiring highly specialized\ncare should be referred to the larger centralized units. In accordance with this principle, a very small number of cases have been so placed during the latter part of\nthe year.\nThe boarding-home or chronic-care programme now in force for over 10 years\nhas continued to maintain a high level of care, and over 850 patients are currently\nplaced in supervised boarding homes. In the coming year it is hoped that, in cooperation with the Department of Social Welfare, this programme will be expanded\nbeyond the immediate precincts of the major metropolitan areas so that patients\nwill be domiciled in close proximity to their family and friends. The setting-up of\na central referral agency in Victoria has been a useful step in providing maximum\nutilization of available resources within that area.\nIntermediate care, under which I include day and night hospitals, group-living\nhomes, nursing homes, and foster homes, out-patient and emergency services, is\npresently under review, and I am hopeful that we will be able to initiate a number\nof these programmes in the coming year.\nIV. Training and Postgraduate Education.\u00E2\u0080\u0094The Mental Health Branch has\ncontinued to provide for and to co-operate in the undergraduate and postgraduate\ntraining of professional staff.\nThe Department of Nursing Education at Essondale has been concerned in\npreparation/training of psychiatric nurses, affiliate student nurses from several general hospital schools of nursing, and basic orientation programmes for psychiatric\naides, as reported elsewhere in the Report.\nIn September, 1967, a select group of psychiatric nurses was granted educational leave with pay to permit them to enrol in a newly developed course at the\nVancouver College, which provides them with an integrated programme specifically\ndesigned to prepare the nurse to undertake employment in which knowledge of and\ncompetence in the use of community resources is essential. Another group of psychiatric nurses obtained educational leave with pay in order that they might enrol\nin specialized courses in administration and supervision at the Simon Fraser University.\nIn the fall of 1968 a limited number of psychiatric nurses were selected to\nenrol in the two-year general nursing course at the British Columbia Institute of\nTechnology in Burnaby.\nThe practice of providing bursaries for professional and postgraduate training,\nfunded by the Mental Health Grant, has been continued. Assistance is provided to\nphysicians to undertake residency training at the University of British Columbia,\nDepartment of Psychiatry, in the specialty; clinical psychologists are assisted in\nobtaining advanced knowledge in their field; social workers are assisted to qualify\nfor advanced degrees in social work; registered nurses are provided bursaries to\npermit them to enrol in university schools of nursing to study for advanced degrees\nin the field of nursing administration for nursing education.\nStaff are encouraged to improve their qualification by the use of appropriate\ncorrespondence courses. For example, the course for medical records technicians\nof the Canadian Hospital Association is most valuable in raising standards in that\ndepartment. Similarly the Canadian Hospital Association course in hospital organization and management enables administrative personnel to improve their qualifications and thereby upgrade the quality of the administrative services. The correspondence course of the American Laundry Institute has been useful in assisting the\nlaundry manager at the Riverview Hospital to upgrade his qualifications.\n GENERAL ADMINISTRATION\nL 13\nThe facilities operated by the Branch are used for field work and practicum\nplacement for students from the university schools. Examples are social work and\nrehabilitation medicine, which have for years used the clinics and hospitals for practical training. The laboratories at the Riverview Hospital are utilized for the training of medical technologists. I would like to draw attention especially to the establishment of a teaching unit in West 3 Ward in the Crease Clinic which is run in conjunction with the Department of Psychiatry, University of British Columbia, to provide experience for the residents in psychiatry.\nAs will be noted in the appropriate sections of this Report, two major projects\nare nearing completion. The Eric Martin Institute will be ready to commence operation in the spring of 1969, hopefully by some form of community association.\nConstruction of the British Columbia Youth Development Centre in Burnaby is in\nits final stages, and I anticipate that the Residential Treatment Centre will phase\ninto operation following the necessary period of in-service training and orientation\nof the staff. The Children's Out-patient, Day Care, and Psycho-educational Programmes will be expanded.\nConstruction of The Glendale Hospital continues according to plan, and it will\nprobably be ready for operation as a multi-purpose extended-care facility in about\ntwo years' time.\nIt is hoped that in the near future the development of societies will permit programming at the local level with the optimum degree of local participation and Government support. The transfer of the Eric Martin Institute to local administration\nis the forerunner of such an approach, and it is possible that other units could, in\ndue course, follow this pattern.\nAs the Branch becomes increasingly involved in consultation and in planning\nfor the over-all mental health of the Province, it is essential that communication\nand liaison be improved with other Government departments, public and private\nagencies. During the past year regular liaison meetings have been taking place with\nthe Psychiatric Section of the British Columbia Medical Association, and senior\nadministrative personnel are either on the board of directors or meet regularly with\nvoluntary and professional organizations, such as the Canadian Mental Health Association, Association for Retarded Children of British Columbia, Registered Nurses'\nAssociation, British Columbia Association of Social Workers, Alcoholism Foundation, and Narcotic Foundation. There is no question that relocation of the Branch\noffice in Victoria has considerably improved communication with other Government\ndepartments.\nIn summary, it may be said that in the past 21 months a major reorganization\nof the Mental Health Branch administration has taken place, and will permit the\nBranch to expand its interest and involvement in the over-all mental health programme of the Province whilst still continuing to provide a high level of direct service to the people of British Columbia.\nIn the coming year we will place emphasis upon the identification of need, the\nevaluation of existing services and programmes, and new delivery systems of care.\n L 14\nMENTAL HEALTH BRANCH REPORT, 1967/68\nREPORT OF THE COMPTROLLER OF EXPENDITURE\nF. A. Matheson, Comptroller\nAttached are the financial reports of the British Columbia Mental Health\nBranch for the fiscal year ended March 31, 1968.\nTable A, covering the in-patient services, shows a daily average population of\n5,925.25, a decrease of 9.13 from the fiscal year 1966/67. However, our maintenance expenditures increased by $2,576,523 in 1967/68, causing the average\ndaily per capita cost to increase from $10.48 to $11.66. The increase of\n$2,576,523 is made up of $2,203,419 in salaries and the balance of $373,104\nin supplies and expenses. Maintenance revenue increased from $1,948 878 in\n1966/67 to $1,967,564 in 1967/68.\nThe Department of Agriculture supplied dairy produce, vegetables, and\nmeat valued at approximately $450,000 to mental health units from the farm\noperations at Essondale and Tranquille for the period under review.\nIt is a pleasure to be able to report the excellent progress that has been made\nduring this fiscal year on a number of major capital projects, as follows:\t\n(1) Eric Martin Institute, Victoria. The Department of Public Works let\na contract in the amount of $5,715,000 for the completion of this\nproject. The contractor is making excellent progress and expects to\nhave it completed by December, 1968.\n(2) Glendale School, Victoria. The contract for the shell of the boiler-\nhouse and laundry has been completed. The plans and specifications\nfor the main hospital unit of some 300 beds are nearly completed and\nshould be ready for tender early in the next fiscal year.\n* ..\nThe Eric Martin Institute, situated on Lee Avenue and east of the Royal Jubilee\nHospital, is designed as a 170-bed intensive-treatment in-patient and day-care psychiatric unit.\n GENERAL ADMINISTRATION\nL 15\nSite of the new Glendale Hospital, Victoria, showing boiler-house and laundry\nalmost completed. The hospital is planned for the care of 300 severely handicapped and\nmoderately to profoundly retarded children and adults.\n(3) British Columbia Youth Development Centre, Burnaby. The contractor is making excellent progress on this project, and the contract should\nbe completed by the end of 1968.\n(4) Renovation of Centre Building, Wards J and K and G and Con, The\nWoodlands School, New Westminster. The first phase of this project,\ncovering the renovation of Wards H, E, and F and the centre section\nof the Centre Building, has been completed. Plans and specifications\nfor the second phase, consisting of renovations to Wards 72, 73, and\n74 and the basement of the Centre Building, have been completed and\nare ready for tendering.\n(5) Renovation of West Lawn Building, Essondale. The Department of\nPublic Works has started preliminary planning on this project and tenders\nhave now been called for.\n(6) Renovation of Kitchen and Dining-room, Riverside Building, Essondale.\nPreliminary plans for this project have been completed.\nIn addition to these major projects, the Department of Public Works completed a large number of smaller jobs that have done much to further improve\nour facilities.\nIt is also a pleasure to be able to report that during this year we were again\nable to maintain buildings, grounds, equipment, and furnishings of all of our\ninstitutions in a satisfactory manner. We purchased a considerable amount of\nnew and replacement equipment.\n L 16\nMENTAL HEALTH BRANCH REPORT, 1967/68\nFINANCIAL TABLES\nTable A.\u00E2\u0080\u0094Showing the Average Number of Patients in Residence Each\nYear, the Total Amounts Spent for Maintenance, and the Gross\nYearly and Daily per Capita Cost, 1958/59 to 1967/68.\nInstitution\nAverage\nNumber in\nResidence\nMaintenance\nExpenditure\nYearly\nper Capita\nCost\nDaily\nper Capita\nCost\n1958/59\nThe Woodlands School \t\n1,377.31\n3,301.84\n282.99\n539.13\n226.33\n282.92\n236.88\n$2,968,725.50\n6,088,091.20\n488,028.69\n961,921.63\n410,529.00\n386,804.84\n1,149,344.46\n$2,155.45\n1,843.84\n1,724.55\n1,784.22\n1,813.86\n1,367.19\n4,852.01\n$5.91\nProvincial Mental Hospital, Essondale.\u00E2\u0080\u0094\n5.05\n4.72\nHome for the Aged, Port Coquitlam\n4.89\n4.97\n3.75\n13.29\n6,247.40\n$12,453,445.32\n$1,993.38\n$5.46\n1959/60\n226.80\n3,135.48\n1,395.44\n53.74\n283.50\n560.16\n230.92\n285.18\n$1,233,254.59\n6,672,849.09\n3,443,231.64\n400,957.24\n523,480.74\n1,400,239.30\n444,975.54\n412,230.25\n$5,437.63\n2,128.17\n2,467.49\n7,461.06\n1,846.49\n2,499.71\n1,926,97\n1,445.51\n$14.86\nProvincial Mental Hospital, Essondale\u00E2\u0080\u0094\nThe Woodlands School \t\n5.81\n6.74\n20.39\n5.05\nValleyview Hospital, Essondale \t\n6.83\n5.26\nSkeenaview Hospital, Terrace \t\n3.95\nTotals for the year \t\n6,171.22\n$14,531,218.39\n$2,354.68\n$6.43\n1960/61\n237.72\n3,008.02\n1,415.30\n126.01\n287.16\n695.41\n232.05\n290.70\n$1,313,678.32\n6,775,567.11\n3,637,555.12\n542,556.16\n518,591.72\n1,754,500.08\n448,792.02\n417,856.55\n$5,526.16\n2,252.50\n2,570.17\n4,305.66\n1,805.93\n2,522.97\n1,934.03\n1,437.41\n$15.14\nProvincial Mental Hospital, Essondale -\nThe Woodlands School\t\n6.17\n7.04\nThe Tranquille School, Tranquille\t\nProvincial Mental Home, Colquitz\t\n11.80\n4.95\nValleyview Hospital, Essondale \t\n6.91\nDellview Hospital, Vernon\t\nSkeenaview Hospital, Terrace\t\n5.30\n3.94\nTotals for the year \t\n6,292.37\n$15,409,097.08\n$2,448.85\n$6.71\n1961/62\n241.92\n2,824.58\n1,351.62\n250.33\n284.90\n736.29\n230.38\n287.28\n$1,344,906.48\n6,927,591.07\n3,639,782.25\n657,736.27\n507,315.85\n1,848,097.68\n464,314.47\n443,255.07\n$5,559.30\n2,452.61\n2,692.90\n2,627.47\n1,780.68\n2,510.01\n2,015.43\n1.542.94\n$15.23\nProvincial Mental Hospital, Essondale._\n6.72\n7 38\n7.20\nProvincial Mental Hospital, Essondale ..\nValleyview Hospital, Essondale. \u00E2\u0080\u0094\n4.88\n6.88\n5.52\nSkeenaview Hospital, Terrace\t\n4.23\nTotals for the year \t\n6,207.30\n$15,832,999.14\n$2,550.71\n$6.99\n1962/63\n236.68\n2,719.32\n1,365.03\n307.13\n214.18\n724.07\n232.55\n296.21\n$1,371,120.17\n7,058,027.01\n3,817,685.18\n779,642.07\n478,229.75\n1,939,191.04\n469,458.08\n441,445.13\n$5,793.14\n2,595.51\n2,796.78\n2.538.48\n2,232.84\n2,678.18\n2,018.74\n1,490.31\n$15.87\nProvincial Mental Hospital, Essondale...\nThe Woodlands School \t\n7.11\n7.66\nThe Tranquille School, Tranquille\t\n6.95\n6.12\n7.34\n5.53\nSkeenaview Hospital, Terrace \t\n4.08\nTotals for the year \t\n6,095.15\n$16,354,798.43\n$2,683.25\n$7.35\n1963/64\n220.63\n2,791.99\n1,306.35\n433.92\n94.07\n737.69\n236.51\n292.83\n$1,442,627.00\n7,534,673.00\n3,916,660.00\n1,077,011.00\n414,787.00\n2,029,118.00\n512,128.00\n713,594.00\n$6,538.67\n2,698.67\n2,998.17\n2,482.05\n4,409.35\n2,750.64\n2,165.35\n2,436.89\n$17.87\nProvincial Mental Hospital, Essondale...\nThe Woodlands School ,\u00E2\u0080\u009E.\t\nThe Tranquille School, Tranquille\t\nProvincial Mental Home, Colquitz\t\nValleyview Hospital, Essondale\t\n7.37\n8.19\n6.78\n14.41\n7.52\n5.92\n6.66\nTotals for the year\t\n6.113.99\n$17,640,598.00\n$2,885.28\n$7.90\n GENERAL ADMINISTRATION\nL 17\nTable A.\u00E2\u0080\u0094Showing the Average Number of Patients in Residence Each\nYear, the Total Amounts Spent for Maintenance, and the Gross\nYearly and Daily per Capita Cost, 1958/59 to 1967/68\u00E2\u0080\u0094Continued.\nInstitution\nAverage\nNumber in\nResidence\nMaintenance\nExpenditure\nYearly\nper Capita\nCost\nDaily\nper Capita\nCost\n1964/65\nCrease Clinic \t\nProvincial Mental Hospital, Essondale\u00E2\u0080\u0094\nTh* W\"\"^la\"d cS cn\ncs vq t\u00C2\u00ABncsoooo\u00E2\u0080\u0094\"\nOv vD vD cn tt\n00\n<\n\u00C2\u00A9Tfcsoo^or-O'-'asoocncni-t m cs so o\n\u00E2\u0080\u0094i i-\" Os CN vo\ns\nIS\n-t in t-i HotNtN HHinrtH .-h en t\nC^ so cs m cn^\nO cn tf\ns\nso\n<\noo rH i-T\ncs\"\ncs\"\nQ\nV*\nw-\nbe\nQ\nZ\nW\n\u00E2\u0080\u00A2a oo\npvO\nX *\na S\n: oo\n\ne so\no\nas\nCS\no\nO\nO\ncs\nOv\ncs\nOv\no\n\u00C2\u00B0i\nq.\nt\\nr^\nBh\nc\nt\u00E2\u0080\u0094t\no^\nin\"\nr-\ncs\"\noo\nOv\noo\"\nOv\nCS\nTt\ntt\nw\nS3 fe\n3__\n\u00C2\u00AB\u00E2\u0096\u00A0\n&\u00E2\u0096\u00A0_\u00E2\u0096\u00A0\nte\n\u00E2\u0096\u00BAJ\n<\ns:s\nQ\nZ\no\n\u00E2\u0080\u00A2oS_g*\nCO\nc o m a\nJr. \u00C2\u00AB_> O\n1151\n]\ncn\ncn\nen\nw\n1\nso\nVO\n5\nCS\ncs\ncs\n<\ncn\nVr\nen\nv>\ncn\nUe-\n0<\nCO\nO\n\u00E2\u0080\u00A2o\nJ) j,\nS 3\n'-\n> a\nr^t^-r^cs>ninr-cnvDoosooTt\u00C2\u00BBncs oooo\nm so vo cn Tt-\ntt\nO'tMooHOr-o^^coinf)'-1 mesvo\nrH t-h OV CS VO\ntt in \u00E2\u0080\u0094* cnocScs hhi^nh .-i cn\noo cn tt\nOs\nr^ vo cs m\nOO r-T\no\"\no\"\n-S_W\nfce-\nPS\n\u00C2\u00A3\nVi\nV*\n>\n2\nw\nX\nH\nU.\nO\nV\nH\ns\nZ\na\nM\nw\nW\n&0\nBJ\n_s\n_^\n<\n\u00C2\u00AB\n3\nO\nH\na\ny_\no\n; c\n3\nCO\nS\na\na\n.1\nz\nw\nCL.\na\nC\n3\ncr\nw\no\n.2\n13\no\no\nX\na\n3\nW\nc\nO\nO\n\n5\no __;\nen\nu\nS w\nU\n\u00C2\u00AB\n\u00E2\u0080\u00A2a\na\no\nu b s ^\naT\n'si\nw\n*c3\nOJ\n,7; i-\nB \u00C2\u00AB\n\nR\na e\n4\ndSoc\nb u *i\ni-t u *>\n1 -a\nsi\na\nH\nX 3 QJ\n;-\u00E2\u0096\u00A0'..:-\nC\n\u00C2\u00AB i-. w c ra 3 a\nc\n.5 3 \u00E2\u0080\u0094\n>\nCO\n_CJ\nrSt\non d c\n|\n\u00E2\u0096\u00A0\u00E2\u0080\u00A2__ 'S \"cfl >\n*; \nH\nu\nu\n|\n0\ns\nT3\nc\n3\n-J\n3\ns\nI-\na\n3\na.\n0\na,\n|\nc\n0\n1 l-\nc\na\np\ns\no\nc\nX\n3\n<\nc\n0\na\nc\nC\nB\n3\nP3\n4J\n3\nOJ\na\n2\n'3\nCQ\nk]\n3\n'\u00E2\u0080\u00A2V\n<\n L 20\nMENTAL HEALTH BRANCH REPORT, 1967/68\noo\nvo\nas\nx\nu\n<\nQ\nW\nD\nZ\nW\n..\nX\nH\nZ\no\nCN\nHi\nO\nFd\nB-T\nW\nH\nto\nZ\no\no\nX\nU\nC/5\nco\na\nZ\n<\nQ\nO\no\nW\nX\nH\no\nH\nZ\nw\nw\nH\n<\nH\nw\nco\nZ\nW\n\u00C2\u00A3-,\nX\nW\nW\n\u00E2\u0096\u00BAJ\nM\n<\n--, to\n>. -__\nin\nCO\nr\u00C2\u00BB\nvc\n-*\nTt\nSO\nin\nr>\nr-\nl>\no\noc\nOv\n\u00E2\u0096\u00A0O\n00\nm\nr~\nCN\nOs\nSO\nen\nTT\nr^incSttrnr-qttenqentj--H-H^H-^en'-;q\nCS\nhV.cN\nsD\nvD-Ht^r^Ovodcn 'enrHi^rtencSGocs ' cS\nm\nCS rl cn\nl>\n*s\ncon cSvOCS r- i-iT-tg-i\no\nt>\nm *-h cn ri tn\nen\"\nr-\nTr\"\nP\nTt\"\nVj-\n&\u00C2\u00BB\nVi-\no\n-. c\nr-ottosu-i-Hor-ttttcs-rtm-HOOOv'-'Os\nts\nOMn\no\no-2\nOn\nr~-vooovovosOOCSoo-Hvo m vo Os r\u00E2\u0080\u0094 en oo Os co\nsC\nrH Os r~-\nCO\nosooTtooenenoTrttr^r^qeno^r^cs^oo^vo\n>n\ntt Os OS\nrH\no\" Tf in J fn -rt vo\" tt\" tt *-h m in tt cs en \u00C2\u00ABn \u00E2\u0080\u0094<\nso\"\nO\" so r-- en cs rN rH m\nm\nO\ngg,\nvo \u00E2\u0080\u0094i tt CS tt\no.\np\nGO\n<\ntt\"\nsO\nvo\"\nVi-\n\u00C2\u00AB\u00E2\u0096\u00A0\nVi-\n\"3*00\n3 vO\nm\nm\nm\nas**.\nm\nin\nin\nw\nin\nin\nv\\n3\n3 ___!\nen\nm\ntn\nOJ\ntt\nTt\ntt\ns\nte-\nt^\nVb\n&. CS\n3\n3s\n*o\n<\nEm\no\n3\n4)\ns -\ni Ov\nas\nON\nr\u00E2\u0080\u0094\nr^\nX>\nen\n**!_\nCO\na\n\u00C2\u00A7^\nm\"\nm\nen\ncn\ncn\nee-\nCQ-\nte\n\u00C2\u00A71\n\u00E2\u0096\u00A0a S_^ -\ncote\nC3\u00C2\u00A3- o g\n8\u00C2\u00BB\u00C2\u00A31\nas\nOC\n00\nas\n00\nvo\nvq\np\n$%%%\n>n\nm\n> o.\"-5 a\nTt\ntt\nTf\n*. a-c u\nw-\n\nse\n*Sfia\n\u00E2\u0096\u00A0a\n4) u\n<_> 3\nr-ottos-H-Hor-ttttcSTtm \u00E2\u0080\u0094 ooov-h\nOs\no t\u00E2\u0080\u0094 m\nr\nx: z.\nr~-vooovottvoocsoo--'voenvoosr-enooos\nTT\nrH as r\u00E2\u0080\u0094\nvo\n=1\n> a\nOsoottoomenottTtt-t\u00E2\u0080\u0094Oenor-csoor-i\nC^\nTt_ OS^ Os_\nVO\nOttinr-i\u00E2\u0080\u0094iTtvott ttr-iu-.inTrcSenin\ncn\nso\" ri\" vo\"\nf-\nOr-i r- r- cn cs cs *-<\nOs\nVO rH Tf cs\n\"1\n*- X\nTt\"\nin\"\nzu\nV5-\n\n3\n\nC\na\n!\n3\n.9\n3\nU\nto'\na*\nfl\no\n4)\n4>\na\na\nc\nB\n(t-H\n0\nG\n'tH\n>s\no\n3\nG\n.2\no\ntfl\na\n\"3\n.2\nt-4\n\u00C2\u00A3 S\n81\no\ncj\nc.2\nrt\nv\nG\na\n0\nTJ\n_3 ^\ncO G\n4)\n!gj\n3\nCO\n O\na\n9\nI\nP\nCO\nu\nB\nX\n4)\naj\nu\nE\nC\n|\n:\n4)\nf\nc\nu\n>\nCT\n4\n5\n>\nTJ\n3\n3\nR\n-1\n5\n\u00C2\u00AB\n0\n3\n4\n\u00C2\u00AB\na.\nc\ncc\ne\nc/\nc\n3\ns\ns\nc\nc\nc\nI\na\n3\ne\n4\nC\nCJ\na\nC\nr\nC\nz\nL\nc\n:_\ni\n<\n\u00C2\u00A3\n1\n1\nc\n1\nu\n[5\n3\nffi\n9\nXI\n3\n1 rS\n\u00C2\u00BB\n03\nu\nTJ\n4\n3\nT3\n<\n GENERAL ADMINISTRATION\nL 21\n*\u00C2\u00AB. to\n^\u00C2\u00BB o\nCSOOi-HOOOOSOttOsOsDcn-nvOTtOOOSDCNcn\nr\u00E2\u0080\u0094 oo Tt\nm\n\u00C2\u00B0-U\nONqr^Osr^inooejoc>i^co^eneNSD^r\u00E2\u0080\u0094 tt~\nco so so\nCO\n>\u00E2\u0080\u00A2 in\nenoinr-ir-ioTrv\u00C2\u00A9 \"so\" \"ttm\" \" cs tt o \u00C2\u00AB-i en\nTt rS in\nVO\n\u00E2\u0080\u0094h Q\nCSCS rH rH rH 00 h HfS \u00C2\u00AB\nt> rH in rH SO\nO rH CS\nSO\ncs^\no\\nCN\ntt\"\ntt\"\n7-1\nse-\nV*\nt*e-\ncn\na\no\nCJ\n*_. c\nrnoo-HTt TtcsinmcSr-inr-osr-m --\u00C2\u00AB so m o\nTt rH fN\n^H\np.\no.2\nso m r\u00E2\u0080\u0094 o oocsosTtcnvOTtinenmr-i csocncn\nTt I\u00E2\u0080\u0094 CS\nin\nOCNcneni\u00E2\u0080\u0094 or\u00E2\u0080\u0094inrHfN]ininT-HT-ii>sor--Osr-\np sO ON\n\u00C2\u00A9^\n<\nooenenrHenr\u00E2\u0080\u0094OSTt tt ho h osen r\u00E2\u0080\u0094\nr-T rH SO\"\ntn\n|&\nosrH r- en Nrt rHen\nr>_ en rn Tt\nTt rlrH\noo\n00\n^O\ncs\"\nCS\"\nQ\nCJ^*\nvi-\ntie-\n69-\nW\n<\nQ\nZ\nW\nCO\nTJ 00\ne-so\nCOOS\nOS\nj\nII\nos\nOs\nm\n3.\n\u00E2\u0080\u009E_,\nm\n\u00E2\u0096\u00A0\np\nso^\nH\nz\nG\nG~\nOs\"\n' Os\"\noo\"\noo\"\n41\nO^\n\u00C2\u00AB\u00E2\u0096\u00A0\n1 m\nVO\nSO\n\u00C2\u00A7\nv>\n&e-\no\ns __i\n2\ntj\n3s\ncN\n<\n05\no\nJ-j\n\u00E2\u0096\u00A0\u00C2\u00A7*\u00C2\u00A3\nB -\n8*.\n^5 3\n! 1 ! cn\nII 1 \u00C2\u00ABn 1 1 I\nCO !\n00\nO\n(In\n4)\n>\nG\ni\no\nTt\nOv\"\ni Os\n\nCD\ncn\no\ncn\n>\nH\nen\nr\u00E2\u0080\u0094\ncn\n> a-3 ft\nTf\nTt\nTt\no\ni\n\u00C2\u00AB\u00E2\u0096\u00A0\nVi-\n-fl-\no\nX\nCJ\nTJ\n00\nSB\nr-co-HTtttooinmcsr\u00E2\u0080\u0094 inrNOvr-inr-isOm l\nUI rH (S\ncs\nw\n-3 \u00E2\u0080\u0094\nsomr\u00E2\u0080\u0094 oooenOsttenvOttTtenm-HcSOen :\nrH t- CN\ncs\nl_l\nvJIG\nocscncnr>r-r\u00E2\u0080\u0094mr-icsm en \"-\u00E2\u0096\u00A0 r- r\u00E2\u0080\u0094 so r- os\n00 so Ov\ntN\n3^\n^ 3\nJ\nooencnT-ienr- OsTt Tt i-i o r-iosen\nen rn so\nm\nO ir\"\nOv rH r\u00E2\u0080\u0094 en cn rn i\u00E2\u0080\u0094i\noo\n3\n>\u00C2\u00A3,\nt^ \u00C2\u00AB -1\ntt\nen\n*_. x\ncs\"\ncs\"\nc.\nz\n\u00E2\u0080\u009Ew\nte-\n&e-\nvi\n<\nOS\nH\nw\ns\nH\nPh\nO\nu\nH\na\nu\nZ\nw\nft\n2\nCO\nw\n_3\nH\nrt\n<\n4)\n-\nH\na\nc/_\nO\n3\nw\nCO\nTJ\nG\n03\n6\na\na\ncd\nZ\ncn\n3\nu\n-3\nW\n.2-\n4)\na.\na\n3\no\n\u00C2\u00AB\n\nu\n'3\n\u00C2\u00AB\nW 3\ng S\n3\nu\ntn\n4)\nu P.\nen\na. '-d\n4>\nw\nC3\nT)\n4) c-\nc M\na >_.\nG\na\no\n*- - 3\n! cj\nTJ tn\" 3\n3\n73\nCO\n1)\nCJ\n\u00C2\u00AB >\nTJ\n\u00C2\u00AB 3\n_i\n\u00E2\u0096\u00A0oSo\n\u00C2\u00AB -a (si {2\n\u00E2\u0080\u0094 vJ G\nG\ncd\nu\ntj tj i .*_;\n3 3> ! TJ\n3 ^TJ C\n0 j-. i- cj\npa\nH X g 4\u00C2\u00BB\n0 u 4> .s _-_\n2 X) O \u00C2\u00AB D\n\" m 3 S\n3 \u00C2\u00A7TJ J\n\u00E2\u0096\u00A02 E2 \n6 - 2 5 w\n4=\nR\n41\ns\n>\nCC\nu\nH\n41\nu\nc\nc\nT\n1\nB\n4\n3\nTJ\n3\n3\nCQ\n-J\nI\nC\nc\na\nc\n1\nc\nc\n\u00C2\u00AB\nc\n1\nc\n3\nCJ\nCJ\nc\n6\nTJ\n3\n<\nG\nOJ\noi\na\nR\n4\n3\n(J\no\nC\nC\n5\n1\n3\n\u00C2\u00A7\nCO\n3\nTJ\n<\n L 22\nMENTAL HEALTH BRANCH REPORT, 1967/68\nTable F.\u00E2\u0080\u0094Expense Statement of the Valleyview Hospital, Essondale,\nfor 12 Months Ended March 31, 1968\nSalaries, Supplies, and\nOperating Expense\nNet Vouchered\nExpenditure\nServices and\nSupplies from\nPublic Works\nDepartment\nActual Cost of\nOperation\nYearly per\nCapita Cost\n$2,276,059\n10,582\n1,939\n1,422\n135,126\n320,986\n19,000\n3,802\n131\n4,629\n115\n97,908\n2,456\n599\n2,494\n714\n576\n$2,276,059\n10,582\n1,939\n1,422\n135,126\n320,986\n19,000\n3,802\n131\n4,629\n115\n97,908\n2,456\n599\n2,494\n714\n576\n92,669\n$3,012.53\n14.01\n\t\n2.57\n1.88\n178.85\n424.85\n25.15\n5.03\n.17\n6.13\n.15\n129.59\n3.25\n.79\n3.30\n.95\n.76\n$92,669\n122.65\nLess\u00E2\u0080\u0094\u00E2\u0096\u00A0\nIncrease in inventory from institu-\n$2,878,538\n8,488\n163\n14,040\n$92,669\n$2,971,207\n8,488\n163\n14,040\n$3,932.61\n11.23\n.22\n18.58\n$2,855,847\n$92,669\n$2,948,516\n$3,902.58\n GENERAL ADMINISTRATION\nL 23\nft\u00C2\u00BB o\nincscscsmsoosenooor-tSrHOs\nSO CN O\nTt\n*3\nTtr>cSrHCNcncSTtrHr>enqos\u00C2\u00BBn\n*n Tt CS\nOS\n00\nr^so'o'rHinsdincNoor-' \" co' o in\nOs in in\nCO\nvo\nPI\nm ri SO l> r-< CN ri t\u00E2\u0080\u0094\nCN tn rH Tt\nin rl\nen^\nen\nOS\ncs\"\nen\"\ncn\"\ni\u00E2\u0080\u0094I\ntnt!\n&e-\nb1!-\nbo-\nco\n\u00C2\u00ABM\n11\nO\n<- a\nr-ooor^osominocsossDoen\nco rn in\no\nCJ\nfit\n<\no-2\nUS\nosr-mttsorNvocnosossovoovo\nm o\ Tt\no\nc> Tt cs^ cN cn^ oo cn m rnm r>^ Ttm so_\ncn rn cn\noo\nvo\" rn cn\" Tt\" cs\" cn oo\" t-T cs\" Tt\"\nOs\" r-\"en\nTt\"\n\"3 \u00C2\u00A3\n?\u00C2\u00A3:\nOS ri m cs o\nm\nen\ns\nTt rH\nVi\nVi\nr^\nVi\nQ\nW\n<\nQ\nZ\nw\n\u00E2\u0080\u00A2OOO\na\"0\n\u00C2\u00AB .\nO r-\nr>\n1 !\n00\n00\nr> m\no\ncs\nCN\n*j\nrH i\u00E2\u0080\u00941\no^\ncn\ncn\nCO\nG\nG7Z\nTt Tf\nTt\ncs\"\ncs\"\nS3\nH\n4)\ngen\n5 cd\nVi\ncs\nVi\ncs\nVi\nZ\no\nTJ\nas\ns\nCN\nO\nG\nis\nas\na .\nrH CO\nSO\nm\nm\n,-H\nm Tt\n^o\nso\nso\n>\ncejoo^\np\ncn^\ncn\nP-\nG\nCNTt\"\nTt\"\ncs\"\ncs\ncs\"\ncs\no\nn.\nVi\nbe\nES\nz\"\no\nz\nT3SJ2-!\nPS\nW\nen\nSO\ncn\nso\nen\nso\n>\nso\nTt\"\nP\nTt\"\nP\nTt\"\nO\nO\no\n^ &rO CJ\n\u00E2\u0096\u00BAJ\n<\nV3-\nVi\nVi\nH\nE\nCO\nTJ\no\nw\n4) u\n\"-H |-H\ni^coor^ososminrHfNossoo\noo en m\no\nOsr^mttr-cssoenenosvosoo\nen Os tt\no\n\u00C2\u00AB-S\nr-TteNcsvorHcnininen r>Tt\nso ,-lc,l\nis\n> a\nz\nHH\n>\nsDrH(s incscn r^ n \nc\na\nu\n1\nCO\ncd\nZ\nw\njs\nrC\nPh\nft\nG\n\"j\"\nX\n1\na\n3\nCO\n4>\n1\nft\n'3\na-\nc\nc\nc\n4.\n!\nU\nc\nv\nu E\nOJ\n4)\n0\n73\n4,\nTJ\nG\ncd\nHi\nt-< t\nTJ\nT\n3\nw\nCO\nE\n4,\nai\n\"88\n3\n3\n1\nX\n\u00E2\u0080\u00A2a\n\u00E2\u0096\u00A0a\nG\nJ\nQ,\nC\n- u\n.2 c\nG\no\nh\nCJ\nM\n1/\nX\n3 4,\n^*c3 \u00E2\u0080\u0094\n4)\nc\ncd\na\nc\na.\n\u00E2\u0096\u00A0ti **\n\"cd \u00C2\u00A3\n'Ii\n11\n3 =\na\nCJj\ni 4\nO\nX\n3\nc\na\nc\ne\n4\n'1\n>\n0\n>\u00C2\u00A3 0\n3 \u00E2\u0080\u0094\n\u00E2\u0096\u00A0h-h CC\n4\u00C2\u00BB .<*\n(J rr-\n>\nr\n>\ni\nn\ntH V\n\u00C2\u00BB O 7-\nft \u00C2\u00AB\ni- 4\n4>\n*cd w\nBT\ncj s\n3\n9\n'3\nr-J\nCQ\nCJ\n-o\n4)\ni/i\n3\ntJ\ncnOHOr>\nQh\nHOO as en 'inTt-Hcsinr^inin\ncn in rn\nVO*\nVO\nm SO CS rH 00 CS O\nCS rH rH\nos\ntn tn Tt\nen\nCN\nOs\n>3\n^4\"\nCN\ncs\"\nrt\nVi\nVi\nV*\nro\nS3\no\no\nPi\nH-\u00C2\u00BB 3\nv0o)T-(^Hr^t^incSrHmr>vocoor-*\nm r- so\ncs\n8.2\nosOscsocscsr-ienoovT-isor^inen\nm rn r>\nSO\nOO O OO J\u00E2\u0080\u0094 SO O VOTtsOSOinrHTtOO\nin m cs\nr>\n<\nTtCSrHOSinTt riHcn rH eN r> r-\ntt Tt cn\nSO\n2\n1ft\nOS rH OS CS rH\nr--\nVO\nen n\nbe-\nSD\nbe\nSO\nbe\nQ\n<\nftl\nQ\nZ\nW\nTJ 00\nGvO\ncdOv\ncn\nOs\nes\nes\nCO\nS3\"\nco\ncn\nTt\nTt\n**\u00E2\u0080\u009E\nS3\nG\nc\u00C2\u00A3\nso\"\ncs\"\noo\"\noo\"\nH\nZ\nom\nbe-\ns\n3 cs\nVi\nVi\no\n2\n3\nTJ\n<\no\nc\n4)\n>\n^\nCN\n*-<\n\u00E2\u0096\u00A0n't-.\nS3\".\ncn\nTt\nr-i\nr~-\nO\noo\nP\nt-\nr>\ntt\n\u00C2\u00BBn\ntt\nG\n\u00C2\u00A7\u00C2\u00AB\nso\"\ncs\"\nos\"\nOs\"\nft.\nv>\nVi\nbe-\n0,2\n1\n<\nfit\nftl\nH\n2S and\ns from\nWorks\ntraent\ncn\nCO\nr-\ncn\noo\nr^\nen\na 3 ,-. *-\nl>-\nr--\nt>\n_i\n\u00E2\u0096\u00A0h3 y cj\n<\n> a\u00E2\u0080\u0094 a\nh a-d 4>\nv>\nVi\nVi\nH\nE\nCO\n\u00C2\u00AB5<\u00C2\u00A3G\no\nTJ\nW\ngg\nJ> 3\nsDcsrH-Ht>r-incs\u00E2\u0080\u0094ior^voooo :\ntn r- vo\no\n\u00C2\u00A3\n43 Z<\nosOsesomeSrHcnosO'-HSDC-in\nr-l Hf\ncs\n= 1\ni^ a\noo q_t\u00C2\u00BB r^oxo^ ^ \"^ <*! ^ \"1, '\"\"1 \"**\"\nr> \"\"j.cs^\n\u00C2\u00B0\\na\nTt\" CN rH Os\" Tt\" Tt\" rH t-i* en\" rH cN t>\nm Tt cn\nr>\nOS rH OS CS\nm\nTt\n>\ncn\n X\nVi\nvs-\nbe-\n<\n\u00C2\u00ABW\nz\nfc\npa\n\u00C2\u00AB\nC/3\na\nS3\nH\nft.\nO\nCJ\nH\nG\nZ\na\nX\nm\nto\nw\n_G\nH\ncd\n<\nH\na\n00\nO\nftl\nCO\nTJ\nG\ncd\ns\na\n>\nC\nZ\nc/T\n3\nv-r\nJZ\nw\n\u00E2\u0080\u00A2 Sh\n4>\np.\na\no\nc\nX\na\n3\nW\n3\nGO.\nB\n4)\n4)\n3\n4)\n3\nd\nCfl\nc\nc\n4\nffi\n\"cd\n4\nc/i\nft\no\nTJ\nB -\ncd S\nCJ *3\n*\u00E2\u0080\u0094 lira \u00C2\u00AB\nI\ni-i\nW\no\n3\nCJ\na\nQ\n_4\nn\"3 G\nB &\n3 ^3 TJ\nQ j_t I-i\nG\nCJ\nP5\n\u00C2\u00A3 X 4)\nG cj i-\n2S =\nc\n3\n1 Occupational\nAudio-visual\nGeneral expe\nir, c cd a\ntJj . CJ Cj X\n<\na\n'C\nK\n1 Office expe\nTravelling\nMedical ca\n>\nH\nC3\n4\n0\n>\nN\nTJ\n3\n3\ncd\n. G n\n8 is\n\u00E2\u0080\u00A2 r- G O\n\u00E2\u0096\u00A0tj 4) Q\nof*\n=\n2\nCJ\nG\n0\nBuildings,\nR\nB\nAdjusted e:\n GENERAL ADMINISTRATION L 25\nTable I.\u00E2\u0080\u0094Institutional Stores\nNet undistributed stores as per Public Accounts $56,435\nAdjustments re farm profits 29,252\n$85,687\nInventory adjustment\u00E2\u0080\u0094\nPlus on hand, March 31, 1967 $584,074\nLess on hand, March 31, 1968 613,174\n29,100\nNet increase in inventory1 $56,587\n1 The increase in inventory has been transferred to the following institutions proportionately using the\n' vouchered expenditure \" as the basis for distribution:\u00E2\u0080\u0094\nRiverview Hospital - \u00E2\u0080\u0094 31,689\nThe Woodlands School _ _ 16,410\nValleyview Hospital _ _ \u00E2\u0080\u0094 8,488\nTotal\n56,587\nTable J.-\n-Expense Statement of the Community Services for 12 Months\nEnded March 31, 1968\nMental Health Centre, Burnaby\nSalaries \t\nOffice expense\t\nTravelling expense\t\nOffice furniture and equipment\nMedical care\t\nDietary \t\nLaundry\nMaintenance and operation of equipment\nTransportation \t\nGeneral supplies\t\nOccupational and recreational therapy\t\nPatients' education\t\nGeneral expense\t\nBuildings, grounds, etc.\t\n$623\n3\n11\n3\n96\n13\n1\n2\n2\n3\n1\n1\n1\n65\n,154\n,298\n,041\n,820\n,536\n,774\n,500\n,856\n,683\n,278\n,491\n,613\n,499\n,810\nTotal\n$832,353\nMental Health Centre, Victoria\nSalaries \t\nOffice expense\t\nTravelling expense\t\nOffice furniture and equipment\nMedical care \t\nMaintenance and operation of equipment\nOccupational and recreational therapy\t\nGeneral expense\t\nBuildings, grounds, etc.\t\nTotal\n$110,685\n2,265\n1,294\n653\n29,871\n536\n136\n462\n14,337\n$160,239\n L 26 MENTAL HEALTH BRANCH REPORT, 1967/68\nTable J.\u00E2\u0080\u0094Expense Statement of the Community Services for 12 Months\nEnded March 31, 1968\u00E2\u0080\u0094Continued\nMental Health Centre, Kelowna\nSalaries $52,115\nOffice expense 653\nTravelling expense 2,498\nOffice furniture and equipment 500\nMedical care 5,040\nMaintenance and operation of equipment 317\nGeneral supplies 56\nGeneral expense 145\nTotal $61,324\nMental Health Centre, Trail\nSalaries $37,547\nOffice expense 889\nTravelling expense 2,032\nOffice furniture and equipment 606\nMedical care 6,766\nMaintenance and operation of equipment 712\nGeneral expense 269\nTotal $48,821\nMental Health Centre, Nanaimo\nSalaries $37,457\nOffice expense 977\nTravelling expense 1,172\nOffice furniture and equipment 131\nMedical care 13,078\nMaintenance and operation of equipment 530\nGeneral supplies 57\nGeneral expense 243\nTotal $53,645\nMental Health Centre, Prince George\nSalaries $32,310\nOffice expense 850\nTravelling expense 3,185\nOffice furniture and equipment 1,199\nMedical care 3,495\nMaintenance and operation of equipment 34\nGeneral supplies 536\nMotor-vehicles and accessories 2,611\nGeneral expense 755\nTotal $44,975\n GENERAL ADMINISTRATION L 27\nTable J.\u00E2\u0080\u0094Expense Statement of the Community Services for 12 Months\nEnded March 31, 1968\u00E2\u0080\u0094Continued\nMental Health Centre, Kamloops\nTravelling expense $205\nMotor-vehicles and accessories 2,242\nTotal 2,447\nMental Health Centre, Chilliwack\nSalaries $36,847\nOffice expense 856\nTravelling expense 528\nOffice furniture and equipment 938\nMedical care 3,117\nMaintenance and operation of equipment 335\nGeneral supplies 100\nMotor-vehicles and accessories 2,294\nGeneral expense 454\nTotal $45,469\nGrand total, $1,369,437.\nMental Health Centre, Vernon\nSalaries $43,492\nOffice expense 1,049\nTravelling expense 2,380\nMedical care 6,338\nMaintenance and operation of equipment '. 611\nGeneral supplies 478\nTotal $54,348\nExpansion of Community Services\nAll expenditures $65,816\n L 28 MENTAL HEALTH BRANCH REPORT, 1967/68\nTable K.\u00E2\u0080\u0094Expense Statements of the Rehabilitation Department and\nOut-patient Services for 12 Months Ended March 31, 1968\nRehabilitation Department\nSalaries $216,879\nOffice expense 879\nTravelling expense 5,420\nOffice furniture and equipment 155\nMedical care 8,197\nDietary 10,067\nLaundry 81\nGratuities to patients 27,521\nTransportation 100\nGeneral supplies 5,356\nOccupational and recreational therapy 661\nGeneral expense 810\nBuildings, grounds, etc. 4,993\nTotal $281,119\nOut-patient Services\nSalaries _ $35,498\nOffice expense 133\nTravelling expense 1,873\nMedical care r 28,906\nDietary 139\nTransportation 903\nGeneral supplies 17\nGeneral expense 354\nTotal $ 67,823\nGrand total, $348,942.\n GENERAL ADMINISTRATION L 29\nTable L.\u00E2\u0080\u0094Expense Statement of General Administration\nfor 12 Months Ended March 31, 1968\nSalaries $303,641\nOffice expense 7,649\nTravelling expense 14,310\nOffice furniture and equipment 1,822\nGrant to trustees of Patients' Comfort Fund 8,000\nGrant to University of British Columbia for mental health\nresearch 30,000\nGeneral expense : 5,809\nSubscription, Social Service Index 4\nAdministration of Psychiatric Nurses Act 2,573\nCouncil of Psychiatric Nurses for Bursary Trust Fund 1,200\nMental health care 249,192\nTotal $624,200\nTable M.\u00E2\u0080\u0094Expense Statement of the Department of Nursing Education\nfor 12 Months Ended March 31, 1968\nSalaries $ 1,130,028\nOffice expense 5,724\nTravelling expense 1,856\nOffice furniture and equipment 293\nMedical care 845\nDietary 10,596\nLaundry 5,000\nGeneral supplies 17,044\nAudio-visual 260\nGeneral expense 3,795\nTotal $1,175,441\n L 30 MENTAL HEALTH BRANCH REPORT, 1967/68\nReconciliation with Public Accounts, 1967/68\nTable L\u00E2\u0080\u0094General Administration\u00E2\u0080\u0094\nSalaries $303,641\nExpenses 320,559\nVouchered expenditure $624,200\nDeduct salary adjustments 19,548\nAs per Public Accounts $604,652\nTable M\u00E2\u0080\u0094Department of Nursing Education\u00E2\u0080\u0094\nSalaries $1,130,028\nExpenses 45,413\nVouchered expenditure $1,175,441\nDeduct salary adjustments 16,476\nAs per Public Accounts 1,158,965\nTable J\u00E2\u0080\u0094\nMental Health Centre, Burnaby\u00E2\u0080\u0094\nSalaries $623,154\nExpenses 209,199\nVouchered expenditure $832,353\nDeduct\u00E2\u0080\u0094\nBuildings and grounds __ $65,810\nPortion of farm profit 235\n 66,045\nAs per Public Accounts 766,308\nMental Health Centre, Victoria-\nSalaries $110,685\nExpenses 49,554\nVouchered expenditure $ 160,239\nDeduct buildings and grounds 14,337\nAs per Public Accounts 145,902\nMental Health Centre, Kelowna\u00E2\u0080\u0094\nSalaries $52,115\nExpenses 9,209\nAs per Public Accounts 61,324\nMental Health Centre, Trail\u00E2\u0080\u0094\nSalaries $37,547\nExpenses 11,274\nAs per Public Accounts 48,821\n GENERAL ADMINISTRATION L 31\nReconciliation with Public Accounts, 1967/68\u00E2\u0080\u0094Continued\nTable J\u00E2\u0080\u0094Continued\nMental Health Centre, Nanaimo\u00E2\u0080\u0094\nSalaries $37,457\nExpenses 16,188\nAs per Public Accounts 53,645\nMental Health Centre, Prince George\u00E2\u0080\u0094\nSalaries $32,310\nExpenses 12,665\nAs per Public Accounts 44,975\nMental Health Centre, Kamloops\u00E2\u0080\u0094\nSalaries \t\nExpenses $2,447\nAs per Public Accounts 2,447\nMental Health Centre, Chilliwack\u00E2\u0080\u0094\nSalaries $36,847\nExpenses 8,622\nAs per Public Accounts 45,469\nMental Health Centre, Vernon\u00E2\u0080\u0094\nSalaries $43,492\nExpenses 10,856\nAs per Public Accounts 54,348\nExpansion of Community Services 65,816\nDeduct salary adjustments, all community\nservices 72,576\nTable C\u00E2\u0080\u0094Riverview Hospital\u00E2\u0080\u0094\nSalaries $8,240,791\nExpenses 3,871,034\nVouchered expenditure $12,111,825\nDeduct\u00E2\u0080\u0094\nSalary adjustments $425,928\nPortion of farm profits 59\nBuilding and grounds 1,340,131\n 1,766,118\n$10,345,707\nAdd sundry adjustments, board, rent, etc. 109,831\n6,760\nAs per Public Accounts 10,455,538\n L 32 MENTAL HEALTH BRANCH REPORT, 1967/68\nReconciliation with Public Accounts, 1967/68\u00E2\u0080\u0094Continued\nTable K\u00E2\u0080\u0094\nRehabilitation Department\u00E2\u0080\u0094\nSalaries $216,879\nExpenses 642,240\nVouchered expenditure $281,119\nDeduct\u00E2\u0080\u0094\nSalary adjustments $10,596\nBuildings and grounds __ 4,993\n 15,589\nAs per Public Accounts 265,530\nOut-patient services\u00E2\u0080\u0094\nSalaries $354,498\nExpenses 32,325\nVouchered expenditure $67,823\nDeduct salary adjustments 2,448\nAs per Public Accounts 65,375\nTable F\u00E2\u0080\u0094Valleyview Hospital\u00E2\u0080\u0094\nSalaries $2,276,059\nExpenses 672,457\nVouchered expenditure $2,948,516\nDeduct\u00E2\u0080\u0094\nSalary adjustments $111,756\nPortion of farm profit 4,692\nBuildings and grounds 92,669\n 209,117\n$2,739,399\nAdd sundry adjustments, board, etc. 22,691\nAs per Public Accounts 2,762,090\n GENERAL ADMINISTRATION L 33\nReconciliation with Public Accounts, 1967/68\u00E2\u0080\u0094Continued\nTable G\u00E2\u0080\u0094Dellview Hospital\u00E2\u0080\u0094\nSalaries $496,797\nExpenses 238,003\nVouchered expenditure $734,800\nDeduct\u00E2\u0080\u0094\nSalary adjustments $23,112\nPortion of farm profit 293\nBuildings and grounds 104,663\nDecrease in inventories 37\n 128,105\n$606,695\nAdd sundry adjustments, board, etc. 4,538\nAs per Public Accounts 611,233\nTable H\u00E2\u0080\u0094Skeenaview Hospital\u00E2\u0080\u0094\nSalaries $394,896\nExpenses 271,866\nVouchered expenditure $666,762\nDeduct\u00E2\u0080\u0094\nSalary adjustments $17,472\nBuildings and grounds 117,837\nDecrease in inventories 1,005\n\u00E2\u0096\u00A0 136,314\n$530,448\nAdd sundry adjustments, board, etc. 7,793\nAs per Public Accounts 538,241\nTable D\u00E2\u0080\u0094The Woodlands School-\nSalaries $4,600,977\nExpenses 1,400,203\nVouchered expenditure $6,001,180\nDeduct\u00E2\u0080\u0094\nSalary adjustments $215,940\nBuildings and grounds 451,689\nPortion of farm profit 8,095\n 675,724\nAdd\u00E2\u0080\u0094\nIncrease in inventories $8,176\nSundry adjustments, board,\netc. 35,382\n$5,325,456\n43,558\nAs per Public Accounts 5,369,014\n2\n L 34 MENTAL HEALTH BRANCH REPORT, 1967/68\nReconciliation with Public Accounts, 1967/68\u00E2\u0080\u0094Continued\nTable E\u00E2\u0080\u0094The Tranquille School\u00E2\u0080\u0094\nSalaries $1,798,061\nExpenses 1,014,990\nVouchered expenditure $2,813,051\nDeduct\u00E2\u0080\u0094\nSalary adjustments $80,820\nBuildings and grounds 437,730\nPortion of farm profit 12,611\n 531,161\nAdd\u00E2\u0080\u0094\nIncrease in inventories $9,901\nSundry adjustments, board,\netc. 28,593\n$2,281,890\n38,494\nAs per Public Accounts 2,320,384\nTable I\u00E2\u0080\u0094Net Undistributed Stores (as per Public Accounts) (prorated to Riverview, Woodlands, and Valleyview) 56,435\nTotal Mental Health Branch expenditure as per Public\nAccounts $25,423,936\n GENERAL ADMINISTRATION L 35\nPERSONNEL REPORT\nG. L. Tomalty, Departmental Personnel Officer\nReport for April 1, 1967, to March 31, 1968\nThe establishment of the Mental Health Branch increased during the fiscal year\nas follows:\u00E2\u0080\u0094\nDeputy Minister's office and community services 54\nIn-patient care facilities 92\nTotal 146\nAs of March 31, 1968, there were 4,060 persons on payroll. This is 49 more\nthan at the same time last year and is comprised of 54 employees of various classifications and five fewer student psychiatric nurses.\nOver-all staff turnover, excluding temporary relief staff, was down slightly, from\n28.6 to 26.7 per cent. Turnover of registered nurses, which was high last year, was\ndown by 11.6 per cent and female psychiatric nurses up by 6.3 per cent.\nThe declining trend in number of male psychiatric nurses has reversed to a\nslight rise of 12 in the past year. Enrolment of male student psychiatric nurses\nincreased by 6, from 14 to 20, as of March 31, 1968.\nMr. J. Dowling retired during the year, and Mr. G. L. Tomalty was appointed\nto take the position as Personnel Consultant.\nReport for April 1 to December 31, 1968\nMr. A. A. Bishop was appointed as assistant to Mr. G. L. Tomalty, Personnel\nConsultant, on May 7, 1968. As of December 1, 1968, the Personnel Consultant\nwas designated to be Departmental Personnel Officer. He will carry out personnel\nadministrative functions for the Deputy Minister, Mental Health Branch and the\nDirector, Mental Health Services.\nThe process of determining personnel requirements, writing and obtaining approval on new job specifications, requesting Orders in Council for positions remaining in Schedule B, and recruiting for the new British Columbia Youth Development\nCentre in Burnaby has continued throughout the year. The establishment is 107,\nand this unit receives administrative support from a combined (Mental Health\nCentre, Burnaby, and British Columbia Youth Development Centre) administrative\nestablishment with 54 positions. All requisitions for new positions in the British\nColumbia Youth Development Centre have been submitted, and approximately 50\nper cent of them have been filled. All senior positions have been assigned, except\nfor the senior psychiatric social worker.\nThe British Columbia Government referred salary and conditions of service\ndemands of the Psychiatric Nurses' Association to the British Columbia Mediation\nCommission. Hearings were held in Vancouver in September and October.\nRecommendations of the Commission were tendered in November.\nThe establishment of the Mental Health Branch increased during this period\nas follows:\u00E2\u0080\u0094\nDeputy Minister's office and community services 33\nIn-patient care facilities 89\nTotal 122\n L 36 MENTAL HEALTH BRANCH REPORT, 1967/68\nMental Health Branch units are now required to review all requests for classification reviews and submit a completed job description questionnaire along with a\nreport showing objective analysis of the position and justification for a classification\nreview. This is considered by the Mental Health Branch Personnel Officer, who\nmay further review the position at the unit. Submissions which warrant further\nconsideration are then forwarded to the Civil Service Commission Classification\nDivision for review and final decision.\nProgress has been made on bringing all Mental Health Branch personnel regulations up to date.\nWith priority on the personnel function, only one meeting of the Branch Safety\nCommittee has occurred. The existing safety programme within the Branch was\nreviewed, and an acceptable mental health safety programme is being developed.\n GENERAL ADMINISTRATION L 37\nSTATISTICAL TABLES\nTable A.\u00E2\u0080\u0094Summary Showing Over-all Staff Totals in Relation to\nSeparation and Recruitment\nStaff recruited, excluding students 1,404\nStaff separated, transferred, etc., excluding students 1,350\nIncrease 54\nTotal staff, excluding students, as of March 31, 1968 3,761\nTotal staff, excluding students, as of March 31, 1967 3,707\nIncrease 54\nQuarterly staff average, excluding students, 1967/68 3,805\nQuarterly staff average, excluding students, 1966/67 3,694\nIncrease 111\nMale Female Total\nStudent enrolment as of March 31, 1968 20 279 299\nStudent enrolment as of March 31, 1967 14 290 304\nChange +6 \u00E2\u0080\u0094 11\nStudent quarterly average, 1967/68 303\nStudent quarterly average, 1966/67 281\nChange +22\n L 38 MENTAL HEALTH BRANCH REPORT, 1967/68\nTable B.\u00E2\u0080\u0094Breakdown by Classification of Recruitment and Separation\nActivity for the Mental Health Branch, Excluding Student Psychiatric Nurses.\nRecruited Separated\nPhysicians 42 43\nDentists 1 1\nRegistered nurses 59 58\nPsychiatric nurses 304 289\nFemale psychiatric aides 318 308\nMale psychiatric aides 90 115\nTeachers 3 3\nOccupational therapists 18 23\nIndustrial therapists 4 3\nRecreational therapists 4 4\nPsychologists 14 18\nSocial workers (psychiatric) 32 29\nDieticians 3 3\nCooks 7 12\nKitchen helpers 75 66\nClerks 18 18\nClerk-stenographers 53 55\nTrades 10 8\nLaundry-workers 35 34\nMiscellaneous professional 18 15\nMiscellaneous technical 9 11\nMiscellaneous 287 250\nSub-totals 1,404 1,366\nMiscellaneous adjustments, transfers, etc \u00E2\u0080\u009416\nTotals 1,404 1,350\n\u00E2\u0096\u00A0\n GENERAL ADMINISTRATION\nTable C.\u00E2\u0080\u0094Summary of Staff Turnover\nBy Major Classification\nL 39\nClassification\n1966/67\n1967/68\nChange\nMale psychiatric nurses\t\nFemale psychiatric nurses..\nRegistered nurses \t\nPer Cent\n16.3\n24.3\n45.8\nPer Cent\n16.9\n30.6\n34.2\nPer Cent\n+0.6\n+6.3\n\u00E2\u0080\u0094 11.6\nNote.\u00E2\u0080\u0094Calculations made against the year-end staff totals.\nBy Pay Division\nPay Division\nTemporary\nRelief Staff\nExcluded,\n1966/67\nTemporary\nRelief Staff\nExcluded,\n1967/68\nPer Cent\nPer Cent\n16.3\n11.1\n19.1\n23.7\n24.7\n30.3\n26.4\n28.7\n40.9\n40.6\n21.5\n33.8\n36.8\n27.4\n21.9\n48.4\n25.9\n24.3\nGeneral Administration-\nDepartment of Nursing Education1..\nRiverview Hospital \t\nThe Woodlands School\t\nThe Tranquille School\t\nValley view Hospital\u00E2\u0080\u0094.\t\nDellview Hospital_\nSkeenaview Hospital\t\nMental health centres\t\nOver-all turnover..\n28.6\n26.7\n1 Student nurses not included.\nNote\u00E2\u0080\u0094Percentages calculated against year-end staff totals.\nTable D.\u00E2\u0080\u0094Comparison of Staff Totals by Unit with Totals for the\nPreceding Fiscal Year\nFiscal Year 1966/67\nFiscal Year 1967/68\nPositions\nin Establishment as of\nMarch 31,\n1967\nNumber on\nStaff as of\nMarch 31,\n1967\nPositions\nin Establishment as of\nMarch 31,\n1968\nNumber on\nStaff as of\nMarch 31,\n1968\n44\n63\n160\n43\n68\n135\n60\n68\n193\n45\n68\nMental health centres \t\n138\n267\n246\n321\n251\nIn-patient care\u00E2\u0080\u0094\n1,569\n868\n358\n444\n92\n74\n1,574\n886\n390\n446\n92\n73\n1,638\n873\n372\n443\n97\n74\n1,605\nThe Woodlands School .\t\n897\n378\nValleyview Hospital. \u00E2\u0080\u0094\t\n457\n97\n76\nTotal of vote.\u00E2\u0080\u0094 \t\n3,405\n3,461\n3,497\n3,510\n3,672\n325\n3,707\n304\n3,818\n325\n3,7611\n299\nTotals \u00E2\u0080\u009E\n3,997\n4,011\n4,143\n4,060\n1 Includes 123 part-time employees.\n L 40\nMENTAL HEALTH BRANCH REPORT, 1967/68\noo\nVO\nas\nX\nu\nfit\n<\n<\ntf>\n<\nX\no\nz\n\nHtr- co oo in t-^ rH\no\n<->\u00C2\u00A3\ni-|i Tt m Ov co co cs in\no\nuH\nm\" Tt cs th \noc\n\u00C2\u00AB-\nt* oo i i o :\n,H\nT-I\nCU\nft.\n,^\ncd\nCD 7-* ! ! 00 :\nO co : ! so !\nOS\nSO\nCO\nO\nH\nOS\nCO\nc\ncu\ntN ! ! !\ncs\nCS\n+\nxt\n3\n(U\nW\n>n CS | | to |\no\nTt\nvO\nrt\n+\nu\nca\n\n|\n00 CS ! -^o :\nrs\nr-\n+\n\u00C2\u00A3\n3\nU\nm vo r\u00E2\u0080\u0094 co oo co\n00\nCV|\nOs\n(J\nco Tt CO \u00C2\u00A9 fN \u00C2\u00A9\nes\nTt\n00\nTt\n0\nH\nvt_> r- co co t> ro\n1\nTf\nTt\n.2\nCO rH CS ri !\n2\n7\nU\n3\nCO ~h CS 0s fO Tt\nr~-\n^_i\nTt\nca\nCS CO rH OS Tt\nVD\nTj-\ns\nCO\nCO\n|\n\u00C2\u00A3\n__\n(U\nM\nCO O t\u00E2\u0080\u0094 ri OS VO\nfN\nr>\nr~\no\ns\nco tt ts cs r- oo\noo\nCO\no\nCN rH rH\nvO\nr-\nA\n1\n^j\n3\nB\nso cs r- co os in\nt-\nOS\nOs\n0\n00 rH 00 t> X> OO\nt>\nas\nu\nCO CS* VO vo' tN fN\nd\nCN\nCN\nV\nTt Tt Tt CO TT Tt 'CO\nTt\nTt\nw_\n\nVO Tt rH tH OS Tt\nvo\nr-\n>,\nCS\nTT\ntT\nPh\n\u00E2\u0080\u0094\n__\n\t\nCU\nco os as r- vo -H\nCS\nr>\nm\nts\ni\ncu\nTt O rH O0 SO\ntN\nr-\nm\nCN rH t-H !\nSO\ntn\n+\n<\u00C2\u00AB\n3\ncu\ncoossoTt-'-HCSOin\nooosinosoinooo\nm\nTt\nH\n0\nCO\nm\n3\nso ts rn ts\" m\" fN \u00C2\u00A9 CO\nm\"\nin\n\nPh\n1-1\n.-\n\u00C2\u00BB\nX)\ncd\n3\nC\n3\nP3\n0 O m d>\n!|If\ny o c c\nCA uU\nlies |\n-J._H\nOv |\n+4\n\"a\nc\n*\u00E2\u0096\u00A0\" 1\n3\nc\nc\nEn\nii\n5J\nc\nci\nC\nX\ns\n>\n_\n>\n3'.\nIf\nrH \nt-\ntU\n>\n(5\n>\n\"a.\ne\n\u00C2\u00AB\n3\ncV\nf-\n3\n3\nU\nO\nH\na\nC\n GENERAL ADMINISTRATION L 41\nREPORT OF COORDINATOR OF MENTAL RETARDATION\nPROGRAMMES\nJ. S. Bland, B.A., M.B., B.Chir., D.P.M.\nThe principal advances in services and facilities for the retarded in the past\nyear have been in the field of residential care. Two major developments have\ntaken place.\nIn November the Bevan Lodge Association in Courtenay finalized agreement\nfor a long-term lease on the Bevan Lodge complex, and in December the first residents were admitted. Bevan Lodge will ultimately accommodate 70 adult retarded\nof both sexes. It is suitable for those who have good self-care skills but who are\nunlikely to be able to manage independently. Initially the majority of residents are\ncoming from Woodlands and Tranquille Schools, but in keeping with the Department's aims of decentralization, they are primarily those whose former place of\nresidence was on Vancouver Island. Additionally the screening committee is considering suitable applications from the local area. The operation of Bevan Lodge is\na good example of co-operation between different Government departments and\nbetween them and local community effort.\nIn December the Provincial Government bought a residential school and\nconvent in Maillardville. This complex, known as the Maillardville Unit, is now\nan integral part of The Woodlands School. It will serve as a preplacement training\ncentre for the adult retarded. The programme will be geared to teaching the\nresidents self-care skills, socially acceptable behaviour, and basic knowledge about\ncommunity life. This will prepare them for subsequent living in supervised group\nhomes or boarding homes and working in sheltered workshops. The Maillardville\nUnit will have 50 residents.\nThe two facilities described above have provided an additional 120 residential\nplaces for the mentally retarded. As the programmes develop, many of the urgent\ncases on the waiting list will be admitted to vacant beds at Woodlands and Tranquille Schools.\nCo-ordinating mental retardation programmes implies co-operation, and this\nI have received in full measure from community agencies and other Government\ndepartments. I am grateful to them.\n L 42 MENTAL HEALTH BRANCH REPORT, 1967/68\nREPORT OF SOCIAL SERVICE CONSULTANT\nMiss A. K. Carroll, B.A., M.S.W.\nReport for April 1, 1967, to March 31, 1968\nDirect consultative service was given to nearly all facilities concerning the\nfollowing:\u00E2\u0080\u0094\n(1) Administration and organization of social service departments. Advice\nwas given in relation to the relocation of staff which the change in\nemphases from hospital to community-based services indicated.\n(2) Pre-admission and after-care functions of social service departments in\nthe mental health services.\n(3) Advice regarding the continuing need for administrative and organizational development in the family-care and boarding-home programme.\n(4) Programme suggestions for the remotivation of groups of patients resident\nin boarding and nursing homes.\n(5) Personnel recruitment, maintenance, and retention; staff patterning;\nstaff development; and advice in relation to the possibility of the use of\nlevels workers to assist and extend the contribution of professionally\ntrained social workers.\nDuring the year 26 social-work students from the School of Social Work of\nthe University of British Columbia were placed in the social service department of\nthe Mental Health Branch for field-work practicum. Of this group, 21 students\nwere in their second year of graduate study and five were in their first.\nFederal mental health bursaries were granted to seven students, six of whom\nwere proceeding to the second year of graduate studies and one to the first year.\nOf this group of seven students, five were members of the social-work staff of the\nMental Health Branch and two were students graduating from the first year of\ngraduate studies at the School of Social Work of the University of British Columbia.\nDuring the year 10 students who had completed studies under Federal mental health\ngrants returned to social-work positions in the Mental Health Branch. The scholarship level of this group was notable in that four graduated with first-class standing\nand six with a high second-class standing.\nThis year showed the beginning of a change in the recruitment picture in that\na considerable number of social-work personnel were recruited from the graduating\nclasses of schools of social work and from social-work practitioners in and outside\nof the Province. The activities in recruitment are carried out in close co-operation\nwith the Chief Personnel Officer of the Civil Service Commission. This year the\nConsultant interviewed some 42 persons who were inquiring about opportunities\nfor social-work practice in the Mental Health Branch. In and around these applications, some 61 letters were written regarding references, etc. In several facilities\nin the Mental Health Branch, the welfare aide is being tried and the contribution\nevaluated. Additionally, personnel with undergraduate degrees in social welfare\nare being employed. This group certainly comes to the services with a very good\nbackground of training, and their contribution indicates that they are a most\nvaluable levels worker in the field of social work.\nAt the end of the year, there were 583 patients on boarding-home leave under\nsupervision of the Mental Health Services. This group is comprised of patients\nreleased from the four major mental health facilities, and is up from a figure of 523\nfor the previous year.\n GENERAL ADMINISTRATION L 43\nThe programme from Riverview did not expand to any great extent through\nplacements from the chronic care units, but the resources of the programme were\nused more extensively by the admitting units than was the case in previous years.\nIt was noted that patients from these latter units, in some cases, did not adjust\neasily to boarding-home care, and some investigation of this problem is needed.\nPossibly more extended use of the Hillside Unit is indicated for certain cases proposed for boarding-home care. The placements made from Hillside were very\nsuccessful, proving the value of the unit for boarding-home preparation.\nThere was a significant upswing in placements from The Woodlands School\nduring the year. Some severely retarded persons were placed and one who is\nprofoundly retarded. It was found that placing retardates and improved mentally\nill together in the same home was good social planning on balance, although this\ntype of grouping is still being evaluated.\nThe Burnaby training home continues to function well, showing impressive\nresults in rehabilitation. In a second home for younger female patients from Riverview, good results are being achieved through the development of a motivational\nprogramme. In a third home, which is a large farm in the country, a good motivational programme for young male schizophrenics is gradually taking shape.\nFour patients from Riverview were discharged to full-time employment during\nthe year, and eight employed and self-supporting persons remain on in their boarding homes still on leave. One of these latter persons is a man of 62 who spent 34\ncontinuous years in Riverview Hospital.\nConsolidation, as well as expansion of the programme at two community\ncentres for occupational therapy, was effected during the year through the efforts\nof the occupational therapist from Riverview and community service groups. A\nthird small centre was started in Maillardville. Retardates from boarding homes\nare included in these programmes, as are a few community people with other\nhandicaps. Some workshop activities were carried on in the centres financed by\ncommunity service group funds and returns from sale of goods. This is a small\nproject as yet, but could expand.\nReport for April 1 to December 31, 1968\nOver the past nine months a great push forward in regional planning for the\nboarding-home programme has taken place, with the development of a Central\nReferral Bureau Centre for the South Vancouver Island area. The Mental Health\nBranch, as one agency co-operating in the Central Referral Bureau programme, will\nprovide fully trained and experienced social workers, who will render social services\nto residents in boarding and nursing homes. Additionally these social workers will\nbe active in the development of programmes which have higher motivational standards of care and which permit creative and occupational skills.\nThe work of the Consultant in the following special committees has continued:\u00E2\u0080\u0094\n(1) Interdepartmental Case Review Committee.\u00E2\u0080\u0094This Committee has submitted special studies of the conditions of children in need of residential\ntreatment and training, as well as produced a written submission concerning the spectrum of services which these troubled children and families\nrequire. The Consultant also submitted a report on programmes and\nfacilities for the retention and retraining of severely behaviourally disturbed adolescents, and additionally appeared before a special committee\ncharged with the extensive study of the needs of this group of children\nat grave risk.\n L 44\nMENTAL HEALTH BRANCH REPORT, 1967/68\n(2) Bevan Lodge Association.\u00E2\u0080\u0094The Consultant has assisted the Bevan Lodge\nAssociation of the Courtenay Mental Health Society in its conceptualization of organization and programme in the Bevan Lodge. The Consultant has, additionally, provided assistance to the association in staff\npatterning and positioning. An in-service training programme has been\nformulated and advice given related to a process of co-ordination of the\nBevan Lodge service with other services existing in the community.\n(3) Welfare Institutions Licensing Board.\u00E2\u0080\u0094The Welfare Institutions Licensing Board has approved the development and the licensing of a number\nof outstanding boarding homes and special-care facilities for the personal\ncare and attention or training of the adult mentally disabled. Notably\nthe opening of two new boarding homes in the Upper Vancouver Island\narea has greatly extended and enriched the services to this group of\nhandicapped persons.\n(4) Liaison Committee.\u00E2\u0080\u0094The Liaison Committee has continued as an effective body in the interdepartmental study and interconsultation around\nprogrammes, procedures, and services relative to family and child welfare,\ntreatment resources, and community care services for both children and\nadults.\nIn all, the last nine months have been notable in bringing to fruition plans and\nservices so basic to the community care and treatment of the mentally ill and so\nimportant in the furtherance of community mental health programmes and services.\nThese last months have presented challenge, stimulation, and, to a degree, the\nsatisfaction of achievement.\nTABLES AND NOTES\nTable 1.\u00E2\u0080\u0094Boarding-home Programme, Calendar Year 1967\nPatient Movement\nRiverview\nHospital\nValleyview\nHospital\nWoodlands\nSchool\nTranquille\nSchool\nNumber of patients on boarding-home programme as of January 1, 1967.\nNumber of new placements during year \t\nNumber of returns to boarding-home care from hospital (replacements ).\nNumber of returns to institution during year..\nDeaths\t\nDischarged from boarding-home programme.-\u00E2\u0080\u0094 \t\nNumber of patients on boarding-home programme as of December 31, 1967. - \t\n337\n92\n32\n86\n2\n16\n1101\n56\n12\n23\n1\n42\n521\n30\n20\n19\n357\n112\n78\n362\n1 Revised figure.\n2 Figures in this column are estimated.\nEXPLANATORY NOTES\n1. A significantly larger number of patients (86) were returned to Riverview Hospital during the year, and\na significantly larger number of these patients remained in hospital (Table 3) than was the case in 1966. This\nmay be related to the fact that there was a freer movement back into hospital for examination or assessment due\nto shortage of both medical and social-work staff to visit the homes. In-hospital staff shortages resulted in delays\nin replacing patients in boarding homes and in less accurate assessments for suitability for boarding-home care.\nA number of patients placed directly from the admitting units did not settle in the boarding home, possibly finding this situation too alien to them at their stage of illness. It is interesting to note that in January, 1967, 13\npatients returned to hospital.\n2. Of the 16 Riverview patients discharged from boarding-home leave, four went to full-time employment,\neight returned to families, three to living independently on Social Allowance, and one to a training programme.\n3. The significantly lower net gain in Riverview persons carried on boarding-home leave at the end of the\nyear as compared with the previous year is related to problems in shortages of in-hospital staff time; lack of\ndevelopment of new resources; sharing of available resources with The Woodlands School, community agencies,\nand admitting units of Riverview (extended-leave patients); availability of suitable candidates for boarding-home\ncare.\n4. The 42 patients discharged from Valleyview were seen in the homes by Dr. Walsh and this decision made.\nFor the most part, they were persons of independent means.\n5. The total of 33 placements made during the year from The Woodlands School was up from nine placements made the previous year.\n GENERAL ADMINISTRATION\nTable 2.\u00E2\u0080\u0094Analysis of Returns to Institutions, 1967 (1)\nL 45\nReason for Return to Institution\nRiverview\nHospital\nWoodlands\nSchool\nTranquille\nSchool\nReturned for reason of psychiatric illness or behaviour problem \t\n76\n10\n4\n3\n4\n5\nTotals -\n86\n7\n9\nTable 3.\u00E2\u0080\u0094Analysis of Returns to Institutions, 1967 (2)\nDisposition of Cases\nRiverview\nHospital\nValleyview\nHospital\nWoodlands\nSchool\nTranquille\nSchool\nReplaced in boarding-home care following hospitalization-\t\n12\n74\n12\n11\n2\n5\n3\n6\nTotals \t\n86\n23\n7\n9\nTable 4.\u00E2\u0080\u0094Patients on Boarding-home Leave Employed\nas of December 31, 1967\nDegree of Employment and Earnings\nRiverview\nHospital\nWoodlands\nSchool\nTranquille\nSchool\nNumber of patients fully employed and self-supporting \t\nNumber of patients fully employed and partially self-supporting\t\nNumber of patients partially employed and partially self-supporting\t\nNumber of patients with seasonable jobs or small but regular job and\nearning own comforts, etc.\nNumber of patients employed in sheltered workshop-\nTotals \t\n29\n43\n13\n L 46 MENTAL HEALTH BRANCH REPORT, 1967/68\nREPORT OF NURSING CONSULTANT\nMiss N. M. Lonergan, B.S., N.Ed., M.N.\nReport for April 1, 1967, to March 31, 1968\nResponsibilities fulfilled during the period of time reviewed in this report were\ndivided evenly between those arising from commitments to nursing education and\nthose to nursing consultation services. A report on the former is confined to major\nactivities of the Department of Nursing Education, whereas that on the latter encompasses undertakings in conjunction with administrators of nursing services,\nperiodic tasks concerning mental health programmes, participation in nursing matters involving government, professional and educational organizations, and community health agencies.\nNURSING EDUCATION\nThe Department of Nursing Education continued to operate its basic programmes\u00E2\u0080\u0094the psychiatric nursing programme, the psychiatric aide programme, and\nthe affiliate programmes in psychiatric nursing. The year-end census for the psychiatric nursing programme was 299 students, compared with 304 for the year ended\nMarch, 1967. The Department processed 389 applications. A total of 171 students\nenrolled in the fall and spring classes; 47 per cent of these had been registered in\nan academic secondary-school programme and the remainder in a vocational one.\nDuring the year 62 students withdrew, 38 due to personal reasons, 7 because of\nillness, and 12 failed academically. One student was fatally injured in a traffic accident. Of the 125 students who completed the programme, 103 were employed by\nthe Mental Health Branch.\nThe faculty continued to develop a variety of techniques for improving the\ncorrelation of academic and clinical student learning experiences. In all areas, students participated in planned ward clinics two hours a week. Instructors used interaction studies and nursing-care plans with some measure of success as tools for\nenhancing the learning of quality nursing care. Formal teaching hours number\n3,692, an average of 263 hours by each teacher. Compared to the previous year,\na significantly greater proportion of each instructor's time was used for clinical teaching in the form of supervision, demonstration, and teacher-student interviews.\nThe psychiatric aide programme offered 39 five-day courses. Of these, 19 were\nconducted at the Education Centre, 18 at The Woodlands School, and 2 at The\nTranquille School. The courses encompassed 1,215 hours of instruction for 375\naides entering the service or on staff at Riverview Hospital, Valleyview Hospital, The\nWoodlands School, and The Tranquille School. Courses were also conducted at\nSkeenaview and Dellview Hospitals to supplement ongoing orientation and in-service\neducation provided in these institutions. The number of class hours showed an\nincrease of 50 per cent; the number of clinic hours, an increase of 130 per cent;\nand the number of aides attending class, an increase of 80 per cent, compared with\nthe figures for the previous year. The scope of the clinical teaching programme was\nenlarged to include all three institutions on the Lower Mainland.\nAffiliate programmes in psychiatric nursing operated for students in the schools\nof nursing of the Royal Columbian Hospital, New Westminster; St. Joseph's Hospital, Victoria; and St. Paul's Hospital, Vancouver, and for public health nurses of\nthe Health Branch. Numbers enrolled in the eight-week programmes totalled 256.\nThe annual review of terms of agreement between the Mental Health Branch and\nthe general hospital schools of nursing took place in March with resultant minor\n GENERAL ADMINISTRATION L 47\nmodification of some items. A senior instructor, appointed in September, was\noriented and assigned teaching responsibilities in the programmes.\nFaculty committees were productive and enjoyed a noticeable improvement in\nquality and efficacy of communication. The residence staff provided accommodation\nfor 560 residents, of whom 513 were newly enrolled students and transient guests.\nInfirmary nurses gave nursing care to 244 students and minor assistance to over\n3,000. The secretariat dealt admirably with its large volume of work and the constant demands of programme deadlines. Alterations in work schedules and job\nassignments resulted in improved maintenance service. The Department was ably\nadministered by the Assistant Director during the frequent absence of the Director.\nNURSING CONSULTATION\nProminent among nursing matters engaging the Consultant in her work with\nnurse administrators were the following:\u00E2\u0080\u0094\n(a) Reviewing policies with the purpose of determining their effect on the\namount of nursing-service time available for patient-care.\n(b) Determining quantity and quality of nursing care in the institutionalized\nservices according to nursing personnel-patient ratios.\n(c) Developing criteria for determining similarities and differences in the\nresponsibilities and functions of Director of Nursing positions within the\nBranch and their comparability to similar positions in the community.\n(d) Studying administrative problems affecting nursing practice.\n(e) Actioning matters referred to Nursing Council.\n(/) Developing plans and proposals for continuing educational opportunities\nfor nursing personnel, both in-service and through community resources.\nNurses from community mental health centres met in conference for the first\ntime in November. They decided that regular meetings were desirable for purposes\nof education, communication, consultation, and co-operation. By the end of the\nfiscal year, some groundwork had been accomplished in preparation for a study of\nthe role of the nurse in a community mental health centre. Plans were also formulated for holding a workshop to assist in such a study.\nThe Nursing Liaison Committee, with a representative membership from\nagencies and institutions engaged in mental health work, met bi-monthly. The\nmajor purpose of discussions and presentations was to facilitate exchange of information concerning developments in community health programmes and psychiatric\nservices, and the implications of these for nursing practice, the role of the nurse in\nrelation to other health workers, and interagency communication systems.\nThe Nursing Consultant conducted studies, prepared reports, and participated\nin planning concerned with nursing administration, practice, and education. She\nrepresented the Branch at various meetings concerned with nursing matters engaging\nthe attention of government, professional organizations, and community institutions\nand agencies. Visits were made to a number of Mental Health Branch facilities;\nin conjunction with these, she was a guest in several health units for orientation and\ncommunication purposes; similarly, she met with nurse administrators of two\ngeneral hospitals for discussions concerning psychiatric facilities and nursing care.\nThe prevailing atmosphere throughout the year was one of optimism as general\nreorganization plans were initiated and began to influence and stimulate nursing\ndepartments throughout the Mental Health Branch.\n L 48 MENTAL HEALTH BRANCH REPORT, 1967/68\nReport for April 1 to December 31, 1968\nDuring the period reviewed by this report, nursing consultation services were\nprovided part time from April to September, and then full time to the end of the\ncalendar year. Many of the Consultant's activities derived from the decisions and\nrecommendations of various nursing committees.\nThrough its Nursing Council, Directors of Nursing obtained a widening of\neducational opportunities for nursing personnel; achieved some progress regarding\nproposed changes in senior nursing positions, classifications, and salaries; submitted estimates concerning the reduction of nursing-service time occasioned by the\nintroduction of revised personnel policies; conducted studies to determine the effect\nof illness, absence, and tardiness on the quantity and quality of nursing care available to patients; and made recommendations relevant to the improvement of nursing\npractice.\nThrough the Nursing Liaison Committee, Directors of Nursing of the Mental\nHealth Branch and nurse representatives of several community institutions and\nagencies held bi-monthly meetings. These provided opportunities to examine facilities and programmes concerned with psychiatric and mental health services in\nthe Greater Vancouver area.\nThe Mental Health Nurses Council convened bi-monthly in Vancouver. It\nmade considerable progress in defining responsibilities and functions of the community mental health nurse. A workshop supported financially by a Federal training grant and directed by a visiting consultant from Rutgers University, New Jersey,\nprovided opportunities for problem identification, review of theoretical concepts,\nand exploration of attitudes, approaches, and techniques useful to the nurse in\ntherapeutic counselling and collaborative teamwork.\nThe Nursing Consultant represented the Branch as a member of several standing, task, and advisory committees on nursing standards and education in the\ncommunity, at hearings concerned with nursing personnel policies, and by convening\nmeetings to establish terms of agreement for the use of Branch facilities by affiliating\nnursing students from educational institutions. Other activities included participation in recruitment for selected positions, preparation of reports on education, staffing patterns and nursing practice, and the provision of regular consultation to the\nDepartment of Nursing Education.\nDuring the latter three months of the year, time was devoted to the termination\nof previous responsibilities, orientation to the nursing position within the terms of\nreference of the Deputy Minister's consultant staff, and consideration of the scope of\nnew responsibilities with beginning delineation of possible priorities.\n GENERAL ADMINISTRATION L 49\nREPORT OF THE STATISTICIAN AND THE\nMEDICAL RECORDS CONSULTANT\nR. S. McInnes, B.A., B.D., M.P.H.\nMrs. P. A. West, R.R.L.\nApril 1, 1967, to December 31, 1968\nIn this reporting period, new units were added to the statistical reporting system.\nThe Branch acquired a statistician on its own staff, and medical records sections in\nlocal units have been strengthened. Early in the period the research officer from\nthe Division of Vital Statistics of the Health Branch, who gave most of her time to\nmental health statistics, resigned. Further assistance on a part-time basis was given\nby another research officer from the Vancouver office of the Division of Vital Statistics. In September, 1968, a statistician was hired by the Mental Health Branch\nfor its headquarters in Victoria. Data processing and tabulation assistance continues to be provided by the Vital Statistics Office in Victoria.\nInitial steps have been taken to explore the possibility of putting the Mental\nHealth Branch statistical system onto a computer. There are many needed analyses,\nsuch as length-of-stay experience of various hospitalized patients, which require the\nlarge capacity and calculating abilities found only in an electronic computer.\nTHE STATISTICAL DATA SYSTEM\nReporting Form Development\nNew or revised individual patient statistical reporting forms were developed\nfor several Branch units. Much time was spent in the revision of the forms used\nby the mental health centres. Temporary forms were first introduced in the early\npart of the year. From these a streamlined, multi-part, largely pre-coded form\nwas finalized with an accompanying manual of instructions, definitions, and code.\nAlso at the beginning of the period, a revised statistical form providing more\ndetailed diagnostic and treatment data was introduced at the Riverview Hospital.\nThe Medical Records Consultant and the Vital Statistics research officer held a\nconsultative meeting with the senior medical records clerks to review the revisions\nand the accompanying manual of instructions and definitions.\nIn the fall of 1968, to meet medical records standards required by the Canadian\nCouncil on Accreditation of Mental Hospitals, the Riverview Hospital reporting\nsystem was changed. These changes will materialize January 1, 1969.\nWith the creation of the British Columbia Youth Development Centre at\nBurnaby, a statistical form and a manual of instruction were developed. The special\nneeds of this facility, with its out-patient, day care, and in-residence programme,\nrequired a careful blending of reporting systems previously used, modified to fit\na children's facility. This package will be implemented on January 1, 1969.\nPlans for developing statistical data forms for The Tranquille School, Dellview\nHospital, and Skeenaview Hospital were temporarily deferred as the result of the\nresignation of the Vital Statistics research officer in October, 1967.\nProcedure Development\nIn order that all in-patient facilities might report patients' incoming and outgoing movements consistently to the Public Trustee, work was commenced on the\nstandardization of reporting forms. A meeting of the business administrators and\n L 50 MENTAL HEALTH BRANCH REPORT, 1967/68\nthe Public Trustee was held to discuss questions relating to the forms, with drafts\nbeing presented for consideration and approval. These changes take effect in\nOctober, 1968.\nA standardized \" form for consent for release of information \" and \" a boarding home treatment record form \" were designed and implemented. The latter\nprovided community doctors with an adequate medical and psychiatric summary\non patients transferred to boarding homes and provides a means for the attending\nphysician, or hospital psychiatrist, to record patient's progress, changes in medication, and other information which would become part of the patient's permanent\nmedical record.\nA procedure manual for medical records departments in mental health centres\nwas compiled and copies distributed to each centre. These provide guidelines for\nuniform medical records and guidance to clerical staff acting as medical records\nclerks.\nData Retrieval\nEarly in the period the Vital Statistics research officer made a study of the\ndata collected during the first three months of mental health centre reporting.\nTables were presented at a meeting of the directors of the mental health centres.\nThese stimulated discussion around some of the apparent trends disclosed in her\nstudy. Many requests for data were received from members of the medical staff\nand other professional staff members within the Mental Health Branch. In planning for the British Columbia Youth Development Centre, data were provided in\nthe form of listings of cases according to age-group, sex, residence, and diagnosis.\nOutside the Mental Health Branch, data were provided to the Public Health\nBranch\u00E2\u0080\u0094relationship between retardation and postnatal cerebral infection through\nmeasles (rubella) virus; University of British Columbia Departments of Psychology and Psychiatry\u00E2\u0080\u0094studies related to suicides; University of British Columbia\nSchool of Social Work\u00E2\u0080\u0094patients discharged from Riverview Hospital; University\nof British Columbia Department of Pharmacology\u00E2\u0080\u0094Huntington's chorea cases\ntreated in mental health facilities.\nADMINISTRATIVE AND PLANNING STUDIES\nA number of studies have been launched by the statistician utilizing Mental\nHealth Branch data and data from other sources. These include the following:\nThe need for psychiatric beds for aged persons; regional profiles of mental health\nneeds and resources; trends in Mental Health Branch services and characteristics\nof patients; the role of mental health centres in reducing admissions to the Riverview Hospital.\nMEDICAL RECORDS DEVELOPMENT AND REPORTING CONTROL\nA large proportion of the time of the Medical Records Consultant was spent\nin assistance to medical records units in development of their procedures, and in\nthe accurate and prompt completion of statistical reporting forms. During the\nperiod both Woodlands and Valleyview Hospitals completed the updating of\nadmissions statistics detail to bring their data into line with the new procedures\ninitiated on April 1, 1966. Visits were made to almost all of the Mental Health\nBranch facilities by the Medical Records Consultant for purposes of consultation\nand in-service training of medical records personnel. The opening of new units\nwithin the Branch necessitated special efforts on the part of the Medical Records\nConsultant to introduce their staff to the reporting system and the essentials of\nmedical records organization and maintenance.\n GENERAL ADMINISTRATION\nL 51\nOn August 1, 1967, Miss L. McSweeney, R.R.L., was appointed to the position of medical records librarian at the Riverview Hospital. Orientation to Mental\nHealth Branch and intensive consultative services were given during the first few\nweeks following her appointment. It was not long before progress was being made\nat Riverview in reactivating the Medical Records Committee and developing a Medical Audit Committee; also preparations to meet the standards required by the\nCanadian Council on Accreditation of Mental Hospitals were begun.\nIn October, 1967, a meeting of the medical records supervisors from all the\nmental health centres was held at the Vancouver branch office. The meeting provided instruction on the completion of the statistical forms and discussion regarding\nvarious aspects of the management of medical records in the mental health centres.\nThe need for formally trained medical records personnel is becoming increasingly apparent as more demands are being placed on medical records departments\nfor service and research projects. It should be noted that this need will be partially\nmet at Riverview Hospital when four medical records personnel presently taking\nthe correspondence course jointly sponsored by the Canadian Hospital Association\nand the Canadian Association of Records Librarians will have qualified as medical\nrecords technicians or medical records clerks.\n L 52 MENTAL HEALTH BRANCH REPORT, 1967/68\nREPORT OF CONSULTANT IN SOCIOLOGY\nRay H. Goodacre, B.A., M.A., M.P.H.\nThis consultant was appointed to the Victoria Mental Health Branch office\nin June in order to (a) participate in the clarification and definition of over-all goals\nfor the Mental Health Branch; (b) develop applied research techniques to evaluate\nthe effectiveness of programmes; (c) act as a consultant to mental health centres\nand institutions wishing to carry out sociological research.\nVisits, most of which commenced during the fall, were made to mental health\ncentres and treatment institutions to review the programme of each facility in order\nto determine programme objectives and methods available for ascertaining the\nextent to which programme objectives were being met.\nConsultative service, including the preparation of interview schedules, was\nprovided to the Northern Interior Mental Health Centre in studying the views of\nformer patients toward care received and their present level of functioning.\nWith the co-operation of the Health Branch Division of Vital Statistics and\nthe staff of Riverview Hospital, a detailed analysis was made of the characteristics\nof Riverview patients admitted from Vancouver Island. This study was initiated to\nassist in planning for bed occupancy at the new Eric Martin Institute in Victoria.\nIn order to facilitate decentralization of the planning and operation of mental\nhealth services, the Province has now been divided into a number of planning regions. Following a review of boundaries currently in use by a number of Government departments administering and financing health and social services, eight\nmental health planning regions were selected. In determining boundaries appropriate for proposed mental health regions, particular recognition was made not only\nof an increasing emphasis by mental health centres on education, prevention, and\nrehabilition, but also an active desire by the Branch to encourage community participation in the planning and financing of a range of mental health services.\n GENERAL ADMINISTRATION L 53\nREPORT OF THE DIRECTOR, INFORMATION SERVICES\nPeter J. Smith, C.P.R.S.\nMay, 1968, saw the establishment of an Information Services Section at the\nVictoria office of the Mental Health Branch. The first and immediate task was to\nendeavour to improve communications between the Branch and the general public\nvia the news media, radio, and television.\nDuring a brief orientation period it was found that some form of communication\nwas also needed that would convey news of happenings and developments from the\nhead office and out to the various institutions and mental health centres. To this\nend a Mental Health Branch newsletter was designed and is now published on a regular monthly basis, with 300 copies mailed throughout the Branch.\nPress releases and news releases have also been prepared and mailed as and\nwhen required. A mailing list of weekly and daily newspapers and radio and television stations has been set up, and it is intended to send out items of special interest\non a regular monthly basis.\nIn June the writer accompanied a C.B.C. producer and camera crew around the\nValleyview Hospital. Medical staff were interviewed and certain film sequences\nwere taken for use in a documentary film on \"Ageing,\" which was aired on December 10, 1968.\nThe Mental Health Branch exhibit in the British Columbia Government Building on the Pacific National Exhibition grounds, Vancouver, was updated.\nCo-operation with the Canadian Mental Health Association has been maintained, and during October spot radio announcements were provided by this department for use by the Canadian Mental Health Association on Victoria's Mental\nHealth Day.\n COMMUNITY MENTAL HEALTH SERVICES L 55\nPART II.\u00E2\u0080\u0094COMMUNITY MENTAL HEALTH SERVICES\nMENTAL HEALTH CENTRE, BURNABY\nA. D. Sleigh, B.A., M.D., C.R.C.P., Director\nReport for April 1, 1967, to March 31, 1968\nDuring the period under review there were a number of important changes\noccurring in this mental health centre. These changes stem from the organizational\ninnovations of the previous year, and this period under study should be considered\nas a transition period for this centre. It would be useful for the reader to refer back\nto the previous year to obtain continuity and perspective.\nThe over-all changes have been going on to establish this clinic as a true\nregional community mental health centre for Burnaby and to ready the unit for the\nincorporation of the new residential treatment unit for emotionally disturbed children. Once the reorganization has been completed, then the mental health centre\nwill be divided into two separate units with very different functions. To summarize,\nthere will be a community mental health centre for Burnaby and a comprehensive\nchildren's treatment unit for children and adolescents of the Province.\nDIRECT SERVICES\nAdult Clinic\nThere was a general levelling-off of service during the year with 855 activations\nin 1967 to 1968, compared to 851 activations in the previous year. Nine hundred\nand one cases were closed during this year, whereas in the previous year 822 cases\nwere closed. This shows that there was a large measure of work completed and with\na fairly brisk turnover of patients.\nAs in the previous year, the sustaining clinic case load showed another increase\nand now amounts to 40 per cent of all cases treated in the Adult Clinic. Again this\nseems to reflect the fact that many of our patients need fairly intensive chemotherapy.\nAs in the previous year, special clinics were organized to handle the sustaining\nclinic case load. Group therapy and family group therapy continued to be used\nextensively by almost all staff members, but the basic treatment tends to remain the\nindividual psycho-therapy session. The patients seen at this clinic vary a great deal\nin their particular needs, and in some cases are seen very intensively, whereas others\nare seen for perhaps 15 minutes every month or even every two months.\nInnovations, too, have been tried by staff to give better patient-care. One such\ninnovation has been the use of marathon group therapy.\nIn the area of the day-hospital operation, the unit functioned effectively during\nthe year with a part-time psychiatric director. Further development occurred in the\noperation of a true therapeutic community with the focus on problem-solving for the\npatients through a \" here and now \" experience or experiences. The day hospital\noperated with essentially full capacity all year, with waiting lists needed from time\nto time. The admissions increased 14 per cent over the previous year, with the average length of stay decreasing from 24 to 22 days. The readmission rate gives some\nreason for concern at 35 per cent, but again this has shown a decrease from the\nprevious year, when there was a 37-per-cent readmission rate. The population\nshowed a composition of 66 per cent female patients and 34 per cent male patients,\nand this is typical for this day hospital.\n L 56 MENTAL HEALTH BRANCH REPORT, 1967/68\nChildren's Clinic\nIn comparing the year under study with the previous year, there seems to be no\nbasic change in the service given. Records show that there were 956 activations\nduring the year, as compared to 986 in the previous year. There were 1,207\npatients closed from the clinic, as compared to 977 in the previous year. The\nout-patient treatment typically centres on individual casework or psychotherapy\nsessions but, as in the last few years, there has been a fair emphasis on family group\ntherapy methods. In the previous year there were four care-giving teams in the\nchildren's unit, but these teams were amalgamated into two treatment teams, and\nneither team specialized in a particular treatment mode. This gave the advantage\nof comprehensiveness of treatment of a patient on the one team\u00E2\u0080\u0094one of the major\naims of this reorganization. However, the reorganization was also required by the\nfact that in the past we have depended on child psychiatrists, or psychiatrists trained\nat least in part in child psychiatry, to head up teams, and during the second half of\nthe year under review there were only two full-time psychiatrists on staff.\nIn terms of innovations in treatment, it should be mentioned that there was\nextensive use of the video-tape recorder unit in both clinics. The Children's Clinic\nstaff used it very effectively for training purposes, and also for treatment purposes,\nespecially in regard to confronting patients and families with their ongoing behaviour.\nThis equipment has proved to be very effective for all forms of group therapy and\nin dealing with individuals who need to see very directly how they behave and how\nthey affect others.\nThe day centre operation was without a director for much of the year, and this\nreduced its effectiveness to some degree. During the year a total of 55 children was\ntreated in this service, and during the summer a special programme was conducted\nfor the purposes of more intensive observation and assessment of a number of children on the Out-patient Clinic case load. An afternoon programme was also\norganized for children with learning problems, and the very small staff of this unit\nwas augmented by a psychologist and volunteer teacher coming to the unit to assist\nthe children with a classroom-type learning experience. Certain conditioning techniques were demonstrated to other staff in this programme and proved very effective.\nForensic Clinic\nAt the time of writing, this clinic is only partly functional as it presently consists of only the psychiatric social worker and a clerk. During the fiscal year the\ndirector resigned, and as yet a replacement has not been found.\nTravelling Clinics\nThere was no basic change in the functioning of this part of the clinic service\nto outlying areas. A certain amount of difficulty was experienced in maintaining\ncontinuity of psychiatrists for the treatment teams that went out to the Skeena area,\nPowell River-Sechelt area, Simon Fraser area, and the Boundary area. This was\ndue to the general shortage of psychiatric personnel and to the fact that the few\npsychiatrists on staff were already taxed with other service requirements. In many\ninstances the social workers acting as travelling clinic and community consultants\nhad to work on an independent basis.\nINDIRECT SERVICES\nAs before, this Clinic has continued to be very much involved in indirect services to the Province of British Columbia. One psychiatrist from the Children's\n COMMUNITY MENTAL HEALTH SERVICES L 57\nClinic continued to give special consultation to such agencies as the Children's Aid\nSociety, the Catholic Children's Aid Society, the Juvenile Courts of Vancouver and\nBurnaby, and the Brannan Lake training-school. Again certain group-living homes\nin the Lower Mainland area were given a screening and consultation service when\nrequired from our senior psychiatrist of the Children's Unit. He also gave consultation to the New Denver school for boys. As in the previous year, the Special\nPlacement Division of the Child Welfare Department worked in close liaison with\nour Children's Unit.\nTRAINING AND EDUCATION\nAlmost all staff members were involved in lectures, talks, seminars, and workshops that were organized to educate the community in mental health and mental\nhealth practices. This type of education and involvement of our staff ranged from\nanswering telephone inquiries to giving formal lectures and seminars. Some staff\nmembers gave literally dozens of talks and lectures to the community. Some very\ninteresting developments occurred, and one that should be mentioned is the fact\nthat the team psychiatrist for the Burnaby team, and a social worker from that team,\nworked very closely with the Canadian Mental Health Association in setting up the\nSecure Organization. These two people were involved in open-line discussions on\nradio and television appearances to help house-bound phobic people get to treatment\nor to the Secure Organization, wherein they were able to get help from volunteers\nand others who had suffered from a similar condition. It proved to be a very worthwhile venture and aided us in establishing a closer liaison with the Canadian Mental\nHealth Association.\nThis same Burnaby team organized several workshops for teachers from the\nBurnaby area, and common problems were worked out together. Communication\nbetween the schools and our treatment centre was vastly improved as a result of\nthese workshops, and further workshops are anticipated with other help-giving\ncommunity agencies.\nA training workshop was held during the year under the direction of Dr. George\nBach, and this workshop centred on the techniques of group psychotherapy. A limited number of professional people from outside our clinic were invited and participated. Later in the year another workshop was held, and this one centred on\ntechniques of psychodrama.\nCo-operation was given by the clinic to societies such as the Y.M.C.A. so that\nthey could hold group marathon and training sessions at the centre. A few of the\nmore-experienced group psychotherapists conducted training groups for school\ncounsellors and Probation Officers, and these same therapists also conducted demonstrations on the use of the video-tape equipment.\nBesides these activities there were many ongoing training activities for students\nfrom the School of Social Work at the University of British Columbia, for Probation\nOfficers, for school counsellors, and others. Over 20 social-work students were involved in \" field placement \" at the Mental Health Centre, Burnaby, and a number\nof these students worked in close co-operation with our therapists and received\nongoing tutorage from them.\nA number of occupational-therapy students and nursing students experienced\nfield placement in our day hospital and day centre. Besides these more formal programmes, many visitors from different treatment units in the Lower Mainland area\nand throughout British Columbia visited our day centre and day hospital, and whenever possible experienced a total day in one of these units. In this way they were\nable to experience first hand the type of advance treatment programme we utilized\nin these areas.\n L 58 MENTAL HEALTH BRANCH REPORT, 1967/68\nIn summary this clinic once again experienced a very busy year in the field of\ntraining and educating both our own staff and the staff from other agencies and\ntreatment centres. Only the highlights have been mentioned in this annual report.\nRESEARCH\nThe research activities have included a token reinforcement classroom for\nlearning and behaviour disorders, a comparison of marathon group psychotherapy\nversus the results from more traditional group psychotherapy, the comparison of\nnormal parents with parents of autistic children on the basis of psychological tests,\ndecision-making processes and critical incidence studies in day-hospital functioning.\nGENERAL\nBesides the general problem of having the whole centre in a transition state\nbecause of the amount of reorganization taking place, a very difficult problem has\nbeen encountered in the fact that we are still experiencing drastic staff shortages in\npsychiatry and psychology.\nThe turnover in staff generally increased (when comparing with the previous\nyear) from 25 to 30 per cent. The highest rate of turnover was in medical specialists, with five full-time psychiatrists and four sessional psychiatrists resigning from\na total establishment of 11.\nIn the area of psychology there still exists six vacancies in the total of 11 established positions. We do need the psychiatric and psychology positions filled to run\nat maximum efficiency in this clinic, and we do need to work toward a greater\ncontinuity of staff members.\nReport for April 1 to December 31, 1968\nWm. C. Holt, M.D., C.R.C.P.(C), Director\nThe most important event in this period for the Mental Health Centre, Burnaby, was the formation of the British Columbia Youth Development Centre to\nprovide comprehensive care for the children of British Columbia and the formal\nseparation on June 1st of the two institutions. What was formerly the Children's\nClinic division of the Mental Health Centre became the out-patient section of the\nYouth Development Centre. Dr. A. D. Sleigh was appointed Executive Director\nof the Youth Development Centre, and Dr. Wm. C. Holt was appointed Director\nof the Mental Health Centre, Burnaby.\nThe functions of the Mental Health Centre, Burnaby, are:\u00E2\u0080\u0094\n(1) To provide a comprehensive diagnostic and consultative service to adults\nand children with emotional disorders from the Burnaby community, as\nwell as limited treatment resources.\n(2) To provide a similar service for adults from other parts of the Lower\nMainland, and the Province in general, which do not have their own\nregional psychiatric facilities.\n(3) To provide specialized treatment resources, such as day hospital, group\ntherapy, family therapy, etc., as seems appropriate and feasible.\n(4) To engage in training of health-care personnel and research on emotional\nillness.\n(5) To employ the knowledge and skills of our multi-disciplinary teams to\ndevelop community-oriented preventive programmes in the mental health\nfield using the broadest possible definitions of mental health and prevention.\n COMMUNITY MENTAL HEALTH SERVICES L 59\nIn order to carry out these functions, clinical personnel in the centre are deployed on either of two out-patient teams, one providing comprehensive services to\nBurnaby, the other providing adult services to other areas, or on the day-hospital\nstaff. Personnel from the out-patient teams also supply services to travelling clinics.\nCLINICAL SERVICES\nIn spite of the advent of medicare, demands for all forms of out-patient\nservices have continued in excess of our capacity to deliver service, particularly with\nrespect to children's services in the Burnaby area. Staff shortages have at times\nforced reduction of intake services, but treatment loads have been maintained. The\nrecruiting of a senior psychologist for a long-empty position will enable us to extend\nour treatment resources into the behaviour therapy and conditioning treatment field.\nTravelling clinics are still functioning on a regular basis in Skeena Health Unit,\nCoast-Garibaldi Health Unit, Boundary Health Unit, and Central Fraser Valley\nHealth Unit. On November 1st, with the establishment of Simon Fraser Mental\nHealth Centre, travelling clinic services to Coquitlam were discontinued, although\na number of patients from this health unit remain in treatment. Attempts have been\nmade in the past year to make better use of local resources by travelling clinics, and\nemphasis has been placed upon consultative and educational functions of travelling\nclinic workers rather than direct-treatment functions.\nThe day hospital has continued to provide a highly effective treatment milieu.\nIts focus remains on treatment in the \" here and now,\" emphasizing reality contact\nand making wide use of group techniques. The programme is under continuing\nscrutiny and revision. One-day workshops on the programme continue to be held\nat approximately six-month intervals; the most recent of these was in October. A\nnew addition to our therapeutic armamentarium is a weekly psychodrama session.\nOccupancy continues high and waiting lists for admission have been necessary from\ntime to time.\nINDIRECT SERVICES AND TRAINING\nThe centre has continued its major involvement with the community as outlined\nin the previous year's report. One might mention particularly that the Secure\nOrganization (see previous report) continues to flourish, and more Mental Health\nCentre personnel have made contributions in past months, including lectures and\ndemonstrations, as well as supervision of individual groups within the programme.\nA preliminary evaluation recently carried out indicates very favourable results and\ncontinued expansion of the programme as well as \" graduation \" of several groups\nto a relative freedom from symptoms.\nThe placement of social-work, occupational-therapy, and nursing students for\ntraining at the Mental Health Centre, Burnaby, continues, as does the visiting of\nprofessionals in these fields from other institutions to study our programmes and\noperation.\nA new venture undertaken this fall was the conducting of a survey course in\ngroup therapy techniques for school counsellors, Probation Officers, psychiatric\nnurses, and other interested professionals. This was in addition to consultation to\nsuch professionals regarding their conduct of groups and some co-therapist training\nexperiences which we already offer. At present we are evaluating responses to this\ncourse and, as is appropriate after an initial venture, will be revising our format\nand presentation with a view to repeating this service.\nA number of educational activities within teams and the centre as a whole are\ntaking place on a regular basis. Response of the staff to outside educational opportunities has also been very keen, and we have been able to sponsor a limited number\n L 60 MENTAL HEALTH BRANCH REPORT, 1967/68\nof staff's attendance at professional training sessions sponsored by the University of\nBritish Columbia Continuing Education Department, Shalal Institute, professional\nassociations, etc. Those staff members who do attend such meetings always bring\nback information and experience to share with fellow staff members, and thus virtually all Mental Health Centre staff ultimately participate both as teachers and\nstudents in the ongoing educational process that must be so much a part of the lives\nof professional people today. We look forward to continuation of co-operative\nrelationships with other institutions and groups to make further training available\nto staff from our own centre and to others in the community with common interests.\n COMMUNITY MENTAL HEALTH SERVICES L 61\nSOUTH VANCOUVER ISLAND MENTAL HEALTH CENTRE, VICTORIA\nA. L. Aranas, M.D., Acting Director\nReport for April 1, 1967, to March 31, 1968\nExperienced clinical staff at this centre are able to provide intensive short-term\ntreatment to maintain a large number of patients to adequate functioning in the community. With the co-operation of social welfare agencies, public health personnel,\nfamily physicians, and other community services, the manipulation of the environmental loci of stress has minimized the patient's disabilities. As the therapeutic relationship broadens to include other professions and disciplines, the treatment and\nrehabilitation of the psychiatrically disabled have been more effective.\nIn spite of the fluctuation in the numbers of professional staff at this centre, a\nhigh standard of services to the community has been maintained.\nTo help develop a highly skilled clinical staff, specially the social workers and\nnurses, the Branch has been most co-operative in authorizing their attendance at\nlocal, national, and international conferences and workshops on mental health.\nDuring the period of May to August, 1967, two students from the University of\nBritish Columbia School of Social Work did their block field-work placement at the\ncentre. They were supervised very closely by Mr. R. N. Crawford and Mrs. A. M.\nNewton-White, and were a most valuable addition to our clinic staff during the\nsummer months.\nAs in previous years, a Christmas party was held for the after-care patients.\nThis was a very therapeutic situation for patients without families in the area.\nThe pharmacy department of the Royal Jubilee Hospital has provided us with\na part-time pharmacist who dispenses our drugs three afternoons a week. Previously\nthis was done by the doctors and nurse. Since the greater number of our patients\nare on one kind or combination of psychopharmacological agents, the pharmacist's\nservices are most valuable and allow the doctors and nurses more time for their\npatients.\nTo facilitate the boarding-home programme in the absence of adequate staffing,\npatients are seen in group therapy. This also applies to the increasing demand for\nservices to after-care patients.\nDuring the year the following staff members resigned from the Mental Health\nBranch: Mr. Robert A. Fatt, Clinical Psychologist, resigned on September 15,\n1967, to accept other employment; Mrs. Mary McLean, Social Worker, resigned\non September 22, 1967, to attend the University of Washington School of Social\nWork to further her education; Mrs. Verna Lister, Public Health Nurse 2, resigned\non September 29, 1967, to take up residence in Vancouver; Dr. John E. Phillips,\nMedical Specialist 1, resigned on February 29, 1968, to accept a university appointment in Vancouver.\nAppointments made were as follows: Mr. Richard R. Boersma, Clinical Psychologist, was appointed on October 16, 1967; Dr. Oliver Henderson, Medical\nSpecialist 1, was appointed on January 15, 1968; Mrs. Lois D. Appleton, Public\nHealth Nurse 2, was appointed on February 1, 1968.\nReport for April 1 to December 31, 1968\nAlex Stewart, M.B., D.P.H., Director\nThe role of this Mental Health Centre in relation to the local community was\nclosely reviewed during the year in the light of increased demands for service. A\n L 62 MENTAL HEALTH BRANCH REPORT, 1967/68\nsystem of priorities was instituted to better utilize the time of the professional staff.\nThis enabled them to become more involved in supporting and helping expand existing agency projects and assist in planning new programmes.\nAttention was also focused on encouraging mental health education projects\nand planning and implementing early case detection services. A decision was made\nto alter the direction of the programme, with emphasis being laid on consultation\nwith community agencies rather than on direct treatment.\nOne favourable circumstance was the increase in number of professional staff.\nCurrently all positions are filled. At the beginning of the year the centre had one\nfull-time psychiatrist and a private psychiatrist working on a sessional basis. By\nthe end of the year there were three full-time and two sessional psychiatrists. The\nnumber of social workers at the master's level was increased by one, bringing the\ntotal to five. In addition, one other M.S.W. was employed on a half-time basis as\na consultant in the area of mental retardation. This social worker acts in a liaison\ncapacity between the local community and Woodlands and Tranquille Schools and\nis available as a consultant to the schools for the retarded, to the Association for\nthe Mentally Retarded, to Family and Children's Service, and to the Greater Victoria Metropolitan Board of Health. An additional psychologist with an M.A.\ndegree brought the staff of that department to two sessional psychologists with Ph.D.\ndegrees and two full-time M.A. workers. The centre has also two mental health\nnurses on staff. With these changes in personnel, the work load of the clerical staff\nincreased greatly. This pressure of work was relieved to a certain extent by the\naddition of a Clerk-Stenographer 2.\nOne change in staff organization was the formation of two multi-disciplinary\nprofessional teams set up to increase the level of effective communication between\nall staff members. One member of each team acts in a liaison capacity with a specific agency. Meetings were held with the various agencies to set up and formalize\ncommunication channels between the respective agency and the Mental Health\nCentre. At the moment it appears impractical to divide the catchment area into\nsub-regions with regional responsibility assumed by a particular team, but the breakdown by agency is regarded as a useful first step. This outreaching into the local\ncommunity stimulated a good deal of interest in the work of the Mental Health\nCentre and resulted in a further rise in the referral rate.\nAnother trend noted during the year has been an increase in the number of\npatients residing locally who have a history of long-term hospitalization. Continued\nefforts were made to improve the availability of vocational rehabilitation and recreational activities for this group. The centre has had much support from the local\nCanadian Mental Health Association in this particular area.\nAn organized programme of in-service education was begun to enable the\nstaff to become more skilled in the various community roles which they are now\nassuming. Seminars and training sessions were also held with general hospital\nnurses, Probation Officers, school counsellors, and the ministerial association to\nhelp enhance their skill in early case detection.\nResearch into the effectiveness of the programme is an integral part of the\nfunction of a mental health centre. At present consideration is being given to the\nquestion of how the resources of the centre can best be deployed so that well-\nplanned and meaningful research can be undertaken. The problem of the role of\nthe mental health centre in preventive psychiatry has also been given much thought.\nWhile many aspects of the work of the centre involve a preventive approach, no\nformal programme has been established as yet.\n COMMUNITY MENTAL HEALTH SERVICES L 63\nCENTRAL VANCOUVER ISLAND MENTAL HEALTH CENTRE,\nNANAIMO\nS. E. Jensen, M.D., C.R.C.P., Director\nReport for April 1, 1967, to March 31, 1968\nORGANIZATION AND STAFF\nThe Central Vancouver Island Mental Health Centre is a community and\nfamily oriented centre for the control of mental illness through prevention, education, and treatment. The centre began operation in April, 1964, serving that part\nof Vancouver Island north of the Malahat and constituted by the combined Central Vancouver Island Health Unit and Upper Vancouver Island Health Unit. In\nthis area, with a population of more than 150,000, there is only one psychiatrist in\nprivate practice.\nThe clinic is located at the Public Health Centre in Nanaimo. Travelling\nclinics serving Duncan, Alberni, Courtenay, and Campbell River work out of\noffices in the local public health unit. Each member of the professional staff has\nspent one day a month in each of these centres. Beds in the Nanaimo Regional\nGeneral Hospital have been available for those patients who require hospital care,\nand as a result very few patients referred have needed to be certified to the Riverview Hospital at Essondale. Nevertheless, it is possible that the Mental Health\nCentre has made litde impact on the admission or discharge rate of patients from\nthis area to Riverview Hospital. This in spite of the fact that prevention of com-\nmital to the mental hospital is a goal of high priority.\nSeveral factors probably contribute to this, as follows:\u00E2\u0080\u0094\n(1) The Mental Health Centre appears to have unintentionally developed\nthe reputation of being primarily a child guidance centre.\n(2) It may be believed that the waiting list at the Mental Health Centre prevents referral of patients in urgent need of treatment. This, however, is\nnot true. We are generally able to provide immediate treatment for urgent\ncases.\n(3) There is still a tendency in the community to feel that the acutely mentally\nill person is a nuisance and a danger and should be made to leave the\ncommunity; consequently they are not referred to the Mental Health\nCentre, which is known to discourage commitment.\nIn spite of the fact that the Nanaimo Regional General Hospital does not yet\nhave but has projected a psychiatric ward, it has been the experience that virtually\nall mentally ill, except those few who have been involved in criminal activities, can\nbe successfully treated there.\nThe objective of the centre has been to provide as comprehensive a service as\nis possible in Nanaimo, and to extend the scope and usefulness of the centre by travelling each month to other principal centres in the district.\nGreat emphasis has also been placed on guiding, counselling, and teaching other\nprofessional groups (welfare workers, nurses, school counsellors, clergy, family\nphysicians, etc.) so as to enable them to better assist in efforts to keep the patient\nemployed and functioning in his community. Much of this work of necessity involves evenings, and the staff has, in the period covered by this report, spoken on\nmore than 150 occasions to groups all over the Island, as well as having participated\non many committees and other meetings of a planning and organizational nature.\n L 64 MENTAL HEALTH BRANCH REPORT, 1967/68\nSpecifically the clinic staff has been involved in the development of several\nimportant community facilities over the past year, notably the Family Life Centre in\nNanaimo, the Group Living Home for Retarded Children in Nanaimo, the new\nbranch of the Canadian Mental Health Association in Ladysmith, and the new Day\nCare Centre for Pre-schoolers in Nanaimo. The latter is an important mental health\nproject that enables separated or widowed mothers to work, eliminating their need\nfor social welfare.\nRehabilitation committees now function in all the centres served by full-time or\ntravelling clinics, and an important part of the social worker's time has been taken\nup in liaison with this committee. This is a new and important endeavour which,\ntogether with the facilities of the Goodwill Enterprises, has provided an excellent\nservice to the community. The Goodwill Enterprises is an organization devoted to\nemployment and rehabilitation of physically and mentally handicapped. The organization, with headquarters in Victoria, has recently established a branch in Nanaimo\nand retail outlets in Duncan and Courtenay. This was brought about through a continued effort by the Mental Health Centre, the Rehabilitation Consultant, and local\nservice clubs.\nIn an attempt to overcome the serious lack of facilities for psychiatric in-hospital\ntreatment of children, a camp for emotionally disturbed children was developed.\nThe camp is, in a sense, a hospital, since it provides all the facilities and types of\ntreatment which would ordinarily be available in a psychiatric hospital for children,\nincluding intensive nursing care. At the same time the children benefit from the\nemphasis on learning and growing up, rather than illness and treatment, the setting\nbeing that of a boarding school rather than a hospital.\nBecause almost all of the children have been referred primarily as school adjustment problems, it has been natural for us to emphasize school assessment. Each\nyear we have hired highly competent staff and have been able to make an extensive\nstudy of the child's school development. This has proven to be of great benefit to\nthe schools and to the children upon returning home.\nTwenty-four children from the area served by our clinic attended the camp\nfor two weeks in 1967, and this has now become an annually recurring part of our\nservice closely tied in with the general programme of the centre. Both children and\nparents are seen in regular counselling and therapy as indicated, and during the year\nthree full-day workshops for the parents of the 24 children were held. This project\nappears to prove that the concept of short-term hospitalization, rather than institutionalizing or residential treatment, is practical for children as well as adults.\nIn evaluating the statistical part of this report, it should be borne in mind that\nfor a considerable part of the fiscal year in question the positions of social worker\nand psychologist were vacant, and also that the Director was absent for a prolonged\nperiod of time due to surgery.\nReport for April 1 to December 31, 1968\nDuring the summer of 1968, for the third consecutive year, 24 children selected\nfrom those referred to this centre had the opportunity of receiving intensive treatment and assessment at our school camp held at Shawnigan Lake. This programme\nis planned to continue in the summer of 1969.\nIn order to provide service to the young teen-age group, a pilot project was\nconceived jointly with the Provincial Probation Services. A group of boys, aged\n13 to 15, with emotional problems which had resulted in delinquent symptomatology\nwere taken for a week-long hike to the west coast of Vancouver Island. It was\n COMMUNITY MENTAL HEALTH SERVICES\nL 65\nanticipated that this would facilitate both an opportunity to observe and get to know\nthe youngsters and to improve communication with them; this is difficult in an office\nsituation. Although it is very difficult to say whether the boys, as a group, are doing\nbetter than they would have done without this form of attention, it is felt that the\ntour was worth while and was a good learning experience for them. As a follow-up\nto this project, parents and boys meet with the staff of the Mental Health Clinic and\nwith Probation Officers for a workshop each month.\nA one-day workshop on alcoholism was initiated by this centre and sponsored\nby the Canadian Mental Health Association during the past month. Two members\nof the staff of the Alcoholism Foundation in Saskatchewan were key speakers for\nthis event. The Director of the Mental Health Centre participated with these\nspeakers in an \" open mike \" radio broadcast, which was well received in this community, as also was the open public meeting held in the evening. This brought an\nexcellent response. A session at the Nanaimo Senior Secondary School was also\nwell received.\nPresently the staff at the centre is involved with the formation of a group-living\nhome for boys in Nanaimo, a Big Brother Society in Port Alberni and Nanaimo to\nhelp fatherless boys, and a day-care centre for pre-school children which has just\nopened, and which promises to improve the mental health of widowed, separated, or\ndivorced mothers by making it possible for them to find employment rather than\ngoing on welfare.\nAn important part of the mental health nurse's time has been taken up in providing liaison and consultative services to the public health nurses, particularly in\ntheir efforts to provide follow-up services to patients discharged from the Provincial\nmental hospital or otherwise chronically emotionally handicapped. The nurse has\nalso conducted group therapy with the hospitalized patients and with a group of\nteen-age girls.\nRecently an approved boarding home for 20 chronically handicapped patients\nfrom the Provincial mental hospital has been established at the Retreit Farm near\nShawnigan Lake, 50 miles south of Nanaimo. The Mental Health Centre has been,\nand will be, involved in providing follow-up and supervision of this home.\nDuring the period covered by this report, about 100 patients spent an average\nof just over 10 days in the Nanaimo Regional General Hospital where, although no\nspecial psychiatric ward is available, a wide range of psychiatric treatment is possible,\nincluding occupational therapy and electrotherapy. A general shortage of beds in\nthe Nanaimo Hospital makes it necessary to restrict admission except to the most\nseverely ill, and basically this means that most of these patients would have otherwise had to be admitted to the Provincial mental hospital or to the psychiatric wards\nin Vancouver or Victoria.\n L 66 MENTAL HEALTH BRANCH REPORT, 1967/68\nSOUTH OKANAGAN MENTAL HEALTH CENTRE, KELOWNA\nF. E. McNair, B.A., M.D., CM., C.R.C.P., Director\nReport for April 1, 1967, to March 31, 1968\nThe work of this Mental Health Centre during the year has been divided into\nseveral categories. The number of cases under active treatment is close to 300,\nand the actual case load is shown in the tabulations.\nSince the advent of a psychiatrist in private practice in Penticton, we have\nelected to see any continuing Penticton cases requiring our assistance, in Kelowna,\nin the hope that the pattern of diversified practice could be encouraged for the\nPenticton area, with the psychiatrist in private practice offering service not only in\nhis own office but also at the health unit.\nWe have felt that a preventive programme should give attention to adults who\ncan identify problems of adjustment but are not themselves sick. Accordingly we\nhave co-operated with the Adult Education Division of the School Board in a\n\" Marriage for Moderns Programme \" and have also taken part under the same\nsponsorship and with the assistance of the local Canadian Mental Health Association in a weekly programme for mothers having difficulty managing their young\nchildern titled \" Coping or Crying.\"\nTo try to gain some indices of our own effectiveness, we have embarked on\ntwo research projects\u00E2\u0080\u0094one with respect to the children dropping out of the school\nsystem, and the other an evaluation of our treatment load.\nThe hospital service continues to be used to maximum advantage, with 99.4\nper cent bed occupancy. A total of 160 patients was treated during the year, five\nof whom were certified to Riverview Hospital. There is a need to improve our\nservices to children, and the development of a special ward for the treatment of the\nemotionally disturbed should not be overlooked.\nThe Family Court is particularly concerned to maintain the integrity of\nfamilies, and the committees assisting the Family Courts in the valley are developing group-living homes for teen-agers requiring this resource. We will be called\nupon to give consultant service when these homes are established.\nThe ideas suggested in the Canadian Mental Health Association report \" More\nfor the Mind\" and the American Psychiatric Association report \"Action for\nMental Health\" are being put into practice in the development of community\nmental health centres with close integration of services with existing medical services. The service is close to home and offers a continuity of care. On the other\nhand, the medical model as such does not completely answer the social needs of\nour patients. Our patients are members of families and, apart from the immediate\nsymptom picture, much of their treatment has to go on in the community in relationship to their families and with the assistance of, other helping personnel. This\nincludes the family doctor, the social agencies, the public health nurses, etc.\nThe time is at hand when further developments within the community must\nbecome the responsibility of a regional group with authority to develop such other\nservices as are required for this area.\n COMMUNITY MENTAL HEALTH SERVICES L 67\nWEST KOOTENAY MENTAL HEALTH CENTRE, TRAIL\nG. R. Mansfield, M.D., Director\nReport for April 1, 1967, to March 31, 1968\nThe West Kootenay Mental Health Centre, now in its fourth year of operation,\nis still serving both the East and West Kootenay regions. A booming economy has\nincreased the combined population to an estimated 131,000. The main clinic,\nbased at Trail, serves the West Kootenay area. The East Kootenay is served once\na month by a travelling clinic to Cranbrook.\nThere are no private psychiatrists in this area at the present time. This means\nthat the primary role of the Mental Health Centre in co-ordinating all activities\nconcerned with mental health must temporarily give way to meeting the heavy demands for direct service.\nThe present staff is comprised of two stenographers, a social worker, and a\npsychiatrist. The positions of nurse and psychologist are currently vacant, although\na psychologist was on staff for four months.\nEDUCATION\nAttempts to reduce education to a minimum were unsuccessful owing to our\nfirm integration with other helping agencies and difficulty in turning down requests\nfor mental health personnel to act as resource people. Furthermore, education and\nprevention are closely related, and this centre places strong emphasis on prevention.\nThe social worker and psychiatrist have given over 50 major addresses and\nnumerous minor ones. This has involved over a hundred planning meetings as well\nas regular meetings associated with ongoing programmes. The permanent programmes will be mentioned first. As a member of the Advisory Board of the Association for Community Planning, there are demands for educational material, project\nplanning, and guidance in this type of endeavour, which is new to Trail. The Mental\nHealth Centre has served in the capacity of adviser to the adult education department of the schools in various places. The programme for the perceptually\nhandicapped child continues to grow in close collaboration with the schools. The\nTrail Youth Liaison Committee, representing all agencies dealing with children and\nadolescents, serves as a vehicle whereby information can be shared and programmes\ndeveloped which are geared to the individual's needs. This organization is also\nsymbolic of the current trend in the therapy of children, indicating a shift from child-\ncentred to community-centred treatment.\nEducation of the public health nurses is carried out by regular weekly meetings\nwhere teaching conferences, formal lectures, films, and group discussion are utilized.\nNurses in the outlying areas working with families and children have an opportunity\nto discuss the cases at regular intervals. One of the valuable programmes that had\nto be temporarily suspended was the foster-parent training programme. This is very\ntime-consuming and, like most educational activities, has to be carried out on the\nworker's own time. Suspending it was a question of time saved rather than value.\nIf an additional social worker becomes available to the centre, it will be started again.\nSome of the short-term educational ventures include preparation of a monograph, \" The Chemical Comforts of Man,\" which served as a basis to teach school\ncounsellors how to carry out an ongoing programme for students on the abuse of\ndrugs. Other educational highlights, to mention only a few, include addresses to\nthe ministerial association, Canadian Mental Health Association, union boards of\n L 68 MENTAL HEALTH BRANCH REPORT, 1967/68\nhealth, P.-T.A. groups, various women's groups, foster-parent associations, Selkirk\nCollege psychology classes, welfare workers' organizations, teachers' organizations,\nregistered nurses' association, and various community-sponsored adult educational\nseries. Perhaps the largest audiences were reached by a number of radio talks on\nsubjects related to mental health. These were by invitation of established radio programmes such as \" Health Forum \" and \" Open Line.\" They provoked a great\ndeal of interest and favourable comment.\nThe regular quarterly meetings of the psychiatric social workers from the Mental Health Centres has proved to be a valuable means of upgrading the quality of\nsocial work by providing the opportunity for communication and the stimulating\nexperience of sharing knowledge. The social worker from this centre is president\nof British Columbia Association of Social Workers, Kootenay Branch. The Kootenay Branch is organizing in such a manner that it will serve as a resource for public\neducation in the fields of mental health and welfare.\nTRAVELLING CLINIC\nThe travelling clinic team serving the East Kootenay holds a clinic at Cranbrook once a month and has seen 242 patients.\nIt is not possible to provide direct treatment. These are consultations which\nare referred back to the family doctor with suggestions for handling, or the family\nmay be involved with the public health nurse in indirect treatment over a period of\ntime. The opportunity for consultation with the clinic team in follow-up work is\navailable to the nurses.\nSERVICE\nThe Mental Health Centre is the only source of direct service in this region;\ntherefore, it is to be expected that the demands are heavy. The following services\nare offered:\u00E2\u0080\u0094\n(a) Consultation:\n(1) Psychiatric.\n(2) Social work.\n(3) Psychological.\n(4) Nursing.\n(b) Treatment:\n(1) Child guidance (casework with parents and play therapy with the\nchild).\n(2) Individual psychotherapy.\n(3) Family-centred psychotherapy.\n(4) Conjoint psychotherapy.\n(5) Group psychotherapy.\n(6) Pharmacotherapy.\n(7) Behavioural therapy.\nDuring the year 482 patients were seen, and, of these, 327 were under 16 years\nof age. Patients treated numbered 346, while there were 136 assessments only. At\nthe end of the fiscal year the clinic team was carrying a case load of 88 patients.\nA total of 2,657 hours was devoted to treatment and assessment during the\nfiscal year. The psychiatrist carried out 1,287 interviews. The social worker spent\n1,253 hours with patients and their families. The psychologist did psychometric\ntesting on 117 patients.\nThe following tables indicate service given to the various regions and individual\nagencies:-\u00E2\u0080\u0094-\n COMMUNITY MENTAL HEALTH SERVICES\nReferrals\nL 69\nSource\nTotal\nArea\nAdults\nChildren\n235\n170\n43\n31\n3\nTrail\t\nCranbrook\t\nTrail \t\n7\n4\n95\n10\n24\n1\nH\n3\n91\n133\n56\nReferrals initiated by Attorney-General's Department\nCranbrook\t\nTrail \t\n9\n15\nCranbrook \u00E2\u0080\u0094\nTrail- \t\n3\n15\nCranbrook\t\nTrail\t\nCranbrook 1\u00E2\u0080\u0094\n2\n1\n2\nTotals \t\n482\n155\n327\nService\nAdults\nChildren\nPatients\nConsultations Only\nMental Health Centre, Trail\t\n27\n12\n15\n16\n14\n41\n6\n5\n41\n53\n21\n21\n70\n66\n136\nTreatment\n79\n6\n153\n108\n232\n114\n85\n261\n346\nReport for April 1 to December 31, 1968\nThe many ongoing programmes outlined in the fiscal year report 1967/68\nhave been pursued with vigour. Support is being given to the formation of a perceptually handicapped children's parent group. To help bridge the dichotomy\nbetween the generations in the face of anxiety-producing rapid social and technical\nchanges, a nine-week series \" Our Changing World \" finishes in December, 1968.\nWe are fortunate in having a trained nursery-school teacher, and she has been\nencouraged to give guidance in starting several classes for the pre-school child\nbetween the ages 3 and 5 years. These volunteer efforts are attracting interest, and\nthere is indication that they may spread to the outlying areas where they are most\nneeded. Support is being given to the endorsement of a kindergarten programme\nfor all instead of just a few. Project \" Head Start \" in Syracuse and the experience\nin Clarkson, Ont., point up the definite advantages of a play-school and kindergarten programme in preparing the child for a successful academic career which\ncreates a better-integrated personality better able to stand the stresses of life.\nEfforts have been made to promote more effective school counselling programmes,\nwith the result that there are now two more school districts in the Kootenays with\npsychologists on staff. Some of the school counsellors as well as staff from the\nDepartment of Social Welfare have asked to join our monthly educational group,\nwhich this year is focused on children and adolescents. Staff of the Mental Health\nCentre continue to be guest speakers on two radio programmes dealing with topics\nrelated to mental health.\nThere is a definite growing awareness of community responsibility for action\nin developing and utilizing its human resources. A gratifying trend has been an\neven closer working relationship with all helping agencies.\n L 70 MENTAL HEALTH BRANCH REPORT, 1967/68\nUPPER FRASER VALLEY MENTAL HEALTH CENTRE, CHILLIWACK\nW. G. Jilek, M.D., M.Sc, C.R.C.P., Director\nReport for April 1, 1967, to March 31, 1968\nThis was the second year of service of the Fraser Valley Mental Health Centre\nto a region comprising the Upper Fraser Valley and most of the Central Fraser\nValley public health areas.\nThe psychiatrist-director was joined by a psychiatric social work consultant\nand a mental health nurse in May, 1967. A second clerk-stenographer was added\nin March, 1968.\nCLINICAL SERVICES\nCase referrals to this centre are as a rule made through the family physician;\nthey are not infrequently initiated by members of agencies working in communities,\nsuch as public health nurses, social workers of the Department of Social Welfare,\nschool counsellors, teachers, ministers, Probation Officers, and Magistrates. It was\nnoted that an increasing number of referrals were initiated by concerned relatives\nthrough their family physicians, especially in the Chilliwack-Abbotsford area.\nIn clinical work the mental health case conference has proved to be a useful\nproblem-solving tool and has contributed to an atmosphere of close co-operation\nbetween the centre team and professionals working in related fields.\nFrom April 1, 1967, to March 31, 1968, the following clinical services were\nrendered:\u00E2\u0080\u0094\nChilliwack Clinic\nPsychiatric assessments (psychiatrist) 148\nInterviews with relatives (psychiatrist) 33\nSocial assessments (psychiatric social work consultant) 97\nTherapeutic sessions (psychiatrist) 316\nTherapeutic sessions (psychiatric social work consultant) 204\nMental health case conferences 129\nTravelling Clinic, Langley\nPsychiatric assessments (psychiatrist) 15\nInterviews with relatives (psychiatrist) 5\nSocial assessments (psychiatric social work consultant) 12\nTherapeutic sessions (psychiatrist) 9\nTherapeutic sessions (psychiatrict social work consultant) 5\nMental health case conferences 28\nTravelling Clinic, Mission\nPsychiatric assessments (psychiatrist) 13\nInterviews with relatives (psychiatrist) 3\nSocial assessments (psychiatric social work consultant) 12\nTherapeutic sessions (psychiatrist) 18\nTherapeutic sessions (psychiatric social work consultant) 7\nMental health case conferences 27\n COMMUNITY MENTAL HEALTH SERVICES L 71\nTravelling Clinic, Abbotsford\nPsychiatric assessments (psychiatrist) 38\nInterviews with relatives (psychiatrist) 14\nSocial assessments (psychiatric social work consultant) 32\nTherapeutic sessions (psychiatrist) 25\nTherapeutic sessions (psychiatric social work consultant) 17\nMental health case conferences 52\nTravelling Clinic, Hope\nPsychiatric assessments (psychiatrist) 7\nSocial assessments (psychiatric social work consultant) 3\nTherapeutic sessions (psychiatrist) 3\nTherapeutic sessions (psychiatric social work consultant) 3\nMental health case conferences 9\nServices Rendered by the Mental Health Nurse throughout\nthe Centre Region\nIndividual and family therapy sessions 245\nGroup therapy sessions 73\nPsychometric and memory testing 13\nConsultative sessions with other professionals 21\nHome visits 25\nDuring the report period an increasing demand to render direct and ongoing\ntherapeutic services was felt and is manifested in the relation of assessment to treatment sessions (377 versus 925), although this centre was primarily designed and\nstaffed to focus on consultative and indirect rather than on direct therapeutic services.\nEDUCATIONAL SERVICES AND COMMUNITY CONTACTS\nPsychiatrist, psychiatric social work consultant, and mental health nurse, either\nas a team or individually, have rendered informative and educational services and\nhave exchanged mutual experiences in extra-curricular get-togethers arranged by or\nfor the following groups: Chilliwack Medical Society; Matsqui-Sumas-Abbotsford\nMedical Society, Abbotsford; Fraser Canyon Hospital staff, Hope; Chilliwack General Hospital auxiliaries; Matsqui-Sumas-Abbotsford Hospital nursing staff, Abbotsford; Nurses' Association, Hope; School Superintendents' Association; School\nCounsellors' Association, Chilliwack; occupational-class teachers, Chilliwack; primary-school teachers, Chilliwack; foster-parents' adult educational class, Chilliwack\nSenior Secondary School; foster-parents' night-school class, Langley; nursery\nschool, Chilliwack; Chilliwack Secondary School students; University Women's\nClub, Chilliwack; Upper Fraser Valley Society for the Handicapped Children;\nHouse of Concord Home, Langley; Chisholm School for Retarded Patients; Twin\nFirs Receiving Home for Adolescents, Abbotsford; Lutheran Women of the\nChurch, Chilliwack; St. Andrew's Parish Association, Mission; Community Action\nCommittee on Alcoholism, Chilliwack.\nThe psychiatric social work consultant has been taking an active role in the\norganization and activity of the Matsqui-Sumas-Abbotsford Community Services\nCommittee. This centre was instrumental in planning and organizing a regional\nbranch of the Canadian Mental Health Association in Chilliwack, and continues\n L 72 MENTAL HEALTH BRANCH REPORT, 1967/68\nto render assistance, for example, in broadcasting programmes and in the formation\nof a volunteer group. An informal way of exchanging information between professionals working in the fields of health, welfare, correction, and education is\nprovided by the monthly \" Academic Luncheon \" at the centre, which was started\nlast summer.\nOn March 28, 1968, the first mental health workshop was held at the centre,\nproviding for a full-day involvement of about 90 professionals in the fields of\nmedicine, public health, social work, probation and correctional services, school\ncounsellors, and ministers of the entire centre region. Papers presented and discussed dealt with \" Schizophrenic Psychosis as Major Mental Health Problem,\"\n\" Psychiatric Disorders of Childhood,\" \" Community Planning for Family and\nChildren's Services,\" \" Rehabilitation for the Mentally 111,\" and \" Psychological\nTest Procedures.\" Participation in the discussions was very active, especially in\nthe panel on community mental health problems. Meanwhile we have received\nwritten comments and suggestions which will guide us in further ventures of this\nkind.\nReport for April 1 to December 31, 1968\nIn June, 1968, a psychologist M.A. joined the staff of the Upper Fraser Valley\nMental Health Centre, which now consists of a psychiatrist, psychiatric social work\nconsultant, psychologist, mental health nurse, and two clerk-stenographers.\nCLINICAL SERVICES\nDirect clinical services comprised assessment and treatment interviews, consultative case conferences with co-operating agencies and professionals, group\nand child play therapy, and nurse's visits to homes, schools, and kindergartens in\nChilliwack, Abbotsford, Mission, Langley, and Hope. During the months of\nApril through October, 1968 (including the summer vacation period), this\npsychiatrist had 400, psychiatric social work consultant 276, and mental health\nnurse 265 sessions with centre patients or their relatives, and all staff members\nparticipated in 126 conferences.\nCOMMUNITY PSYCHIATRY\nStaff members, either as a team or individually, continued to render informative and educational services to and also participated in discussion meetings with\nallied agencies such as public health units, social welfare departments, school\ncounselling, and rehabilitation and probation services throughout the centre region.\nSimilar indirect services were rendered to the following resources: Chilliwack\nHomemaker Service; M.S.A. Community Services Council, Abbotsford; Canadian\nMental Health Association, Chilliwack (during Mental Health Week in May, 1968,\npsychiatrist and psychiatric social worker went on the air at radio station CHWK\non the C.M.H.A. party line); Training Workshop, Vancouver; P.-T.A. and kindergarten parents' groups; Chilliwack junior high schools (panel discussions);\nAdult Education Programme, Chilliwack; Y.M.C.A. Youth-Parents Forum, Chilliwack; Twin Firs Receiving Home, Abbotsford; foster-parents' associations;\nYouth Council, Abbotsford; Health, Education, and Welfare Committee, Agassiz.\nA \" teach-in\" was sponsored by the Mental Health Centre in December,\n1968, and included contributions by psychiatrists and public health, social work,\nprobation, and education professionals of the area under the broad heading of\n\" Current Trends, Future Developments, and Prospectives.\"\n COMMUNITY MENTAL HEALTH SERVICES L 73\nNORTH OKANAGAN MENTAL HEALTH CENTRE, VERNON\nA. J. Bennee, M.B., B.Ch., C.R.C.P., Director\nReport for April 1, 1967, to March 31, 1968\nThis unit commenced operation in January, 1967, to serve the North Okanagan\nRegion, which has a population of about 48,000. By July, 1967, the staff consisted\nof the director, a psychologist, one stenographer, a social worker, and a mental\nhealth nurse.\nInitially our degree of effectiveness and functional ability was largely dependent on our office services (clerical, receptionist, and stenographic). In April, 1967,\nwe took a second stenographer on strength and things improved.\nTravelling clinics have been held two days per month in Salmon Arm and\nRevelstoke. A weekly travelling clinic to Kamloops was held from June, 1967,\nat The Tranquille School. Although Kamloops is not within the bounds of the\nNorth Okanagan Region, it was felt that it would serve a useful purpose to have a\nweekly clinic there.\nAs from January, 1968, we have been servicing the Golden area because it is\ncloser to Revelstoke than to its own travelling clinic in Cranbrook.\nDellview Hospital has been visited weekly as a consultation service. Group\nconferences are held on a regular basis with school counsellors and public health\nnurses. Individual consultations on specific case problems are held whenever\nnecessary.\nBecause the boarding-home programme in this region is expected to serve not\nonly patients from The Tranquille School and Dellview Hospital, but also patients\nfrom Riverview, the Vernon Jubilee Hospital, the Mental Health Clinic, plus referrals from the Department of Social Welfare, the whole programme is under review\nwith the idea of establishing a co-ordinating committee.\nThis centre is providing community psychiatry with emphasis on family therapy\nand marriage counselling. A full psychiatric service is being provided to the region,\nmade possible by concentration on short-term therapy.\nCases are seen almost immediately they arise by minimizing the paper work\npreviously required from the public health nurse. Both patient and family are then\ninterviewed, together, by the psychiatrist and a decision made as to disposal or\ntreatment.\nThe psychologist has spent most of his time treating children with learning\ndifficulties. A large percentage of the centre's case load consists of these children\nwho so often end up as drop-outs, delinquents, or social misfits because of a lack\nof community facilities.\nThe social worker held a course in family therapy for interested ministers in\nKamloops. Four sessions were held and 10 ministers attended.\nIt has been found that the mental health nurse is best used in this clinic (1)\nas the main contact with social agencies (particularly the Canadian Mental Health\nAssociation), (2) to orient nurses in general hospitals, (3) liaison with the health\nunit, and (4) to be responsible for public education (helped by the rest of the staff\nwhen necessary).\n L 74 MENTAL HEALTH BRANCH REPORT, 1967/68\nReport for April 1 to December 31, 1968\nTwo staff members have resigned during this period\u00E2\u0080\u0094namely, the Stenographer 1 and the mental health nurse. These positions have now been filled, and\nthe unit is functioning well and the morale is good.\nSince June 30, 1968, our travelling clinic to Kamloops has been discontinued,\nthe reason being that a director has been appointed to the Mental Health Centre\nthere.\nThe subject of boarding homes, which was mentioned in the first part of this\nannual report, is being investigated by the Interdepartmental Co-ordinating Committee, which has now met three times to work out regional problems.\nEarly in November a meeting was called with representatives from the Social\nWelfare Department, Public Health, rehabilitation consultant, R.C.M.P., Probation\nOfficers, John Howard Society, city welfare, Magistrates, and Family and Children's\nCourt. The meeting was primarily to make personal contacts with the various\ndepartments and agencies, to define and clarify our roles, and to solve present problems. It was so successful that those present requested another meeting in the new\nyear, and it is our intention to try to involve other agencies and, if possible, to develop\na regional planning council in this area.\nThis meeting also brought to light the need for co-ordination of effort on the\npart of various agencies who might be working with a family so that unnecessary\nduplication could be avoided, and the whole question of duplication of services is\nnow under review.\nThe social worker, Mr. Zimmerman, has held a profitable meeting with the\nlocal church ministers and found them to be extremely interested in the subject of\nmarital and family counselling.\nRegular consultative meetings are being held with public health nurse groups\nand of school counsellors as well as individual consultation to discuss cases whenever\nthe need arises.\n COMMUNITY MENTAL HEALTH SERVICES L 75\nNORTHERN INTERIOR MENTAL HEALTH CENTRE, PRINCE GEORGE\nJ. A. Steedman, M.D., Director\nReport for April 1, 1967, to March 31, 1968\nThe Northern Interior Mental Health Centre was opened on June 1, 1967, in\nthe building containing the Northern Interior Health Unit. The Mental Health Clinic\nteam has consisted of the clinical director (Dr. J. A. Steedman), social worker (Mr.\nJohn Snyder), mental health nurse (Miss Ann Geddes), and a senior and junior\nstenographer.\nA total of 586 patients was seen by this clinic from June, 1967, until March 30,\n1968. The total number of individual interviews conducted was 1,629. There have\nbeen 69 cases closed during this time. The whole range of diagnostic categories has\nbeen seen, with the major treatments directed at problems with children and marital\ndifficulties.\nThe centre is functioning as a community psychiatric service, and, as a result,\nall therapists have active participation with community personnel and services. The\ncentre also takes an active part in the psychiatric programme at the regional general\nhospital and the Simon Fraser Hospital. The clinic team has been involved with\npublic lectures, and has worked with voluntary organizations, Courts, welfare, and\nthe schools.\nA number of progressive changes are taking place in the areas served\nthroughout the last year. An alcoholic half-way house has been opened, a receiving\nhome for children has been started, and a boarding-home programme for the chronically mentally ill and handicapped is being considered. There are many projected\nplans for the future for this town and this area, and we are involved in the planning\nof these facilities.\nThe travelling clinic has visited Williams Lake and Quesnel every month, and\nFort St. John and Dawson Creek every other month. On one occasion the team\nmade a trip to Vanderhoof and Burns Lake. All personnel are involved in these\ntrips and in the treatments and assessments conducted. One of the main functions\nis to counsel and advise paramedical and other interested personnel, as well as doing\ndirect treatment in these areas.\nThe mental health travelling team is using the Mental Health facilities at Williams Lake and Quesnel. Two basement rooms in the Quesnel extension have been\nfurnished, as will be three rooms in the new extension of the Mental Health Building\nat Williams Lake.\nThe first year of operation has been a rewarding one, and all members of the\nteam have enjoyed their participation in this community psychiatric project.\nReport for April 1 to December 31, 1968\nDuring the clinic trip to the north in October, a first attempt to meet with the\nlocal physicians was made. On future visits this meeting will be further developed.\nIn addition to working as a mental health team, the various professional\ngroups have been contacted by the team members; for example, nurses and social\nworkers. This assists in bridging the gap between the patient's needs and available\nresources.\nMeetings with other agency staff in Burns Lake and Vanderhoof were held\nin May, June, and September. As these areas become familiar with the mental\n L 76 MENTAL HEALTH BRANCH REPORT, 1967/68\nhealth team and its services, an increase in referrals is occurring. This also has\nresulted in increased consultation to these areas, both in person and by telephone.\nThis latter is used frequently because of barriers of distance, weather, and time.\nBecause of the relative closeness of Williams Lake and Quesnel, the service\nprovided is greater than to west or north. In many instances, people travel 150\nmiles for appointments between clinic visits, thus the mental health team is able to\nprovide some ongoing treatment in addition to consultation. In this area as well\nas in Prince George, the mental health team has participated in staff education\nprogrammes.\nSince April the number of people seen in assessment and treatment in Prince\nGeorge has increased from 191 to 255; also the staff have increased their involvement in community activities. In May the local Community Health and Welfare\nCouncil developed a Resource Planning Board. This board consists of representatives from education, welfare, health, hospital, mental health, probations,\ncity council, regional districts, clergy, Canada Manpower, Indian Affairs, and\nrehabilitation. This board establishes a priority of needs for the community, followed by a programme to develop the resources made.\nThe local half-way house for alcoholics receives consultation from the social\nworker. He participates with the men in the rehabilitation programme and on\nthe board of directors.\nIn September a psychiatric programme in the regional hospital was established\non a three-month trial basis. This has improved the care to the psychiatric patients,\nbut still has many problems to be solved. The mental health nurse assists the nursing\nstaff with planning nursing care for these patients.\nThe result of working in the community is rewarding and satisfying for the staff.\nHowever, because of the tremendous increase in demands, it becomes obvious that\nan increase in staff is essential; also some pressure is felt by the isolation from similar resources. For this reason it has been most effective for staff morale to attend\nmeetings, conferences, and workshops in other areas. The stimulation these sessions\nprovide results in improved service to the community.\nIn September a psychologist was hired from the School Board 1 Vi days a week.\nThis has assisted greatly in the assessment and planning of treatment, especially for\nchildren. Hopefully, within the next year, this service could be expanded to a full-\ntime programme for a psychologist with diagnosis, treatment, and some research.\n COMMUNITY MENTAL HEALTH SERVICES\nL 77\nSTATISTICAL TABLES\nTable Ia.\u00E2\u0080\u0094Mental Health Centres' Population Movement by Clinic,\nAdults and Children, April 1, 1967, to March 31, 1968\nLocation of\nMental Health\nCentre\nFirst Activations\nReactivations\nTotal Activations\nTerminations\nAdult\nChildren\nAdult\nChildren\nAdult\nChildren\nAdult\nChildren\nBurnaby.. ,. \t\nVictoria \t\nKelowna \t\nNanaimo \t\nTrail \t\n628\n199\n161\n107\n106\n81\n249\n285\n711\n138\n87\n115\n272\n85\n191\n184\n268\n80\n50\n40\n32\n24\n72\n43\n205\n32\n19\n15\n72\n26\n34\n67\n896\n279\n211\n147\n138\n105\n321\n328\n916\n170\n106\n130\n344\n111\n225\n251\n979\n249\n213\n144\n131\n23\n116\n31\n950\n146\n93\n69\n309\nChilliwack\t\nVernon\t\n20\n55\n38\nTotals\t\n1,816\n1,783\n609\n470\n2,425\n2,253\n1,886\n1,680\nTable Ib.\u00E2\u0080\u0094Mental Health Centres' Case Load by Clinic,\nApril 1, 1967, to March 31, 1968\nLocation of\nMental Health\nCentre\nActive\nCases,\nApr. 1, 1967\nFirst\nActivations\nReactivations\nTotal\nCase Load\nTerminations\nActive\nCase Load,\nMar. 31,\n1968\nBurnaby \t\nVictoria \t\n1,269\n425\n275\n424\n46\n82\n86\n1,339\n337\n248\n222\n378\n166\n440\n469\n473\n112\n69\n55\n104\n50\n106\n110\n3,081\n874\n592\n701\n528\n298\n632\n579\n1,929\n395\n306\n213\n440\n43\n171\n69\n1,152\n479\n286\nNanaimo \t\nTrail \t\n488\n88\n255\n461\nPrince George1 \t\n510\nTotals\t\n2,607\n3,599\n1,079\n7,285\n3,566\n3,719\n1 Unit opened in 1968.\n L 78\nMENTAL HEALTH BRANCH REPORT, 1967/68\nTable 2.\u00E2\u0080\u0094Activations to Mental Health Centres by Health Unit and\nSchool District of Residence, April 1, 1967, to March 31, 1968\nHealth Unit and School District\nFirst\nActivations\nReactivations\nTotal\nActivations\nHealth Unit and School District\nFirst\nActivations\nReactivations\nTotal\nActivations\nEast Kootenay, Cranbrook\u00E2\u0080\u0094\n8\n46\n69\n17\n11\n20\n35\n11\n7\n45\n101\n19\n1\n18\n28\n1\n3\n175\n17\n1\n45\n9\n202\n93\n1\n63\n3\n2\n1\n10\n10\n1\n21\n42\n;\n12\n29\n363\n3\n1\n12\n90\n41\n1\n125\n21\n1\ni\n57\n91\n1\n13\n16\n3\n~15\n13\n3\n9\n31\n5\n10\n11\n2\n39\n4\n8\n3\n49\n20\n29\n3\n2\n27\n23\n4\n6\n52\n1\n30\n10\n33\n8\n30\n27\n9\n59\n85\n20\n11\n35\n48\n14\n7\n54\n132\n24\n1\n28\n39\n1\n5\n214\n21\n53\n12\n251\n113\n92\n3\n5\n1\n10\n12\n48\n65\n16\n35\n415\n3\n13\n120\n51\n158\n29\n87\n118\nCentral Fraser, Mission\u00E2\u0080\u0094\nSchool District No. 35\t\n\u00E2\u0080\u009E 42\t\n21\n32\n16\n2\n17\n377\n376\n43\n17\n11\n28\n8\n23\n21\n3\n15\n8\n1\n6\n15\n2\n1\n1\n273\n33\n26\n4\n23\n12\n18\n70\n9\n42\n1\n31\n22\n2\n2\n2\n2\n6\n3\n10\n8\n9\n2\n4\n146\n119\n24\n2\n4\n2\n7\n7\n1\n5\n2\n3\n5\n104\n3\n6\n1\n2\n2\n1\n33\n3\n6\n15\n3\n31\n' 2 \t\n40\n\u00E2\u0080\u009E 3 \t\n\u00E2\u0080\u009E 75\t\n25\n\u00E2\u0080\u009E 4 \t\n\u00E2\u0080\u009E 76\t\n4\n\u00E2\u0080\u009E 18\t\nMetropolitan Board of Health of\nGreater Vancouver\u00E2\u0080\u0094\nSchool District No. 38\t\n\u00E2\u0080\u009E 86 \t\nSelkirk, Nelson\u00E2\u0080\u0094\n21\n\u00E2\u0080\u009E \u00E2\u0080\u009E \u00E2\u0080\u009E 39\t\n523\n\u00E2\u0080\u009E 8 \t\n\u00E2\u0080\u009E 41 \t\n495\n\u00E2\u0080\u009E 10 \t\n\u00E2\u0080\u009E 44\t\n67\nWest Kootenay, Trail\u00E2\u0080\u0094\nSchool District No. 9\t\n\u00E2\u0080\u009E 11 \t\n\u00E2\u0080\u009E 45\t\n19\nCoast-Garibaldi, Powell River\u00E2\u0080\u0094\nSchool District No. 46\t\n11\n\u00E2\u0080\u009E 12 \t\n\u00E2\u0080\u009E 47\t\n32\n\u00E2\u0080\u009E 13 \t\n\u00E2\u0080\u009E 48\t\n10\nSouth Okanagan, Kelowna\u00E2\u0080\u0094\nSkeena, Prince Rupert\u00E2\u0080\u0094\nSchool District No. 52\t\n30\n\u00E2\u0080\u009E 15\n 53\t\n28\n\u00E2\u0080\u009E 16\t\n\u00E2\u0080\u009E 17\n 54\t\n\u00E2\u0080\u009E 80.-\t\n4\n20\n\u00E2\u0080\u009E 23\n 88..\t\n10\n\u00E2\u0080\u009E 77\t\nNorth Okanagan, Vernon\u00E2\u0080\u0094\nPeace River, Dawson Creek\u00E2\u0080\u0094\nSchool District No. 59 \t\n\u00E2\u0080\u009E 60\u00E2\u0080\u0094\t\n9\n20\n\u00E2\u0080\u009E 21. \t\n\u00E2\u0080\u009E 22 \t\n , 83 \t\nGreater Victoria Metropolitan\nBoard of Health-\nSchool District No. 61\t\n2\n\u00E2\u0080\u009E 89..\t\nSouth Central, Kamloops\u00E2\u0080\u0094\nSchool District No. 24 \t\n25\n377\n\u00E2\u0080\u009E 62\t\n36\n 63....-\t\n32\n, 26\n\u00E2\u0080\u009E 64-\t\n5\n\u00E2\u0080\u009E \" \u00E2\u0080\u009E 29\t\nCentral Vancouver Island, Nanaimo\u00E2\u0080\u0094\nSchool District No. 65.\t\n\"\u00E2\u0080\u009E 30\t\n25\nCariboo, Williams Lake\u00E2\u0080\u0094\n\u00E2\u0080\u009E 66\t\n14\n\u00E2\u0080\u009E 67.. \t\n19\n\u00E2\u0080\u009E 68\t\n103\nNorthern Interior, Prince\nGeorge\u00E2\u0080\u0094\n\u00E2\u0080\u009E 69\t\n12\n\u00E2\u0080\u009E 70\t\n48\n\u00E2\u0080\u009E 79 \t\nUpper Island, Courtenay\u00E2\u0080\u0094\nSchool District No. 71 \t\n\u00E2\u0080\u009E 72\t\n1\n\u00E2\u0080\u009E 56\t\n\u00E2\u0080\u009E \u00E2\u0080\u009E 57 \t\n46\n\u00E2\u0080\u009E 58\n25\nUpper Fraser Valley, Chilliwack\u00E2\u0080\u0094\n\u00E2\u0080\u009E 85.\t\n2\nSchool districts not covered by\nhealth units\u00E2\u0080\u0094\nSchool District No. 49-\t\n\u00E2\u0080\u009E 84-\n\u00E2\u0080\u009E 33\t\n\u00E2\u0080\u009E \u00E2\u0080\u009E \u00E2\u0080\u009E 34\t\n2\n2\nBoundary, Cloverdale\u00E2\u0080\u0094\n2\nEx-Province\t\n6\n\u00E2\u0080\u009E 37\nUnknown\t\n3\nSimon Fraser, New Westmin-\nTotals \t\n3,599\n1,079\n4,678\nSchool District No. 40 \t\n\u00E2\u0080\u009E 43\t\n COMMUNITY MENTAL HEALTH SERVICES\nL 79\nTable 3.\u00E2\u0080\u0094Total Activations to Mental Health Centres by Clinic,\nAge-group, and Sex, April 1, 1967, to March 31, 1968\nClinic and Sex\nAge-group (Years)\nTotal\nActivations\n0-9\n10-16\n17-19\n20-29\n30-39\n40-49\n50-59\n60 and\nOver\nBurnaby\u00E2\u0080\u0094\nMale \t\nFemale \t\n242\n93\n399\n181\n97\n64\nno\n160\n82\n116\n54\n77\n29\n62\n21\n25\n1,034\n778\nTotals\t\n335 [ 580 | 161\n270\n198 | 131\n91\n46 | 1,812\nVictoria\u00E2\u0080\u0094\nMale \t\nFemale \t\n47\n14\n79\n30\n16\n27\n34\n53\n25\n47\n11\n26\n6\n17\n7\n10\n225\n224\nTotals \t\nfil\nmq\n43\n87\n72 | 37 | 23 | 17\n449\nKelowna\u00E2\u0080\u0094\nMale \t\nFemale\t\n26\n9\n46\n25\n11\n17\n19\n27\n16\n28\n19\n28\n9\n18\n5\n14\n151\n166\nTotals \t\n35 | 71 | 28\n46\n44 | 47 | 27\n19 | 317\nNanaimo\u00E2\u0080\u0094\nMale\t\nFemale.\t\n31\n11\n56 7\n32 | 10\n13\n35\n3 | 13\n29 j 16\n6\n8\n4\n3\n133\n144\nTotals-\t\n42 | 88 | 17 | 48\n32 | 29 | 14 | 7 | 277\nTrail\u00E2\u0080\u0094\n77 168\n34 65\n15\n15\n19\n22\n1\n10 j 14\n17 [ 13\n4\n5\n2\n2\n309\n173\nFemale \t\nTotals... _\n111 | 233\n30 [ 41\n27 | 27 | 9\n4\n482\nChilliwack\u00E2\u0080\u0094\u00E2\u0096\u00A0\nMale \t\nFemale\t\n25\n10\n45\n31\n15\n5\n12\n15\n9\n16\n9\n11\n5\n3\n3\n2\n123\n93\nTotals \t\n35 | 76 [ 20\n27\n25 | 20 ] 8 | 5\n216\nVernon\u00E2\u0080\u0094\nMale-\t\nFemale\u00E2\u0080\u0094 \t\n66\n27\n80\n52\n26\n20\n26\n40\n22 | 27\n59 | 34\n10 14\n30 1 13\n271\n275\nTotals\t\n93 | 132 | 46\n66\n81 | 61\n40 | 27\n546\nPrince George\u00E2\u0080\u0094\n70\n41\n84\n56\n16\n30\n54\n79\n38\n50\n13\n21\n11\n11\n1\n4\n287\nFemale\t\n292\nTotals\t\n111 | 140 | 46 | 133\n88\n34\n22 | 5\nTotals-\nMale \u00E2\u0080\u0094 - \t\n584\n239\n957\n472\n203 287\n188 1 431\n205\n362\n160\n226\n80\n154\n57\n73\n2,533\n2,145\n823\n1,429\n391 1 718\n567\n386\n234\n130\n4,678\nTable 4.\u00E2\u0080\u0094Mental Health Centres' Terminations by Type of Service and\nClinic for Children and Adults, April 1, 1967, to March 31, 1968\nLocation of\nMental Health Centre\nTotal Terminations\nAssessment without\nTreatment\nAssessment with\nTreatment\nAdults\nChildren\nAdults\nChildren\nAdults\nChildren\n979\n249\n213\n144\n131\n23\n116\n31\n950\n146\n93\n69\n309\n20\n55\n38\n235\n22\n61\n49\n62\n16\n35\n5\n389\n14\n35\n29\n72\n20\n33\n9\n744\n227\n152\n95\n69\n7\n81\n26\n561\n132\n58\n40\nTrail -\n237\n22\nPrince George \t\n29\n1,886\n1,680\n485\n601\n1.401 1 1.079\n L 80\nMENTAL HEALTH BRANCH REPORT, 1967/68\nTable 5. \u00E2\u0080\u0094 Total Cases Terminated from Mental Health Centres by\nPsychiatric Diagnosis and Age at Termination, April 1, 1967, to\nMarch 31, 1968\nPsychiatric Diagnosis\nAdults\nChildren\nTotal\nNumber\nPercentage\nBrain syndromes\u00E2\u0080\u0094\n2\n30\n22\n2\n52\n0.1\n1.4\nTotals- - \t\n32\n22\n54\n1.5\nPsychoses\u00E2\u0080\u0094\n338\n32\n13\n8\n4\n21\n128\n3\n466\n32\n13\n8\n4\n24\n13.0\n0.9\n0.4\n0.2\nPresenile, senile, with or without cerebral arteriosclerosis\n0.1\n0.7\nTotals\t\n416\n131\n547\n15.3\nPsychoneuroses\u00E2\u0080\u0094\n139\n337\n39\n19\n21\n12\n158\n358\n51\n4.5\n10.0\n1.4\nTotals\t\n515\n52\n567\n15.9\n64\n32\n96\n2.7\nDisorders of character, intelligence, and behaviour\u00E2\u0080\u0094\n202\n204\n22\n5\n8\n159\n31\n3\n126\n7\n34\n40\n552\n442\n105\n146\n14\n236\n244\n22\n5\n560\n601\n136\n149\n126\n21\n6.6\n6.8\nAlcoholism-\u00E2\u0080\u0094 \t\n0.6\n0.1\n15.8\n17.0\nMental deficiency \t\n3.8\n4.2\n3.5\n0.6\nTotals\u00E2\u0080\u0094 \t\n767\n1,333\n2,100\n59.0\n5\n4\n33\n50\n7\n63\n40\n12\n4\n96\n90\n0.3\n0.1\n2.7\nObservation without need for further psychiatric care\t\n2.5\n1,886\n1,680\n3,566\n100.0\nTable 6.-\n-Cases Active in Mental Health Centres as at March 31, 1968,\nby Length of Treatment Period and Clinic\nLocation of Mental Health Centre\nNumber of Months\nTotal, All\nUnder 3\n3-5\n6-11\n12-23\n24 and\nOver\nCases\n310\n109\n72\n99\n53\n52\n142\n159\n260\n61\n50\n98\n19\n55\n113\n179\n230\n90\n60\n60\n9\n85\n160\n172\n207\n70\n64\n129\n4\n63\n46\n145\n149\n40\n102\n3\n1,152\n479\n286\nNanaimo -\t\nTrail \t\n488\n88\n255\n461\n510\n996\n835\n866\n583\n439\n3,719\n IN-PATIENT SERVICES L 81\nPART III.\u00E2\u0080\u0094IN-PATIENT SERVICES\nREPORT OF THE DIRECTOR OF MENTAL HEALTH SERVICES\nH. W. Bridge, M.B., B.Ch., M.Sc, C.R.C.P.(C)\nReport for April 1, 1967, to March 31, 1968\nThis report is based upon the present organization of the Mental Health Branch\nand relates only to the Mental Health Services, which constitutes one division of that\nBranch. For the first five months of the period reported on, no Deputy Minister had\nbeen appointed to the Branch and Dr. F. G. Tucker was Acting Director. Following\nthe appointment of Dr. Tucker to be Deputy Minister of Mental Health, the writer\nwas appointed Director of Mental Health Services, with responsibility for the inpatient facilities operated by the Branch.\nThe extent and scope of the in-patient services provided is indicated by a few\nheadline figures which have been extracted from the detailed reports which follow:\u00E2\u0080\u0094\n11,175 persons received psychiatric treatment as in-patients (Riverview\nHospital, 6,736; Schools for the Mentally Retarded, 2,319; Geriatric Division, 2,120).\n2,168,643 patient-days of service were provided to the 11,175 in-patients\n(Riverview Hospital, 994,137 patient-days; The Woodlands School,\n469,560 patient-days; The Tranquille School, 241,598 patient-days;\nValleyview Hospital, 276,524 patient-days; Dellview Hospital, 80,-\n546 patient-days; Skeenaview Hospital, 106,278 patient-days).\n4,060 persons were employed on March 31, 1968, in the Mental Health\nServices to provide the services highlighted above.\n$25,276,134 was expended to operate the in-patient institutions of the\nBranch.\nThe daily per capita cost for the institutions was $11.66.\nMAJOR EVENTS AND TRENDS\nWith the resignation of Dr. A. E. Davidson as Deputy Minister of Mental\nHealth Services and Director of Mental Health Services, a Mental Health Committee\nunder the chairmanship of Dr. F. G. Tucker was established by the Minister. The\noutcome of the work of this Committee largely sets the stage for new developments\nand determines the direction of trends which are apparent throughout the Mental\nHealth Branch, including the Services Division.\nThe major result has been a recognition of the desirability of decentralization\nof the mental health programmes, with concentration on development of community\nresources, and maximum involvement of community participation in as wide a\nspectrum of programmes as possible. These developments are accompanied by a\nrecognition of the desirability of the integration of the methods of care with those\nof other branches of medical, social, and hospital services throughout the Province.\nSince the existing in-patient facilities of the Mental Health Services had grown up\nduring a period when centralization of services had appeared appropriate, they are\nseen in the light of contemporary philosophy and policy as somewhat anachronistic\nstep-children of the mental health needs of today's society. Thus it was appropriate\nthat the centralized in-patient services should continue to operate at the highest\npossible level of patient-care, but should be seen as an interim service meeting public\nneeds only until such time as these needs can be more appropriately provided for on\na decentralized, community-oriented, and medically integrated basis.\n L 82 MENTAL HEALTH BRANCH REPORT, 1967/68\nIt is obvious from the statistical highlights already quoted that the services\nrendered are so extensive that it must be anticipated that a considerable number of\nyears must elapse before any adequate and comprehensive community-based alternatives can be developed, which will suffice to enable the bulk of the central services to\nbe dispensed with in their present form and the physical plant, wherever suitable,\nput to more appropriate uses. During these interim years it is my responsibility to\nensure that the highest possible standard of care and treatment will be available in\nthese facilities to that proportion of the population of our Province which may still\nlack the facilities to receive appropriate treatment in their own local regions.\nSTATISTICAL COMMENTS\nTables 1 and 2 provide a summary of the movement of patient population in\nthe facilities of the Services Division of the Mental Health Branch.\nDuring the year 4,179 persons were admitted to the in-patient units. This is a\ndecrease of 823 as compared with 1966/67. There was a decrease of 805 in the\nnumber of patients admitted to the Riverview Hospital\u00E2\u0080\u00943,470 compared with 4,275\nin 1966/67.\nIn the schools for the retarded there was a decrease of 106 in the numbers\nadmitted\u00E2\u0080\u0094227 compared to 333 in 1966/67.\nThe Geriatric Division experienced a reduction in admissions of 49. The total\nwas 602 in 1967/68, as compared to 651 the previous year.\nThe Riverview Hospital provided care for 6,736 patients in 1967/68, a\ndecrease of 1,018 from 1966/67. There was also a slight decrease in the numbers\ncared for in the schools for the retarded\u00E2\u0080\u00942,319 compared to 2,348 in 1966/67.\nIn the Geriatric Division there were 2,120 patients under care in 1967/68, a\ndecrease of 7 from the 1966/67 total of 2,127.\nOn March 31, 1968, there were 103 fewer patients in residence in the institutions than on the same date in 1967. The satistics relating to the in-patient facilities\nof the Mental Health Services suggest that a peak has been passed with respect to\nadmissions, discharges, and totals under care. The impression gained is that the\nincreasing provision of alternative resources in the community and the widespread\nacceptance of the concept that in-patient institutional care should be reserved only\nfor very special groups of patients under very special circumstances has led to a\nreduction in the demand for in-patient care as the first resort even in those cases in\nwhich it was not necessarily the most appropriate measure.\nGENERAL COMMENTS\nDuring the 1967/68 year I have laid great stress with the administrations of\nall in-patient facilities on the necessity for a high standard of patient-care and a high\nquality of service. I believe there has been an excellent response from the staffs of\nthe in-patient facilities, and any relief from which they have benefited by a reduction\nin number of admissions has been applied to raising the standard of care to the\nindividual patient. When a medical-staff shortage occurred, no reduction in standard\nof care was permitted, but the number of admitting beds in operation in the Riverview Hospital was temporarily reduced. The morale of the staffs of the various\nunits was considerably raised by direct encouragement and personal contact from\nthe former Minister, the Honourable Wesley D. Black, who visited the units personally and devoted considerable time to gaining an understanding of the problems.\nHis approval of the Riverview Hospital's application to request accreditation did\nmuch to boost morale and inaugurated a vigorous programme of reorganization of\nthe hospital to enable it to meet the required standards.\n IN-PATIENT SERVICES\nL 83\nThe Department of Nursing Education continued under the directorship of Miss\nLonergan and graduated a class of 104 women and 7 men. The graduation ceremonies were held in the auditorium of the New Westminster Secondary School on\nthe evening of April 26, 1967. The address to the graduates was given by the\nHonourable Mr. Justice F. Craig Munroe.\nThe 1967 annual meeting of the Council of Psychiatric Nurses was held on\nApril 24, 1967, in Vancouver. Two hundred and sixty-four applicants were licensed\npursuant to the Psychiatric Nurses Act and regulations in 1967/68.\nThe Mental Health Services have again had occasion to recognize the fine\nwork undertaken on behalf of the patients by the volunteer groups which have\ndonated so much time and effort to various facilities.\nReport for April 1 to December 31, 1968\nThis report is an interim narrative to cover the period mentioned during the\nchange-over from a fiscal to a calendar year as the basis for reporting.\nMAJOR TRENDS AND EVENTS\nDetailed statistics will be reported separately. Trends appear to indicate a\nreduction in the number of admissions, but little change in the total number of\nin-patient days of service.\nThe period under consideration has been characterized by a great deal of\nquestioning and evaluation of traditional policies and procedures in the in-patient\nservices. The impact on the traditional role of in-patient institutions of the new\nBranch policy of decentralization and community integration announced by the\nHonourable W. D. Black during his tenure as Minister made this inevitable.\nIn spite of anxieties, which are to be expected in association with any such\nperiod of change and self-examination in an organization, staff morale appears to\nhave improved in response to the hope of improved patterns of service being\nintroduced.\nDuring October the surveyors from the Canadian Council on Hospital Accreditation made a first visit to Riverview Hospital. Some of their informal comments were regarded as encouraging. No report has as yet been received from\nthe Council.\nWork has continued on the construction of the British Columbia Youth\nDevelopment Centre at Burnaby and staff recruitment and training continues, but\nit will be 1969 before it is possible to begin admitting in-patients to residence.\nThe Department of Nursing Education has lost its Director, Miss Margaret M.\nLonergan, who has moved to Victoria on the staff of the Deputy Minister, and\nvigorous recruitment activity continues to find a suitable replacement.\nGraduation ceremonies took place in the auditorium of the New Westminster\nSecondary School on the evening of April 24, 1968. A class of 7 men and 125\nwomen was graduated. The address to the graduates was given by Mr. Russell\nK. MacKenzie, Assistant Director of Pupil Personnel Services Division of the Vancouver School Board.\nThe annual meeting of the Council of Psychiatric Nurses for 1968 was held\non April 23, 1968, and 261 psychiatric nurses and three mental deficiency nurses\nwere licensed pursuant to the Psychiatric Nurses Act and regulations in the period\nunder consideration.\nThe work of the volunteers continues to form a valuable component of the\nservices provided to the patients in the institutions of the Mental Health Services.\n L 84\nMENTAL HEALTH BRANCH REPORT, 1967/68\nSTATISTICAL TABLES\nTable 1.\u00E2\u0080\u0094Showing Patients in Residence in Various Facilities of the\nMental Health Branch, April 1, 1967, and March 31, 1968, Together\nwith Increase or Decrease.\nIn Residence, Apr\n. 1, 1967\nIn Residence, Mar.\n31,1968\nIncrease\nMen\nWomen\nTotal\nMen\nWomen\nTotal\nDecrease\n1,456\n746\n368\n254\n89\n293\n1,312\n531\n290\n494\n126\n2,768\n1,277\n658\n748\n215\n293\n1,414\n749\n374\n251\n70\n278\n1,269\n527\n285\n507\n132\n2,683\n1,276\n659\n758\n202\n278\n\u00E2\u0080\u009485\nThe Woodlands School \t\n\u00E2\u0080\u0094 1\nThe Tranquille School\t\nValleyview Hospital, Essondale\t\n+1\n+ 10\n\u00E2\u0080\u0094 13\n\u00E2\u0080\u009415\nTotals . \t\n3,206\n2,753\n5,959\n3,136\n2,720\n5,856\n\u00E2\u0080\u0094 103\nTable 2.\u00E2\u0080\u0094Showing in Summary the Admissions and Population Increase\nof the Mental Health Branch for the 10-year Period April 1, 1958,\nto March 31, 1968.\nYear\nTotal\nAdmissions\n65 Years\nand Over\nAdmissions\n15 Years\nand Under\nInformal\nPopulation\nIndex of\nAdmissions\nAdmissions\nIncrease\nIncrease\n2,993\n425\n135\n1,118\n-90\n\u00E2\u0080\u00943.00\n3,296\n506\n182\n1,316\n20\n0.61\n3,924\n580\n254\n1,695\n42\n1.07\n4,193\n557\n200\n2,023\n\u00E2\u0080\u0094 156\n\u00E2\u0080\u00943.72\n4,248\n554\n213\n2,086\n-63\n\u00E2\u0080\u0094 1.48\n4,569\n550\n243\n2,187\n31\n0.68\n4,518\n702\n215\n2,194\n-39\n-0.86\n5,069\n844\n206\n2,278\n\u00E2\u0080\u009492\n\u00E2\u0080\u0094 1.81\n5,002\n757\n175\n2,095\n-2\n\u00E2\u0080\u00940.04\n4,179\n690\n166\n1,558\n-103\n\u00E2\u0080\u0094 1.73\n41,991\n6,165\n1,989\n18,550\n\u00E2\u0080\u0094452\n1958/59..\n1959/60...\n1960/61-\n1961/62.\n1962/63-\n1963/64...\n1964/65...\n1965/66..\n1966/67-\n1967/68 .\nTotals.\nTable 3.\u00E2\u0080\u0094Comparative Summary of Increases and Decreases in Resident\nPopulation by Major Divisions of Mental Health Branch, 1958/59\nto 1967/68.\nFiscal Year\nRiverview\nHospital\nSchools for\nMentally\nRetarded\nGeriatric\nDivision\nTotal\n1958/59\u00E2\u0080\u0094\n1959/60\u00E2\u0080\u0094\n1960/61\n1961/62 \u00E2\u0080\u0094\n1962/63\t\n1963/64\t\n1964/65 ......\n1965/66 \u00E2\u0080\u0094\n1966/67-\t\n1967/68\t\n\u00E2\u0080\u0094 144\n-229\n\u00E2\u0080\u009492\n\u00E2\u0080\u0094236\n-137\n-55\n-134\n\u00E2\u0080\u0094 103\n-47\n-85\n+ 86\n+93\n+75\n+73\n+62\n+79\n+77\n+31\n+51\n-30\n+ 156\n+59\n+7\n+ 12\n+7\n+ 18\n\u00E2\u0080\u009420\n-6\n\u00E2\u0080\u0094 18\n+20\n+42\n\u00E2\u0080\u0094 156\n-63\n+31\n-39\n\u00E2\u0080\u009492\n\u00E2\u0080\u00942\n\u00E2\u0080\u0094 103\n IN-PATIENT SERVICES\nL 85\nTable 4.\u00E2\u0080\u0094Comparative Summary of Total Patients under Care for Major\nDivisions of Mental Health Branch by Fiscal Years 1958/59 to\n1967/68.\nFiscal Year\nRiverview\nHospital\nSchools for\nMentally\nRetarded\nGeriatric\nDivision\nTotal\n1958/59-\n1959/60-.\n1960/61-\n1961/62-\n1962/63-\n1963/64..\n1964/65-\n1965/66-\n1966/67..\n1967/68...\n7,121\n7,163\n7,376\n7,679\n7,765\n7,931\n7,540\n7,706\n7,754\n6,736\n1,481\n1,740\n1,868\n1,960\n2,023\n2,042\n2,178\n2,198\n2,348\n2,319\n1,373\n1,459\n1,587\n1,642\n1,677\n1,738\n1,937\n2,097\n2,127\n2,120\n9,975\n10,362\n10,831\n11,281\n11,465\n11,711\n11,655\n12,001\n12,029\n11,175\nTable 5.\u00E2\u0080\u0094Movement of Population of Mental Health Branch,\nApril 1, 1967, to March 31, 1968\nPsychiatric\nDivision\nSchools for Mentally Retarded\nDivision\nGeriatric\nDivision\nTotal\nM.\nF.\nT.\nM.\nF.\nT.\nM.\n1\nF.\nT.\nM.\nF.\nT.\nIn residence, April 1, 1967\t\nOn extended leave, carried forward\nfrom 1966/67\u00E2\u0080\u0094\n1,456\n156\n52\n4\n1,312\n186\n100\n2,768\n342\n152\n4\n1,114\n59\n15\n821\n78\n5\n1,935\n137\n20\n636\n101\n620\n161\n1,256\n262\n3,206\n316\n67\n4\n2,753\n425\n105\n5,959\n741\nOther \t\n172\nOn escape, carried forward from\n1966/67\n4\nTotal as at April 1,1967\t\n1,668|1,598| 3,266\n1,188\n9041 2,092\n737\n7811 1,518\n3,593] 3,283\n6,876\nAdmissions\u00E2\u0080\u0094\nFirst admissions to Mental Health\nServices \t\nReadmission to different facility....\n789\n2\n952\n762\n941\n1,551\n2\n1,893\n76\n12\n35\n46\n8\n23\n122\n20\n58\n215\n21\n7\n254\n23\n13\n469\n44\n20\n1,080\n35\n994\n1,062\n31\n977\n2,142\n66\n1,971\n1,743| 1,703 [3,446\n123\n771 200\n243\n290\n533\n2,109] 2,070\n4,179\nTransfers in\t\n16| 8| 24\n13\n141 27\n41\n281 69\n701 50\n120\nTotal admissions to individual\nfacility \t\n1\n1,759 1,711\n3,470\n136\n91\n227\n284\n318\n602\n2,179\n2,120\n4,299\nTotal under care1 \t\n3,427[ 3,309] 6,736\n1,324\n9951 2,319\n1,021\n1,0991 2,120\n5,702| 5,353\n11,0551\nSeparations\u00E2\u0080\u0094\n1,662\n87\n176\n65\n7\n1,558\n77\n188\n206\n2\n3,220\n164\n364\n271\n9\n85\n10\n75\n21\n38\n15\n104\n12\n123\n25\n179\n33\n45\n237\n96\n38\n237\n158\n83\n474\n254\n1,792\n334\n347\n86\n7\n1,634\n329\n450\n218\n2\n3,426\n663\n797\n304\nDied v\nOn extended leave in boarding\nhomes \t\nOther \t\nOn escape\t\n9\n1,997\n16\n2,031\n9\n4,028\n25\n191\n10\n169\n14\n360\n24\n378\n44\n433\n27\n811\n71\n2,566\n70\n2,633\n50\n5,199\n120\nTotal separations from individ-\n2,013\n2,040\n4,053\n201\n183\n384\n422\n460\n882\n2,636\n2,683\n5,319\nNet increase or decrease \t\n\u00E2\u0080\u0094421 \u00E2\u0080\u0094 431 \u00E2\u0080\u009485\n+9\n-9| 0\n\u00E2\u0080\u0094 37\n+ 19| \u00E2\u0080\u009418\n\u00E2\u0080\u0094701 \u00E2\u0080\u009433\n\u00E2\u0080\u0094 103\nIn residence, March 31, 1968\t\n1,414\n1,2691 2,683\n1\n1,123\n812\n1,935\n599\n639\n1,238\n3,136\n2,720\n5,856\n1 Total under care for all Mental Health Services includes total as at April 1, 1967, plus the total admissions\nto individual facilities minus transfers out.\n L 86\nMENTAL HEALTH BRANCH REPORT, 1967/68\nTable 6.\u00E2\u0080\u0094Movement of Population in Individual Institutions,\nApril 1, 1967, to March 31, 1968\nGeriatric Division\nValleyview Hospital,\nEssondale\nDellview Hospital,\nVernon\nSkeenaview\nHospital,\nTerrace\nTotal\nM.\nF.\nT.\nM.\nF.\nT.\nM.\nM.\nF.\nT.\n254\n96\n494\n147\n748\n243\n89\n5\n126\n14\n215\n19\n293\n636\n101\n620\n161\n1,256\nOn extended leave, carried forward from 1966/67\u00E2\u0080\u0094\n262\nOther . \t\nTotal as at April 1, 1967\t\n350\n641 | 991\n94\n140\n234\n293\n737\n781\n1,518\nAdmissions\u00E2\u0080\u0094\nFirst admissions to Mental\n158\n19\n5\n210\n22\n10\n368\n41\n15\n40\n2\n1\n44\n1\n3\n84\n3\n4\n17\ni\n215\n21\n7\n254\n23\n13\n469\nReadmission to different facility\t\nReadmission to same facility\u00E2\u0080\u0094\n44\n20\nTotal admissions\u00E2\u0080\u0094 __\n182\n242 | 424\n43\n48\n91\n18\n243\n290\n533\nTransfers in \t\n12\n7 | 19\n6\n21\n27\n23\n41\n28\n69\nTotal admissions to indi-\n194\n249 | 443\n49\n69\n118\n41\n284\n318\n602\nTotal under care1\t\n544\n890 | 1,434\n143\n209\n352\n334\n977\n1,072\n2,0491\nSeparations\u00E2\u0080\u0094\n35\n131\n83\n32\n193\n131\n67\n324\n214\n7\n53\n13\n6\n44\n27\n13\n97\n40\n3\n53\n45\n237\n96\n38\n237\n158\n83\nDied .\n474\nOn extended leave in board-\n254\nOther\t\n249\n356\n605\n73\n77\n150\n56\n378\n433\n811\n44\n27\n71\n\t\n\t\n44\n27\n71\nTotal separations from in-\n293\n383\n676\n73\n77\n150\n56\n422\n460\n882\nNet increase or decrease\t\n-3\n+ 13 ] +10\n-19\n+6\n-13\n-15\n\u00E2\u0080\u009437\n+19\n-18\nIn residence, March 31, 1968\n251\n507 | 758\n1\n70\n132\n202\n278\n599\n639\n1,238\n1 Total under care for the Geriatric Division includes total as at April 1, 1967, plus the total admissions to\nindividual facilities minus transfers out.\n IN-PATIENT SERVICES\nL 87\nTable 6.\u00E2\u0080\u0094Movement of Population in Individual Institutions,\nApril 1, 1967, to March 31, 1968\u00E2\u0080\u0094Continued\nSchools for Mentally Retarded\nThe Woodlands School,\nNew Westminster\nThe Tranquille School,\nTranquille\nTotal\nM.\nF.\nT.\nM.\nF.\nT.\nM.\nF.\nT.\n746\n41\n11\n531\n67\n3\n1,277\n108\n14\n368\n18\n4\n290\n11\n2\n\t\n658\n29\n6\n1,114\n59\n15\n821\n78\n5\n1,935\nOn extended leave, carried forward\nfrom 1966/67\u00E2\u0080\u0094\n137\nOther \u00E2\u0080\u0094\t\n20\nOn escape, carried forward from\n1966/67 . - ...\nTotal on books, April 1, 1967\t\n798\n601 | 1,399\n390\n303\n693\n1,188\n904\n2,092\nAdmissions\u00E2\u0080\u0094\nFirst admissions to Mental Health\n64\n9\n32\n40\n5\n19\n104\n14\n51\n12\n3\n3\n6\n3\n4\n18\n6\n7\n76\n12\n35\n46\n8\n23\n122\n20\nReadmission to same facility _\n58\n105\n64 | 169\n18\n13\n31\n123\n13\n77\n14\n200\nTransfers in \t\n5\n4 1 9\n8\n10\n18\n27\nTotal admissions to individual facility\t\nno\n68\n178\n26\n23\n49\n136\n91\n227\nTotal under care1 \t\n908\n669 | 1,577\n416\n326\n742\n1,314\n981\n2,295\nSeparations\u00E2\u0080\u0094\nDischarged in full\t\nDied . . \t\n64\n10\n59\n18\n30\n11\n83\n9\n94\n21\n142\n27\n21\n16\n3\n8\n4\n21\n3\n29\n4\n37\n6\n85\n10\n75\n21\n38\n15\n104\n12\n123\n25\nOn extended leave in boarding homes\nOther \t\n179\n33\nOn escape \t\n151\n133 ] 284\n40\n36\n76\n191\n169\n360\n8\n9 | 17\n2\n5\n7\n10\n14\n24\nTotal separations from individual\nfacility -\t\n159\n142 1 301\n42\n41\n83\n201\n183\n384\nNet increase or decrease \t\n+3\n-4 ] -1\n+6\n-5\n+ 1\n+9\n\u00E2\u0080\u00949\no\nIn residence, March 31, 1968.\u00E2\u0080\u0094\t\n749\n527\n1,276\n374\n285\n659\n1,123\n812\n1,935\ni Total under care for Schools for Mentally Retarded Division includes total as at April 1, 1967, plus total\nadmissions to individual facilities minus transfers out.\n L 88 MENTAL HEALTH BRANCH REPORT, 1967/68\nREPORT OF THE DEPARTMENT OF NURSING EDUCATION\nMrs. E. Paulson, B.S.N., Acting Director\nThe year-end census for the psychiatric nursing programme was 258 students,\nas compared with 299 at the end of the fiscal year. During the period of time reviewed in this report, the Department processed 279 applications. Seventy-three\nstudents were accepted for the fall class; of these, 49 had been enrolled in an academic secondary-school programme and the remainder in a vocational programme.\nForty students withdrew for the following reasons: Illness, 3; unsuited, 7; personal,\n13; clinical or academic failure, 17. Seventy-five students completed the programme, and, of these, 68 were employed by the Mental Health Services. The faculty continued with the revision of the curriculum. Programme policies and a clinical-experience record book were revised. The first-term class block was extended\nfrom six to eight weeks. The added period of time enabled instructors to prepare\nstudents more thoroughly for their assignment to the clinical area. The classroom\ncourse in geriatric nursing was integrated into the clinical programme at Valleyview\nHospital. More \" activities \" hours were incorporated into classroom blocks, and\nall levels of students participated in projects. Students affiliating at The Woodlands\nSchool received experience in the pre-kindergarten and operant conditioning programmes.\nIn the psychiatric aide programme, 17 five-day courses were conducted\u00E2\u0080\u0094five\nat the Education Centre and 12 at The Woodlands School. Numbers enrolled in\nthe courses totalled 116. At Riverview and Valleyview Hospitals and The Woodlands School, the courses were followed by 112 clinic hours given by instructors.\nSupplemental courses were provided for 20 aides at Skeenaview. Minor changes\nin curriculum content were made in consultation with nursing service. In September the senior instructor enrolled at Simon Fraser University. The programme continued under the direction of an acting senior instructor.\nTwo hundred and one students enrolled in the affiliate programmes in psychiatric nursing. This number included six third-year basic baccalaureate students\nfrom the School of Nursing, University of British Columbia. Terms of agreement\nfor the operation of a nine-week programme, three times annually, were drafted for\napproval by the parties concerned. These are subject to reconsideration in 1969.\nThe co-ordinator resigned in October. A senior instructor who had been assisting\nwith the programme was appointed to the position.\nIn September Miss M. M. Lonergan, former Director of Nursing Education,\nassumed the position of full-time Nursing Consultant with the Mental Health Branch,\nVictoria. The Assistant Director was appointed Acting Director of Nursing Education. An Instructor 1 was promoted to an Instructor 2 position in October. Two\nInstructor 1 vacancies exist.\nThe establishment of the Department comprises 70 persons\u00E2\u0080\u0094instructors, secretariate, infirmary nurses, home supervisors, and maintenance staff. The continued\nco-operation of all members contributed substantially to the successful operation of\nthe Department.\n IN-PATIENT SERVICES\nL 89\nRIVERVIEW HOSPITAL\nB. F. Bryson, B.A., M.D., CM., F.A.P.A., Superintendent\nReport for April 1, 1967, to March 31, 1968\nGENERAL COMMENTS\nThe following table gives a summary of the movement of population for Riverview Hospital for the 12 months ended March 31, 1968:\u00E2\u0080\u0094\nMale\nFemale\nTotal\nIn residence, April 1, 1967 \t\nOn extended leave\u00E2\u0080\u0094\nBoarding home -\nOther - -\n1,456\n156\n52\n4\n1,312\n186\n100\n2,768\n342\n152\n4\nTotals .. \t\n1,668\n1,598\n3,266\n1,743\n15\n1\n1,703\n7\n1\n3,446\nTransfers from geriatric facilities \u00E2\u0080\u0094\t\n22\n2\n1,759\n1,711\n3,470\nTotal under care \u00E2\u0080\u0094 \t\n3,427\n3,309\n6,736\nSeparations\u00E2\u0080\u0094\n1,662\n87\n12\n4\n176\n65\n1\n1,558\n77\n8\n1\n188\n206\n2\n3,220\nDied \t\n164\n20\n5\nOn extended leave\u00E2\u0080\u0094\nBoarding home\t\nOther \t\n364\n271\n9\n2,013\n2,040\n4,053\n-42\n1,414\n\u00E2\u0080\u009443\n1,269\n\u00E2\u0080\u0094 85\nIn residence, March 31, 1968-\t\n2,683\nA review of the above statistical summary of patient movement, compared to\nthat for the previous year, reveals that there has been a marked decrease in both\nadmissions and separations. This year there were 3,470 patients, including 1,759\nmen and 1,711 women, admitted to Riverview as either new admissions, readmis-\nsions, or transfers from other mental health facilities, a decrease of 805 or 18.82\nper cent of the last year's total intake.\nOf the total admissions, 1,558 or 44.9 per cent, came of their own accord as\ninformal admissions, while 1,701 or 49 per cent required certification as involuntary\npatients under the Mental Health Act, 1964, including 20 patients transferred from\nFederal penal institutions. The remaining 211 or 6.1 per cent were admitted under\nvarious sections of the Criminal Code, including 61 by Orders in Council and 73 by\nCourt order. Magistrates' warrants (Form A) were used for 76 admissions, a drop\nof 25 compared to the number admitted by this procedure last year. Of all admissions from the community, 196 or 12.5 per cent were under 19 years of age. Only\none patient could be accepted for admission for alcoholic treatment under section\n26 of the Mental Health Act, 1964, compared to 62 during the previous year. It\nis felt that the significant drop in admissions this year has resulted from several\nfactors, including the need to limit admissions due to a decrease in the number of\nphysicians on staff during a large portion of the year, as well as the increasing\neffectiveness of new treatment resources in various areas of the Province.\n L 90\nMENTAL HEALTH BRANCH REPORT, 1967/68\nSeparations also decreased significantly by 733 and totalled 4,053 for the\nyear, including 2,013 men and 2,040 women. Of these, 3,220 or 79.4 per cent\nwere discharged to the community, but were 898 less than were returned to community life the previous year. As may be expected with an increasingly larger\nnumber of aged patients in the hospital population, separations by death increased\nby 35 to a total of 164 for the year, representing 4.1 per cent of total separations,\nbut only 2.4 per cent of the number of patients under care of Riverview Hospital.\nThe significant drop in the number of patients discharged from hospital care not\nonly reflects the above-noted need to reduce the admission of new patients but also\nthe increasing difficulty that has been met in locating suitable boarding homes or\nnursing homes in the community for many patients who no longer require care in\na psychiatric facility.\nAt the year's end there were only 22 more patients in boarding-home care\ncompared to last year and now total 364, including 176 men and 188 women.\nAs of March 31, 1968, the number of patients in residence at Riverview Hospital totalled 2,683 (1,414 men and 1,269 women), a decrease of 85 compared to\nthe same date a year ago.\nTREATMENT SERVICES\nThe past year has been a very active year for all staff in meeting the treatment\nrequirements of the large number of patients requiring admission and in attempting\nto upgrade the standards of treatment and services given. On October 5, 1967,\napplication was made to the Canadian Council on Hospital Accreditation for a survey of Riverview Hospital for accreditation purposes. The standards for the\nAccreditation of Canadian Mental Hospitals have served as a useful guide for the\nevaluation and upgrading of hospital standards of treatment. On December 27th\nThe highest standards of medical and surgical care are adhered to at the Riverview Hospital.\nHere a surgical team is at work in the operating-room for general and neuro surgery.\n INPATIENT SERVICES L 91\nthe medical staff prepared a proposed set of by-laws, rules, and regulations for a\nmedical-staff organization on the patterns outlined in this accreditation guide, which\nhas been forwarded to the Deputy Minister for Governmental approval. A Medical\nAudit Committee has been formed and has been extremely busy surveying standards\nof care and treatment facilities throughout the various units of the hospital.\nWhile psychoactive drugs are still of great importance, and electroconvulsive\ntherapy modified by anaesthesia and muscle relaxation used on selective cases, there\nhas been a significant increase in the use of the therapeutic community approach\nand in group therapy sessions. An even greater emphasis is being laid on preparation of the patient for return to the community and in referral to appropriate community resources. In most cases, patients are referred back to the care of their\nprivate physician, but in selected cases they have been seen in follow-up care by\ntheir hospital physician. The number of such patients attending the after-care\ndepartment as of March 31, 1968, was 823 patients. Medical and social service\nstaff are active in providing supervision to 364 patients transferred on boarding-\nhome leave to approved boarding homes. During the year a pilot project was\ninitiated whereby a number of patients on discharge were referred from the Crease\nUnit to the Vancouver General Hospital Psychiatric Out-patients' Department.\nDuring the year there were several changes in senior medical staff. Dr. Peter\nM. Middleton, the former Clinical Director, resigned on September 8, 1967, being\nreplaced by Dr. W. J. G. McFarlane on October 9, 1967. There were changes in\nunit directors in three of the six units. Serious shortages of qualified psychiatrists\nthroughout much of the year have hampered the maintenance of a satisfactory\nstandard of medical care, and forced, on January 11, 1968, the reduction of the\noperational bed count in the Crease Unit by 40 beds. This in turn forced a restriction of admissions and the accumulation of a waiting list for admission to the\nhospital, which may partially explain the reduction in the total number of admissions to the hospital during the year. In spite of this reduced admission rate, a\nlarge number of patients have been admitted who could have been treated more\nsatisfactorily in the community had adequate pre-admission services and alternative resources to hospitalization existed.\nTwo categories of patients have continued to pose severe difficulties\u00E2\u0080\u0094the\nemotionally disturbed adolescent and the criminally insane. One hundred and\nninety-six patients under the age of 20 years were admitted to hospital this year.\nIt is hoped, however, that the development of the residential treatment centre at\nBurnaby for emotionally disturbed adolescents will provide a more satisfactory\ntreatment facility.\nOne hundred and thirty-four patients were admitted under Court order or by\nOrder in Council during the year, there being 99 such patients in residence on\nMarch 31, 1968. This group of prisoner-patients continues to be disruptive of\ntreatment services to such an extent that a serious disturbance of riot proportion\noccurred on April 2, 1967, and a second such disturbance was narrowly averted\non October 22, 1967, by the emergency transfer of several of these patients to penal\ninstitutions. These occurrences, together with the fact that several patients have\nscaled the security fence, illustrate the point that our security area can be considered\nonly minimal by prison standards, and also points up the need for a separate institution for such patients.\nThe hospital will continue to be recognized for six months' postgraduate training in surgery on rotation from the University of British Columbia integrated graduate training programme in surgery. Negotiations have subsequently been held with\nthe University of British Columbia Department of Psychiatry in order to develop a\nclinical teaching unit at this hospital in affiliation with the University of British\n L 92\nMENTAL HEALTH BRANCH REPORT, 1967/68\nColumbia for such postgraduate training in psychiatry, which it is hoped will be\nrecognized by the Royal College of Physicians and Surgeons of Canada. Undergraduate clinics were held throughout the year for second-, third-, and fourth-year\nmedical students.\nStaff have been active in a variety of research projects. Dr. W. T. Brown has\nthroughout the year conducted controlled studies of various sedative and tranquillizing drugs. Dr. A. C. Greiner has continued his researches into biochemical factors\nin the etiology of schizophrenia. Staff of various disciplines have co-operated with\nDr. Thomas Perry of the University of British Columbia Pharmacology Department\nin his research into possible biochemical anomolies in Huntington's chorea and in\nschizophrenia.\nNURSING SERVICES\nIn the past year the Department of Nursing has taken several specific steps to\nidentify and measure the activities occurring within the Department as a basis for\nimmediate and longer range planning.\nA time and activity study for all levels of ward staff, for a seven-day period,\nwas completed in December, 1967. This provided additional clarification of the\nfunctions carried out by nursing. Eleven positions have been released to the Department of Housekeeping (in addition to those previously released) to free nursing\nstaff of major housekeeping duties, thus making them available for appropriate\nduties.\nThe standards established by the Committee on Accreditation of Psychiatric\nHospitals, 1964, have been used as a guide to enable us to study and evaluate our\ncurrent practices. Some changes have been made to bring the Department of Nursing into accord with the stated expectations.\nA great deal of time is spent by psychiatric nurses in participating with their patients. This\ntype of personal relationship is important in helping patients work through their problems.\n IN-PATIENT SERVICES L 93\nIntensive remotivation programmes have been implemented in two wards, and\nminimal care, or intermediate quarters, has been established for 12 women patients.\nThe latter has been in operation since October, 1967, the goal being to help this\ngroup toward increased independence while living in hospital. It is planned by the\nDepartment to develop several more such residences for separate groups of men and\nwomen.\nThe number of Order in Council patients and others referred by the Courts has\nfluctuated little in the past year. Increased opportunities for work and other activities for these patients have been developed.\nThe growing numbers of infirm patients in hospital is of great concern. It has\nbeen necessary to establish two more wards of 40 beds each, staffed and equipped,\nto provide adequate care for these physically and emotionally handicapped patients.\nThroughout the year there has been marked emphasis on staff education, and\nwe have taken advantage of many opportunities to improve the effectiveness and\nskills of our nursing staff. These include:\u00E2\u0080\u0094\n(a) The 10-month diploma course in Administration of Hospital Units,\nSchool of Nursing, University of British Columbia.\n(b) The psychiatric nurses' co-ordinated programme, offered for the first time\nat Vancouver City College.\n(c) The extension course in Nursing Unit Administration, sponsored jointly\nby Canadian Nurses' Association and Canadian Hospital Association,\nwhich included two intramural sessions of one week each at the University of British Columbia.\n(d) The regional workshop for directors of nursing service in hospitals, held\nin Vancouver, May 2 to 5, 1967.\n(e) A day's workshop on group psychotherapy at the Mental Health Centre,\nin September.\n(/) A series of 16 lectures on drugs and somatic complaints, presented at\nVancouver General Hospital from September to February.\n(g) The workshop on surgical ward nursing, held December 7 and 8, 1967.\n(/.) The third institute on psychiatric nursing at the University of British Columbia. The topic was \" The Troubled Adolescent.\" This was sponsored by the Extension Department and School of Nursing, University\nof British Columbia. The planning committee included two representatives from Riverview Hospital.\n(i) The institute for head nurses, sponsored by the Registered Nurses Association of British Columbia, at which the topic was \" Evaluation as a\nMeans of Improving Staff Performance.\" This was the first time the\nRegistered Nurses Association of British Columbia extended an invitation\nfor charge nurses to be included by the opening of an R.N.A. educational\nproject. The planning committee included a representative from Riverview Hospital.\n(/) The orientation classes offered at the Education Centre by instructors in\nthat department for psychiatric aides.\nA total of 226 members of the nursing staff attended these programmes.\nThe nursing service of Riverview Hospital has continued to provide clinical\nareas for the nursing education of students in the psychiatric nursing programme of\nthe Mental Health Branch, as well as for community agencies, including affiliate\nstudents from St. Paul's, Royal Columbian, and St. Joseph's Hospitals; students from\ndegree and diploma programmes at the School of Nursing, University of British Columbia; and public health nurses.\n L 94 MENTAL HEALTH BRANCH REPORT, 1967/68\nIn order to improve the supervision and general welfare of the many patients\nwho are engaged in work situations on the grounds, a Nursing Supervisor of Outdoor\nWorkers was established on January 15, 1968. This has improved communications,\nand there is now more emphasis on teaching and assessing changes in patients'\nperformance and potential. Five aides supervising these patients were given 12\nlectures on first aid to prepare them to give any necessary initial treatment before\nreturning the patient to the ward.\nIn May, 1967, resignations were received from over 350 psychiatric nurses in\nprotest over salaries and a desire for changes in certain personnel practices. These\nwere withdrawn before June 1 by all but nine when a fact-finding committee was\nformed to deal with the matters in dispute.\nPSYCHOLOGY DEPARTMENT\nThis year has been one of satisfactory progress in the Psychology Department\ndespite the acute shortage of full-time personnel. Through the initiation of special\npolicies permitting the casual employing of psychologists on hourly-rate and sessional basis, it was possible to gain sufficient professional assistance to permit a\nmaintenance of departmental services.\nIn total, 27 lectures were given, mostly within the framework of instructional\nprogrammes for nurse trainees, but also included were talks to other affiliating\nstudents and visiting groups.\nA total of 1,506 psychological tests were administered, the greater number of\nwhich were used in the preparation of patient evaluations. In total, 428 such reports\nwere prepared in response to referrals for diagnostic evaluation, intellectual measurement, and personality assessment.\nThe Department actively continued its therapeutic programmes. In total, 838\ntherapeutic sessions were conducted, the majority within the context of intensive\nin-patient psychotherapy services for the adolescent and neurotic adult, but including out-patient marital group therapy and conjoint interviews.\nResearch interest has continued strongly. Studies being undertaken altogether\nare:\u00E2\u0080\u0094\n(1) Examining the efficacy of selection procedures for nursing-school candidates.\n(2) Attempting to delineate antecedent factors underlying suicide behaviour.\n(3) Relating to the development of an automated testing procedure.\nThe Department continued an affiliation with the Lower Mainland universities\nin repeating, for an eighth summer, an internship programme designed to familiarize\nthe prospective graduate clinical student with the duties and demands facing the\nclinical psychologist.\nSOCIAL SERVICE DEPARTMENT\nIn line with the growing emphasis on community-based services, the Social\nService Department has continued to have as a major objective the expansion of\nservices at the community rather than the institutional level. To this end an additional social worker from the Crease Unit in-hospital staff was assigned part time\nto the After-care Clinic, thereby increasing services available to patients in the\nGreater Vancouver area. Social and casework services to patients resident in this\narea were further enhanced by the implementation of a pre-admission service designed to assist and to support potential patients and their families in preparing for\nthe experience of hospitalization, or assisting in referral to other community health\nand welfare resources where indicated.\nFor patients from more remote and less urbanized regions of the Province, it\nwas necessary to continue to offer a concentration of social services at the ward\n IN-PATIENT SERVICES L 95\nlevel, due largely to insufficient community resources in their home areas. This\nwas particularly true of minor patients admitted to Centre Lawn Unit, whose numerous and varied needs for supervision, care, and treatment were beyond the capacity\nof existing community facilities.\nAs in previous years, the supervised boarding-home programme continued to\nmake a worth-while contribution toward the integration of institutional clinical services with those of other health and welfare agencies. During the year, in co-operation with the Departments of Social Welfare and Public Health, and with valuable\nassistance from local service clubs, it was possible to resettle 123 patients in licensed\nboarding homes under the ongoing treatment and management supervision of Riverview Hospital. Of this total, 91 were initial placements and 32 were concerned with\npatients who had had previous placement experiences from the hospital. In addition, 16 patients were discharged from the programme to live in more independent\ncommunity situations.\nPlanning for the community resettlement of patients was hampered considerably by a shortage of boarding-home beds. This shortage was particularly acute in\nlarge municipalities such as the City of Vancouver, and seemed to be closely related\nto the current housing crisis coupled with rising construction costs. As a result of\nthis, a number of beds which had formerly been used specifically for patients from\nthis hospital were no longer available, the homes in question having been converted\nto private dwellings.\nIn all hospital units, including the After-care Clinic, social workers were increasingly involved in patient therapy groups, either on the basis of casework\ntreatment to a group of selected patients or in conjunction with other treatment\ndisciplines. This service was extended to include one boarding home in which the\nmajority of the patients were young adults suffering from severe problems in interpersonal relationships.\nThe over-all work of the Department is reflected in the statistical summaries of\nservices rendered, which reveal that a total of 4,381 patients in hospital and 740\npatients in after-care received direct social and casework services. These figures\nrepresent a slight reduction from those of the previous year.\nEducational responsibilities were met by various members of the staff through\nparticipation in orientations, workshops, and speaking engagements. In addition,\nthe services of senior members of staff were again requested by the School of Social\nWork, University of British Columbia, in order to provide field-work supervision for\nsix second-year students who were assigned to the hospital and the After-care Clinic\nfor practical supervised experience during the final year of their Master's education.\nREHABILITATION DEPARTMENT\nThe Rehabilitation Department has been engaged in a wide variety of services\ngeared to preparing patients for life in the community. While much of the Department's work is involved in vocational preparation and assessment, there is an increasing concern that our programmes go beyond this to ensure the development of\nthe type of responsible behaviour necessary for successful community life. Every\nopportunity is taken to have realistic community-based experiences for patients as\nthey prepare to leave the hospital.\nThe work placement programme handled a total of 1,554 new referrals. These\nhave involved individual interviews by the staff and follow-up of the patient's work\nperformance. Efforts have been made in this last year to improve the hospital working conditions for the patients, and a number of reports have been submitted with\nspecific requests for improvements. A large berry-picking project was carried on\n L 96\nMENTAL HEALTH BRANCH REPORT, 1967/68\nduring the summer, and the patients involved were very enthusiastic, both for the\nexperience of the work and the amount of money they were able to earn. We are\nworking toward even more community-based work projects in order to give our\npatients the real work experience they will need after leaving the hospital.\nOne hundred and eighty-three new referrals for vocational assessment were\nhandled. This is a service which is valued by outside employment agencies, as the\nfindings can be most helpful in finding employment in the community for the\npatient when he is discharged. We have maintained a close liaison with the Canada\nManpower organization, and arrangements have been made for one of its counsellors to spend one day per week at Riverview Hospital to interview and assist\npatients in finding suitable work following discharge. Due to the employment\nscarcity this year, it has been necessary to give more service to patients trying to\nenter the labour market. Help in job-finding, beyond what is available in the\npublic agencies, is furnished by the job placement officers at the hospital. It is\nfelt strongly that the opportunity for the patient to work in the community is most\nimportant therapeutically in terms of his making a good community adjustment,\nand the economic advantage is most evident.\nThe rehabilitation residences Vista and Venture have remained very active,\nwith more beds being requested than are available. Due to this pressure, a third\nresidence has been opened next door to Venture with 6 more beds for men. This\nresidence is just starting operation and will be supervised by the existing staff at\nVenture. A total of 53 patients was served in the rehabilitation residences this\nyear, some of them staying over an extended period of time. Due to the pressure\nof referrals, it is likely that the length of individual patient stays will have to be\nshortened in order to prevent the formation of waiting lists for services at these\nhomes. \\nRiverview's machine-shop manufactures many items for hospital use and also maintains a\nlarge repair and service department. The shop employs an average of 15 to 20 patients.\n IN-PATIENT SERVICES L 97\nThe Hillside Rehabilitation Unit has now been in operation for over a year.\nDuring this year a total of 118 patients has been served in programmes designed\nspecifically for preparing patients to live as successfully as possible in the community. Patients referred to Hillside are those with special problems making discharge difficult. Many have had repeated hospitalizations, and the programme\nhere is designed to give concrete help on matters related to making a satisfactory\nadjustment following discharge. Follow-up services required to make this kind of\nprogramme successful are a little difficult to provide conveniently due to the large\nnumber of patients going into the Vancouver area.\nThe Department continues to make use of a large variety of community resources and agencies to help patients before and after discharge. We are finding\nan increasing acceptance of psychiatric referrals by employers and agencies dealing\nwith other handicapped groups in the community. This is especially true when\nwe can provide meaningful assessments of our patients as they utilize the rehabilitation services offered within the community. Good communication with these outside resources has helped to break down the barriers between the hospital and the\nnormal community.\nOCCUPATIONAL THERAPY DEPARTMENT\nDuring the year the resources of the Occupational Therapy Department have\nbeen extended by demands from hospital and community for further coverage.\nConflicting needs to provide occupational therapy for individually referred\npatients and assistance to ward-centred activation groups have been difficult to\nresolve, particularly as staff stability declined during the summer. Locum tenans\nappointments staved off the crisis until permanent staff could be recruited. Vacancies\nfor senior supervisory staff still exist, however, in five of the six units.\nDue to a preponderance of new graduates on staff, staff development and\neducation has been of major importance. In-service lectures and discussions have\nbeen supplemented by oportunities to attend workshops on \" Group Process \" and\n\" Caring for the Dependent Patient \" and a course on neuroanatomy.\nIn addition to treating individually referred patients and participating in therapeutic community situations, some occupational therapists have been involved in\ntwo new programmes. In the short-stay areas, an evening educational programme\ndealing with general everyday activities developed from a pilot project on one ward\nto serve patients from Crease, Centre Lawn, and Hillside. Weekly, volunteer\nexperts from the community have been invited to share their experiences about\ntopics such as job-finding, budget management, child-care, and the use of community facilities. The second programme was centred in East Lawn to train activity\naides. Six patients successfully completed a six-week course to prepare them to\nassist in occupational and recreational programmes and with activity groups organized by nursing personnel.\nOnce again the Canadian Mental Health Association volunteer organization has\nassisted this Department in several ways. Volunteers provided equipment for the\nA.D.L. (Activities of Daily Living) Unit, assisted with the preparation and distribution of materials, and enriched the pre-boarding-home programme by welcoming\npatients to luncheons, community clubs, and community activities.\nThe boarding-home programme has also been indebted to volunteers as it\ncontinues to grow. Another day centre in Maillardville has been started on a similar\nbasis to those at White Rock and Haney. One full-time occupational therapist and\nan assistant carry a case load of 180 transfer-to-boarding-home patients from\nRiverview and The Woodlands School, using social, recreational, and educational\n L 98 MENTAL HEALTH BRANCH REPORT, 1967/68\nfacilities. The Co-ordinator of Boarding Homes, public health nurse, social welfare\nstaff, and boarding-home operators have been involved in the programming of this\nexpanding service, which was featured in a paper read by our boarding-home occupational therapist at the Canadian Association of Occupational Therapists' annual\nconference in Halifax this year.\nA growing emphasis on activating patients in the extended-care areas has made\nincreased demands on the Rehabilitation Workshop, a joint venture run by both\nthe Occupational Therapy and Rehabilitation Departments. Disassembly work in\nsix different wards is co-ordinated by the workshop staff as limited space has precluded an expansion of the central workshop area. Enlarged storage areas became\nvital to cope with the bulk of work needed for the shop and the wards it supplies.\nThe Construction Shop's programme to provide a realistic heavy-work experience for male patients has also included outdoor projects such as the construction of a summer picnic shelter. Referrals to the shop continue to be co-ordinated\nby job placement officers, who use it as an assessment area.\nConcern to improve the occupational-therapy service, and particularly transfer\nfrom one activity area to another, has focused attention on progress records. A\nnew method of recording on colour-coded, shingled report forms was instituted in\nconjunction with the other activity departments, and a close liaison with the job\nplacement officers was encouraged. New procedures were introduced to improve\ncommunication to medical staff and other related departments.\nOther activities covered by the Department include the distribution of ward\nChristmas decorations, floral arrangements for graduation, and an art show, all of\nwhich provided many reality-based opportunities for collaborative experience for\npatient groups. The annual sale of occupational-therapy work realized a total\nof $3,948.\nIn addition to direct patient-care, the staff were responsible for supervising a\ntotal of eight graduate and undergraduate interns from the Universities of Manitoba\nand British Columbia during the summer months. They were also involved with\nongoing orientation programmes for affiliating student nurses, and with providing\nconsultative help to the programming for the New Denver Youth Centre.\nThrough the year, occupational-therapy staff in all units handled 2,569 patients,\nwith a daily average of 399. A total of 95,699 treatment sessions was given.\nRECREATIONAL THERAPY DEPARTMENT\nA review of the Recreational Therapy Department for the year covers a wide\nrange of activities, carried out under many different circumstances at widely varying times of the day and evening and on almost every day of the year. The grand\ntotal added up to 5,537 sessions, with total patient attendances of 204,751.\nIn carrying out its function as part of the treatment team, the recreational-\ntherapy staff was involved in organizing and giving leadership to a total of 1,680\ndaily sessions conducted in all six units of the hospital. A total of 55,277 attendances was recorded in these sessions by patients who were thus afforded an opportunity to share in the stimulation and socializing values of group activation.\nDuring the year a notable gain in facilities was made with the opening in\nCentre Lawn in January of a new well-equipped centre for recreational therapy.\nIn each unit, activities were adapted to the needs of the patients.\nIn addition to the daily treatment-centred activities mentioned above, leisure-\ntime activities (bingos, card socials, teas, ward parties, dances, etc.) were conducted\nwithin the units on 885 occasions, with a total of 49,529 recorded attendances.\n IN-PATIENT SERVICES L 99\nSpecial events such as Christmas \" open house \" programmes and observation\nof special seasonal holidays (Easter, summer sports days, Hallowe'en, Thanksgiving,\nNew Year's, St. Valentine's Day, etc.) provided further occasions for unit-centred\nactivity. Picnics, cook-outs, hikes, fishing expeditions, swimming parties, mystery\nbus trips, and the attendance of busload groups of patients at concerts, movies,\nsporting events, the Pacific National Exhibition, the Shrine Circus, and other\ncommunity events provided considerable opportunities to keep patients aware of,\nand to assist in their readjustment to, the world outside the hospital. Such special\noutings were held on 395 occasions, with attendances of 10,389.\nNot all of hospital life is lived within the individual units, a fact readily discernible from a study of programmes provided in and around the hospital's community centre at Pennington Hall. Here major events, such as visiting concert\nparties, weekly bingos, Friday night dances, and individual and group participation\nin music, bowling, badminton, roller skating, etc., lead to a total recorded attendance\nof 59,993 in 1,090 scheduled events and open sessions. Softball, bowling, and\nvolleyball league play saw representative teams meet in intense but friendly competition on 194 occasions, with 3,782 in attendance. Continued lack of a swimming-pool cut off this source of healthy recreation for the great majority of our\npatients, but advantage was taken of limited off-grounds resources to provide a\nswimming opportunity for busload groups of patients on 95 occasions throughout\nthe year.\nThe provision of special week-long vacation activities for patient workers was\nagain provided by the Recreational Therapy Department. Some 624 patients took\npart in a 16-week programme enjoying hikes, picnics, outings, tours, and trips to\nStanley Park, special sporting events, etc.; in all, a total of 101 events, with\nattendance of 2,433.\nA further new development in summer activity lay in the seven weeks of resident camping provided for East and West Lawn patients at Camp Garibaldi, involving some 40 group sessions and a total attendance of 1,196.\nOnce again music and music-making in all its forms provided a most popular\nand sought-after resource throughout the hospital during the year. Group sessions\nwere held in all six units on 394 occasions, for a total participating attendance of\n9,115, while live music provided by combined patient-staff orchestras was a feature\nof most ward parties and Pennington Hall dances.\nContinuing efforts toward the development of a patients' glee club, a dance\norchestra, and various smaller musical combos brought further dividends when these\npatient groupings, assisted by visiting volunteer entertainers, were able to stage a\npopular summer series of mid-week concerts on the outdoor stage.\nThe popular patients' newspaper, The Leader, published every three weeks\nunder the guidance and supervision of the recreational-therapy staff, has continued\nto grow, with a present circulation of 1,200 couples. During the year a total of\n225 patients contributed to its production, of which approximately 90 are regular\ncontributors as ward reporters or assist in The Leader office. In October of 1967\nThe Leader was granted membership in the International Institutional Press Association, which has headquarters in Washington, D.C., and represents approximately\n660 publications. The Leader exchanges with 134 of these institutions.\nPATIENTS' SCHOOL\nThe school was open for 234 regular school-days, with a total enrolment of\n85 pupils (55 male and 30 female). Of these, 34 were adolescents with an average\nage of 16 years, and 51 adults averaging 26.9 years. Seventy-four attended daily\n L 100\nMENTAL HEALTH BRANCH REPORT, 1967/68\nclasses in the schoolroom, while 11 required instruction on the ward. The average\nperiod of attendance per patient was 6.7 weeks. Thirty-five of the school group\nwere able to leave the hospital on discharge.\nInstruction suited to the individual's needs continued to be employed as a\npreparation for the patient's return to the community, where he would either resume\nhis interrupted schooling or prepare for a job. Forty students followed the standard\ngrade curricula, and 45 undertook one or more correspondence courses. Both\nacademic and vocational subjects were offered.\nThe former scholastic achievement levels and age differences of the patients\nnecessitated a wide grade level of instruction. Twenty-three students were enrolled\nin the elementary grades, 33 in the junior secondary grades, and 23 in the senior\nsecondary grades. In addition, a class in English for New Canadians was attended\nby six patients.\nIn January an experimental programme was initiated wherein four selected\nOrder in Council patients were permitted to attend the regular afternoon classes\nrather than continue to receive individual instruction on their wards. Their greatly\nimproved work habits and achievements indicate the value of an integrated social\nsetting as an incentive to learning.\nA poll among the major Canadian mental hospitals was recently conducted\nby this Department to determine the extent of formal educational facilities available\nto patients. Approximately 50 per cent of the hospitals polled were conducting\nin-patient programmes similar to that at Riverview, and over 30 per cent are at the\npresent time engaged in setting up workable plans for such services. These data\nreflect the increasing awareness among our hospitals of the importance of an in-\nservice educational programme as a factor in the rehabilitation and post-hospital\nadjustment of many patients.\nRADIOLOGY DEPARTMENT\nThe Radiology Department technicians and visiting radiologists provided a\ncomprehensive diagnostic service throughout the year, during which time 10,902\npatients were examined and 16,541 films taken. A new automatic film-processor\nwas installed in the Crease Unit, which greatly decreases the time required for film\nprocessing and drying.\nPATHOLOGY DEPARTMENT\nThis Department reports increased activity over the past year. A total of\n80,205 procedures was performed in the several laboratories, representing 162,292\nunits of clinical laboratory work. This is an increase of 3,475 procedures or 17,096\nunits of work compared to the previous year. These increases occurred mainly in\nhsematological, biochemical, and bacteriological procedures.\nA total of 150 autopsy examinations was carried out, and constitute approximately 81 per cent of the deaths that occurred both at Riverview and Valleyview\nHospitals.\nThe Riverview laboratories continue to function as a training-school for laboratory technologists, and the pathologist and technical staff have continued to participate in the investigation of melanin metabolism as it relates to the etiology of\nschizophrenia.\nDEPARTMENT OF NEUROLOGY\nThis Department provides neurological, electroencephalographic, and neurosurgical consultative services to the Mental Health Branch. On July 1, 1967, Dr.\nR. P. Joneja was appointed as Director of this Department, replacing Dr. P. Bratty,\nwho previously served part time as our neurological consultant.\n IN-PATIENT SERVICES L 101\nDuring the year 203 neurologic consultations were provided. An echoen-\ncephalograph obtained in August, 1967, was put into immediate use, and since that\ntime 105 examinations have been done. A total of 1,059 E.E.G. examinations was\nperformed this year, 842 at Riverview Hospital, of which 143 were referrals from\npenal institutions, 167 were done at The Woodlands School, and 50 at the Burnaby\nMental Health Centre.\nDr. Frank Turnbull continues as the neurosurgical consultant, and during the\npast year carried out 11 neurosurgical operations, 11 carotid arteriograms, and six\npneumoencephalograms.\nDENTAL DEPARTMENT\nThe Dental Department has continued to provide a wide range of dental services to Riverview patients, with emphasis on maintaining a high level of dental care\nand hygiene for the long-term resident population. However, emergency service to\nshort-term patients has been provided wherever necessary. Denture work continues\nto be in constant demand. A second technician position has now been added to\nthe establishment, and recruitment into this early in the new year is anticipated.\nCompletion of dental care for patients being prepared to leave hospital to boarding-\nhome care continues to receive priority attention.\nSeveral needed changes were provided by the Public Works staff. The dental\nlaboratory particularly received a face-lifting with the provision of stainless-steel\nbench surfaces, enlarged sinks, and improved cupboard space. The darkroom also\nhas received new equipment. These improvements have helped considerably, but\nthere is still need for a general updating of operating equipment and space allocation\nin order to provide the most efficient dental service to patients.\nA review of the services rendered by the dental staff indicates a general increase\nof service to patients. During the year 3,305 patients were treated and 10,166\nprocedures carried out. This represents an increase of 409 patients and 546 procedures compared to the previous year.\nPHARMACY DEPARTMENT\nThe past year has seen a further increase in the services provided by the Riverview pharmacy. During the early part of the year the increased demands presented\ncertain problems. However, with the recruitment of an additional part-time pharmacist, some administrative changes, and time-saving equipment, full service was maintained and backlogs in prescriptions caught up.\nPrescription service to out-patients and in-patients continues to be the greatest\narea of service, and increased by 1,317 to a total of 27,124 prescriptions filled.\nThe number of prescriptions for narcotics and controlled drugs decreased signifi-\ncandy.\nIn addition to the individual prescription service, the pharmacy dispensed\n47,200 items of ward stock pharmaceuticals, as well as 20,300 items of surgical\nsundries.\nTime-saving and control procedures instituted during the year included a system of prepackaging control cards and an improved list to facilitate ward stock\nrequisitioning. A tube and jar filler, tube crimper, and homogenizer have been\nsecured and have proven to be very helpful.\nAs a result of these changes, the senior pharmacist has been able to carry out\na series of ward visits to supervise and assist nursing in the storage and control of\nward stock pharmaceuticals.\n L 102 MENTAL HEALTH BRANCH REPORT, 1967/68\nPHYSIOTHERAPY DEPARTMENT\nDuring most of the year this Department has been able to maintain a comprehensive physiotherapy service to patients, but, as a result of fluctuations in staffing\nand difficulties in recruitment of fully qualified physiotherapists, there have been\nperiods when service was affected.\nOn December 4th a senior physiotherapist was appointed as head of the Department. Since this date the service has expanded and is now better able to cope\nwith the heavy demands from increasing numbers of elderly and physically handicapped patients. Requests from the acute surgical and medical wards for newer\nphysiotherapy procedures, such as specialized treatment in the field of chest physiotherapy and intermittent positive pressure breathing treatments, have also increased.\nLack of a therapeutic pool to provide a full range of water-supported exercises\nfor physically and mentally handicapped persons has limited treatment in this area.\nDuring the year a total of 611 patients received treatment involving 8,677\nvarious treatment procedures.\nDepartment staff, in collaboration with the Department of Nursing Education,\nprovided a series of lectures on physiotherapy to senior student nurses during their\nstay in North Lawn wards. The students were taught how to give passive movements, how to position patients in bed with regard to certain medical conditions,\nand were also given instruction on simple bed exercises and the maintenance of\nmuscle tone to assist in the prevention of contractures and deformities in handicapped patients. Some in-service lecture programmes have also been provided for\ngraduate nurses.\nCHAPLAIN SERVICES\nThe religious needs of Riverview patients have continued to be served throughout the year by our resident chaplains through regular church services in Pennington Hall, the Crease Unit chapel, and by their regular ward visits and special attentions to the sick and bereaved.\nOf special interest this year has been the increased interest of community\nchurches and their clergy in our patients and the hospital. During the year the\nsecretary-general of the religious order of our Roman Catholic chaplain visited the\nhospital to become acquainted with the service at Riverview. This was later followed by the interest of the religious publication The B.C. Catholic, which printed\na long article on the work of our Roman Catholic chaplain. Senior students from\nthe Roman Catholic seminary and the Anglican seminary have also visited the hospital to view the scope and challenge of their work in this large patient-group.\nThere has also been an increase in the regular visiting programme of clergy\nfrom both the Lutheran Church and of the United Church of Canada.\nOf particular significance was the inauguration of a six-week field training\ncourse in clinical pastoral training at Riverview, conducted under the auspices of\nthe New Westminster Foundation.\nLIBRARY\nIn the patients' library efforts were concentrated on expanding the services to\npatients lacking grounds privileges. Success is largely due to the co-operation of\nthe volunteers. Books are deposited at East Lawn, West Lawn, and Centre Lawn,\nand volunteer staff see that these books are circulated throughout the units. All\nwards in Riverside now have their own small book collections, which are administered by the patients themselves. Book collections in all units are rotated quarterly to ensure variety and interest and to keep patients abreast with new publica-\n.\nJ\n IN-PATIENT SERVICES L 103\ntions. Almost 5,500 books were borrowed during the year. This is slightly less\nthan the previous year, but the decrease can be accounted for by the extension of\nlibrary services to other areas. During the year the fiction collection was revitalized\nlargely through donation of books from members of staff. The hospital Rehabilitation Department has again used the library as a job-placement area, and there has\nbeen a continuous succession of patients assigned to library duties. Magazine subscriptions now total 33. When out of date, these popular journals are circulated to\nvarious wards or used to augment the library's expanding illustrations collection.\nSeveral new services commenced this year in the medical library. A \" clippings \" file is now kept of articles appearing in the local press concerning the hospital and its services. \" What's New in the Library \" has been revived but in a\ndifferent form. This regular publication now lists current articles likely to interest\nthe staff instead of reviews of one or two interesting articles. The response to this\nlist, not only from the hospital staff but also the staff of the Province's Mental Health\nServices, adequately justifies the time spent in producing it. Bibliographies on topics\nof current interest are now being issued. So far, L.S.D., therapeutic communities,\nand barbiturate addiction have been dealt with. Some 1,736 books were circulated\nduring the year. This is a marked increase over previous years and emphasizes the\ncontinuing heavy use the library receives. Current journal subscriptions now total\n196. Approximately half the library's budget is spent purchasing these works;\nhowever, an extensive journal collection is essential if the library is to be kept up\nto date. Amongst the more difficult queries received and answered during the year\nwere those asking for information on histidinemia, pyridoxine deficiency in mental\nillness, and excephtalmus (unilateral).\nDuring the year 252 new books were added to the patients' library, bringing\nthe total collection to 3,931. The medical library received 362 new items, bringing\ntotal stock to 4,736.\nMEDICAL RECORDS DEPARTMENT\nA main goal throughout the year has been a review of the functions of the\nDepartment using as a guide the Standards for Accreditation of Canadian Mental\nHospitals, 1964, by the Canadian Council on Hospital Accreditation. To provide\nthe services recommended, the Medical Records Department's responsibilities have\nbeen extended. With the objective of furthering the elevation of the standards of\nclinical records, a quantitative analysis of the medical records of patients separated\nfrom the hospital is steadily developing. Thus a better base will be provided for\nthe medical-care analysis by the Medical Audit Committee. Additional services\nalso include the expansion of Riverview Hospital indexes to include medical diagnosis and operative procedures, which will provide a wider scope of data for research\nand a useful instrument for administrative purposes.\nAs requirements for higher standards demand more intensive procedures, an\nattempt is being made to provide the training necessary to meet the requirements.\nFour medical records staff have enrolled in the extension courses for training medical records personnel, sponsored jointly by the Canadian Hospital Association and\nthe Medical Record Librarians' Association. The approval of mental health bursaries for three of the applicants has greatly assisted this training objective.\nIn facilitating research programmes which required the use of patients' medical\nrecords, the Department was involved in two projects and supplied 268 medical records for reference purposes. There were 10 special statistical reports compiled in\nresponse to requests by departments of Riverview Hospital and the University of\nBritish Columbia.\n L 104 MENTAL HEALTH BRANCH REPORT, 1967/68\nVOLUNTEER SERVICES\nDuring the year 160 Canadian Mental Health Association hospital volunteers\ndonated 21,920 hours of service to the residents of Riverview Hospital.\nSome of the activities which were carried on throughout the hospital were as\nfollows: Apparel-shop, socialization and activation programmes, luncheons, volunteers assisting with occupational and recreational programmes, shopping trips, ethnic\ngroups, admission suite hostess service, library service, personal hygiene groups,\ntyping classes, birthday parties, drives.\nThe volunteers' apparel-shop has completed another successful and busy year,\nand issued a total of 3,331 articles of clothing to 2,178 patients, including many\nwho are resident in the community under our boarding-home programme.\nThe annual Christmas gift programme proceeded with success, and each resident of Riverview Hospital received a Christmas present. This totalled 2,870 gifts\nwhich were donated through the community at large.\nThe volunteers and hospital staff enjoyed a Christmas tea this year at the\nVolunteer Centre to endeavour to renew and augment staff-volunteer relationships\nand acquaintances. Approximately 300 staff and volunteers enjoyed this brief visit\nto the Volunteer Centre.\nLuncheon programmes this year increased in numbers; over 200 residents of\nthe hospital have been taken to private homes and churches for these outings. This\nprogramme has much therapeutic benefit for the residents attending.\nEthnic groups continue to function, our Japanese, Chinese, and Polish volunteers being active. These groups also provide interpreting service for residents of\nthe hospital when requested and needed.\nThe tailor-shop, which is under the direction of the Volunteer Services, has\nagain completed a busy and productive year, much to the benefit of residents in hospital. During the fiscal year there have been 1,852 articles repaired, mended, and\nfitted and altered at the shop. This represents a 25-per-cent increase over the past\nyear.\nTours through the hospital this year have accommodated various community\ngroups; that is, schools, churches, clubs, university students. Numbers touring\nequalled 807 individuals.\nGENERAL ADMINISTRATION AND SERVICE DEPARTMENTS\nIn view of the changing concepts of modern psychiatric care and treatment,\nthe increasing development of community resources, and the changes that have\noccurred in the organization of the Mental Health Branch, a great deal of study and\nreassessment has been carried out in most areas of the hospital during the year.\nConsiderable study and discussion by the senior administrative staff of the hospital\nhave been directed toward an evaluation of the present and future role and function\nof Riverview Hospital within the Mental Health Branch, and in relation to the\nvarious community resources for the treatment of emotional disorders for the\ncitizens of the Province. In particular, a review has been made of the total organization and administration of the hospital and its interdepartmental relationships,\nwhich resulted in the submission of a comprehensive report and recommendations\nearly in the year.\nThe changes that occurred in the reorganization of the office of the Deputy\nMinister of Mental Health were welcomed as a new and progressive approach to\nmental health care.\n IN-PATIENT SERVICES\nL 105\nA very considerable amount of effort has gone into endeavours to improve the\nfunctional operations of the departments of the Business Administrator. In particular, much planning and some progress have been achieved in improving our\nresponsibility and control over hospital accounting functions, the establishment of\na co-ordinated administration of laundry, linen, and clothing services and the provision of a Personnel Officer for Riverview.\nWe have enjoyed co-operation from the Department of Public Works in our\nendeavours to improve the hospital facilities under capital construction programmes.\nConsiderable work has gone into planning of the Riverside kitchen, dining, and\nindustrial-therapy facilities. The Centre Lawn Building has been under review,\nand plans are going ahead for some of the areas in this building. Ward D5 has\nalready been completely renovated, and Ward E5 is under development. Ward Dl\nhas been converted to a very welcome recreation area. Occupational-therapy facilities and the central administrative facilities will be carried out possibly in the forthcoming year. We were pleased to secure a very much needed dining-room for the\nWard HI patients. The conversion of a storage area has turned out to be a real\n\" bright spot\" for Ward HI. We plan to progress with changes in East Lawn as\nfunds are made available.\nConsiderable thought has gone into the planning of our laundry facilities. This\nis a major project which must be accommodated within the next year. Tenders for\nrenovations to the West Lawn Unit have been called for. The office and ward areas\nof East Lawn have also been under review, as these sections of the hospital will soon\nneed modernization.\nDIETARY DEPARTMENT\nDietary services to patients and staff have been updated with the installation\nof large central coffee-making facilities in Centre Lawn, new kitchen equipment in\nEast Lawn main dining-room, and the renovation of C4-A4 dining-room in West\nLawn. In addition, we have foreseen the need of a reduction in the practice of\nutilization of patient workers in the dietary area. It will soon be necessary to replace\nthese patient workers with paid personnel. For this reason, and in an endeavour\nto arrive at a five- or ten-year plan for the Dietary Department, arrangements have\nbeen made for a comprehensive survey by dietary consultants of all dietary facilities,\nfunctions, and services.\nHOUSEKEEPING DEPARTMENT\nThe Housekeeping Department has made a very considerable contribution in\nthe areas in which it has been engaged, and has been well received by the Nursing\nDivision. Our building service staff have cleaned an average of 15,000 square feet\nper employee day on a five-day-week basis. A recent cost analysis has established\nthat our cost runs at 30 cents per square foot per annum. It is our belief that we\nare receiving excellent value for the funds expended, and that the programme of\nhousekeeping within this institution should be accelerated so that we might reduce\nthe costs in the other hospital areas. Preventive maintenance pays.\nINDUSTRIAL THERAPY DEPARTMENT\nProduction-line methods on a limited scale were introduced to some of the\nshops this year. Results have proven both stimulating and instructive for the patient\nparticipants. Many of the items manufactured on assembly-lines were the direct\nproduct of Departmental research and manufactured for specific area needs. Chairs\nwere designed for incontinent patients; commodes, teaching aides, crib-side beds,\ngatch beds, wardrobes, bedside tables, etc., were also manufactured.\n L 106\nMENTAL HEALTH BRANCH REPORT, 1967/68\nIt is of interest to note that the Industrial Therapy Department has played an\nimportant role in relieving tensions in the Order in Council wards by employing two\nlarge groups of patients in the mattress-shop and the upholstery-shop over the past\neight months. The results achieved from this programme have been heart-warming,\neducational, and therapeutic.\nThe Audio-Visual Department is to be praised for its part in a technical achievement of a 16-mm. movie entitled \" Ward 71 \" produced for the psychiatric unit at\nThe Woodlands School. This film, telling the story of a ward for autistic boys, is\nto be used as a teaching-tool in staff-training and for ward orientation. The conference of the American Association for Mental Deficiency held in New Westminster\nwas the setting for the first public showing. Comments following this presentation\nconfirm that this is one of a very few films dealing with autism which is available.\nThe film library shipped 2,311 educational films to borrowers encompassing\na viewing audience of 70,354 persons.\nDay and evening concert music is piped to all parts of the hospital grounds.\nRecreational movies, 16 and 35 mm., were enjoyed by many patients throughout\nthe winter months.\nThe music activation programme broadcast to East Lawn and North Lawn\nwards each morning has proven a stimulating therapy.\nThere was an average of 200 patients employed daily in the industrial-therapy\nshops, with an average turnover of 30 new patients per month.\nLAUNDRY\nIn May of this fiscal year a comprehensive analysis of Riverview laundry, linen,\nand clothing problems was prepared by the hospital business administrator. The\nlaundry, when built in 1953, was designed to process a load demand of 6,240,000\n.st\n\u00E2\u0096\u00A0.,\u00E2\u0080\u009E>\u00E2\u0096\u00A0......\u00E2\u0096\u00A0\n__________HH-M \u00E2\u0096\u00A0 ill' i> i\n\u00E2\u0080\u00A2ft \u00C2\u00AB.\"- \"\u00E2\u0080\u00A2 -'\u00C2\u00BB ** \u00E2\u0080\u00A2-\u00E2\u0080\u00A2*\nkJ' .3:\u00C2\u00A7r i\"\n.\u00C2\u00AB:\n\u00C2\u00AB e;;:\nliar\n'^'i.^Wt/\nThe broadcasting room, showing recently installed equipment. Daily musical programmes, live broadcasts, and prescribed therapeutic programmes are sent out daily over\nthis system to the wards and hospital grounds.\n IN-PATIENT SERVICES L 107\npounds per annum. This year a total volume of 10,864,400 pounds of linen was\nprocessed, an increase of 399,956 pounds over the previous year. The Department\nof Public Works, however, has demonstrated an interest in our problems and has\nbeen working with us to improve our physical plant. In addition, five laundry staff\nwere added to the working force this year.\nPlans are under way to restructure the laundry administrative organization so\nthat we might provide a comprehensive laundry, linen, and clothing service which\nwill meet our changing concepts and standards of care.\nBARBER AND BEAUTICIAN SERVICE\nContinued stress has been placed in encouraging patients to be interested and\nresponsible for their grooming and personal appearance through the use of the\nbarbering and beauty-parlour services. In the longer-stay units especially, patients\nhave been encouraged to attend at the barber-shop and beauty-parlour on their own\ninitiative as they would in the community, rather than being served on the wards\nin a less personal manner.\nThis newer concept, however, has required a review of our barbering facilities\nand has led to several changes, including the establishment of a well-equipped\nbarber-shop area in the Riverside Annex to serve patients in the Riverside Unit.\nThe barber-shop in the West Lawn Building has been moved to a new location in\nthe same building to make way for a much-needed central linen supply area for\nthis unit. The new shop has an additional chair, much-improved lighting, and has\nbeen well patronized.\nThe beauticians have continued to give the many services required for the\nproper grooming of our female patients. This year they carried out 44,657\nprocedures.\nPODIATRY SERVICE\nIn addition to supplying Riverview, Valleyview, and The Woodlands School\nwith podiatric services, our podiatrist has extended his services to the boarding\nhomes on a request basis. A new procedure has been established in supplying\northopaedic and special footwear. We have found that this has resulted in better\ncontrol and has expedited the provision of prescription shoes. There was a total\nof 2,850 treatments carried out during the fiscal year, involving 1,525 patients.\nTRANSPORT SERVICE\nIt is with regret that we must report the death of Mr. Gordon Nolan, our\ntransport supervisor, who passed away on January 19, 1968, after giving to the\nMental Health Services 23 years of faithful and loyal service.\nThe Transport Division is another section of the hospital that has been under\nclose review and for which many changes are planned. A dispatcher now coordinates all radio-controlled vehicles; the role of the supervisor is being expanded;\nschedules of transport priorities have been prepared; we have commenced preliminary planning for garage maintenance and stock-control improvements; offloading facilities have been the subject of review and improvement; a \" slick rail \"\nhas been installed in the East Lawn central linen room; several of the older passenger vehicles have been retired from service; a new bus has been added to the\nfleet; and a new gas pump was installed. There are many improvements still\nneeded: we must keep pace with out \"mobile generation.\" Our Transport Division continues to provide a very vital link in our hospital's expanding programme\nand increased involvement in the surrounding community.\n L 108\nMENTAL HEALTH BRANCH REPORT, 1967/68\nCOMMUNICATIONS AND RECEPTION SERVICES\nAdditional telephones have been installed this year to meet the ever-growing\nneed of the hospital. Our staff of eight operators working around the clock on a\n24-hour basis handle well over a thousand calls a day, one hundred of these being\nlong-distance calls. The telephone services form a vital link in the hospital's communications system and form a part of our emergency call system.\nThe previously independently operated \" centre desks \" in each unit were\nreorganized this year into a co-ordinated information and reception service, involving a staff of 20 under the direction of a supervisor. While the switchboard is the\nfirst line of contact with the community, the receptionist and information clerk are\nthe second line of contact between the institution and the public, and in this role\nthey offer a very important service to the hospital.\nThe postal services continue to render an efficient communications function in\nthe distribution of hospital mail and the processing of the Government of Canada\npostal services. A small vehicle was added this year to facilitate the distribution\nof mail throughout the hospital complex.\nESSONDALE CIVIL DEFENCE DISASTER ORGANIZATION\nAlthough general interest in civil defence activities has been minimal during\nthe year, the Essondale Disaster Planning Committee has met on several occasions,\nand the Superintendent, as Civil Defence Co-ordinator for this area, has kept in\ncontact with the office of the Zone Co-ordinator of the Vancouver area in the\nreception of regular reports and directives.\nDuring the month of November, our senior E.E.G. technician attended the\nProvincial Radiological Defence Course in Victoria and is now qualified in radiological analysis, monitoring, and source handling as a Radef officer.\nReport for April 1 to December 31, 1968\nThe following report covers in general special activities of note or new procedures or programmes introduced during the April 1 to December 31, 1968,\nperiod, and supplements the report covering the fiscal year 1967/68.\nAlthough official statistics of patient movement are not available at this time,\na review of the monthly statistical returns indicates that there have been no significant changes or trends compared to the previous 12 months. During the period\nApril 1st to November 30th, total intake of patients numbered 2,418, with total\nseparations being only slightly more at 2,429. The number of patients in residence\nat the end of November numbered 2,672 (1,423 men and 1,249 women), a decrease\nof only 11 compared to the number in residence as of March 31, 1968.\nSeveral important projects designed to improve treatment services to patients\nand reported to be in the planning stages in the report for the fiscal year 1967/68\ncame to fruition during the period under review in this report.\nA clinical teaching unit, developed in affiliation with the Department of Psychiatry of the University of British Columbia, began operation on August 1, 1968,\non Ward West-3 of the Crease Unit.\nOn October 7th and 8th the hospital was visited by Dr. C. J. Doherty, field\nrepresentative of the Canadian Council on Hospital Accreditation, and Dr. C. H.\nMoorhouse, psychiatric consultant, for the purpose of an accreditation survey.\nAlthough no official report has been received concerning this survey, it has been\nintimated that the visit may be regarded as a courtesy consultation with a final\nsurvey to be conducted in about six months.\n IN-PATIENT SERVICES L 109\nDuring November, plans were completed to establish a special area on Ward\nWest-4 of the Crease Unit for patients receiving intensive somatotherapies, such as\nsleep treatment, somnolent insulin, intensive E.C.T., etc. This unit of 9 beds is\nto be under the direction of a psychiatric specialist, and specially trained nursing\nstaff is available to provide safer and more effective application of somatotherapy\nfor patients in the Crease Unit.\nThe use of minimal care, or intermediate quarters, has been extended so that\nthree residences on the hospital grounds are now in use \u00E2\u0080\u0094 two for women, and\nthe newest, which opened October 21, 1968, for men.\nDuring November, integration of patients was introduced on Ward D5 in\nCentre Lawn. This is the sixth ward now caring for both men and women patients\nwith both male and female staff.\nThe Nursing Service Department is now providing field-work experience for\nstudents from two British Columbia Institute of Technology programmes. This is\nin addition to the clinical areas already provided for affiliate students from various\nagencies and schools.\nPresentations were made by the Psychiatric Nurses' Association to the Mediation Committee at hearings held in September and October. The resulting decisions,\nwith their effect on the Nursing Department, are not known.\nThe policy of permitting sessional affiliation with the Department of Psychology\nhas been continued and modified to permit the extension of fee-for-service privileges\nto thoroughly experienced psychologists with Master's degree training along with\nthose having doctoral qualification. With this adjustment in terms, the prior policy\nof retaining casual employment on an hourly-rate basis has been discontinued.\nConsiderable interest has been expressed in this form of professional affiliation by\ncommunity-based psychologists, and it is expected that within the near future it may\nbe effectively utilized as a service resource.\nThe Department has strongly maintained its research interest. The study\natttempting to delineate antecedent behavioural factors underlying suicide has been\ncompleted. An attempt is now being made to determine the extent to which a\nsuggested relationship between sterioid level and suicide propensity may provide\nreliable antecedent data. Development continues in the task of constructing an\nautomated testing procedure. At the moment, effort is being applied to the writing\nof necessary computer programmes and the costing of various installations that\nmight be utilized to make such a testing service operational.\nThroughout the year the move toward increased social services at the community level received considerable impetus. The expansion of the boarding-home\nprogramme to Vancouver Island areas, other than Victoria City and its immediate\nsurroundings, made available to the hospital some additional and much-needed beds.\nIt was possible during the seven-month period covering April 1 to October 31, 1968,\nto place a total of 92 patients in licensed boarding homes under the ongoing supervision of the hospital, of which group 57 were new placements.\nDuring the past nine months special attention has been given toward improvement in the efficiency of the dental service, particularly in respect to improved\nrecording of dental work accomplished and in the communication of this information\nto patients' doctors and the clinical files. To this end, new dental record cards\nhave been designed and implemented, and new forms and procedures for referral\nand reporting on each patient have been instituted.\nDuring the period under review, the Medical Records Department has continued to concentrate on the application of the standards recommended by the\nCanadian Council on Hospital Accreditation.\n L 110 MENTAL HEALTH BRANCH REPORT, 1967/68\nThe accreditation requirement of centralization of all reporting of patient\ntreatment on the medical record was reviewed and systems initiated to provide\nrecording from the following treatment services: Dental consultations; optical consultations; podiatry consultations and activity therapies progress; notes which\ninclude psychology group therapy, rehabilitation work, placement reports, and\noccupational therapy.\nThe registration and statistical reporting of all medical and surgical patients\ntemporarily transferred from other mental health facilities commenced on November\n1, 1968.\nOn June 17, 1968, a major innovation became implemented with the appointment of Mr. R. J. Phillips to the newly established position of Personnel Officer for\nRiverview Hospital.\nPreviously the responsibility for personnel matters had been incorporated in\nthe duties of the Business Administrator. The new position of Personnel Officer\nis a staff position with direct responsibility to the Superintendent for the supervision\nand maintenance of all personnel records and route functions of the Personnel\nOffice. In addition, the Personnel Officer will be in a position to expand the scope\nof personnel services, with increased attention to the welfare of Riverview staff on\nboth an individual and collective basis.\nTo date, several major projects have been initiated, including the following:\u00E2\u0080\u0094\n(a) A safety and accident-prevention programme was inaugurated in July\nwith a new concept in safety committees being initiated.\n(b) Staff-training resources have been investigated, and extensive research\nhas been undertaken to provide administration with information concerning various resources available, both internally and from community\nagencies, for the development of staff. Special attention has been given\nto the development of training experiences for first- and second-line\nsupervisory staff in personnel management.\n(c) Employee relations and staff welfare have been of major concern, and\nsteps have been taken to recognize and assist staff who are ill or bereaved,\nthrough letters and hospital or homes visits.\n(d) The Riverview staff bulletin has also been revitalized with a change in\nthe format and content of this form of communication to staff.\n(e) Special attention has also been given to employee job satisfaction through\nsurveys of job classifications, salary scales, fringe benefits, etc.\n IN-PATIENT SERVICES\nSTATISTICAL TABLES\nL 111\nTable 1.\u00E2\u0080\u0094Movement of Population, Riverview Hospital, Essondale,\nApril 1, 1967, to March 31, 1968\nMale\nFemale\nTotal\nIn residence, April 1,1967\u00E2\u0080\u0094\t\nOn extended leave, carried forward from 1966/67-\nBoardinghome \t\nOther \t\nOn escape, carried forward from 1966/67\t\nTotal on books as at April 1,1967\t\nAdmissions\u00E2\u0080\u0094\u00E2\u0096\u00A0\nFirst admissions to Mental Health Services..\nReadmissions to a different institution of Mental Health Services..\nReadmissions to the same institution \t\nTotal admissions! \t\nTotal under care _ \t\nSeparations-\nDischarged in full.. \t\nDied \t\nTransferred to geriatric facilities-\nTransferred to facilities for mentally retarded-\nOn extended leave and still out\u00E2\u0080\u0094\nBoarding home - \t\nOther \t\nOn escape but not discharged..\nTotal separations\t\nNet decrease \t\nIn residence, March 31, 1968-\n1,456\n156\n52\n4\n1,312\n186\n100\n1,662\n87\n12\n4\n176\n65\n7\n1,558\n77\n8\n1\n188\n206\n2\n2,013 2,040\n\u00E2\u0080\u009442\n1,414\n-43\n1,269\n2,768\n342\n152\n4\n1,668\n1,598\n3,266\n789\n18\n952\n762\n8\n941\n1,551\n26\n1,893\n1,759\n1,711\n3,470\n3,427\n3,309\n6,736\n3,220\n164\n20\n5\n364\n271\n9\n4,053\n\"^85\"\n2,683\ni Includes 15 male and 7 female transfers from geriatric facilities, 1 male and 1 female transfer from\nfacilities for the mentally retarded.\n L 112\nMENTAL HEALTH BRANCH REPORT, 1967/68\n1\nTable 2.\u00E2\u0080\u0094First Admissions to Riverview Hospital, Essondale, by Health\nUnit and School District of Residence and Sex, April 1, 1967, to\nMarch 31, 1968.\nHealth Unit and School District\nMale\nFemale\nTotal\nHealth Unit and School District\nMale\nFemale\nTotal\nEast Kootenay, Cranbrook\u00E2\u0080\u0094\nMetropolitan Board of Health of\n3\n4\n7\n 3\t\n4\n1\n5\nSchool District No. 38\t\n21\n29\n50\n 4\t\n3\n3\n 39\t\n313\n313\n626\n\u00E2\u0080\u009E 18\t\n1\n1\n2\n 41 \t\n34\n54\n88\n\u00E2\u0080\u009E 86\t\n1\n4\n5\n\u00E2\u0080\u009E 44\t\n23\n20\n43\n\u00E2\u0080\u009E 45 ...\n7\n4\n11\nSchool District No. 7\t\n6\n7\n13\n, 8\t\n1\n2\n3\nSchool District No. 46\t\n2\n4\n6\n\u00E2\u0080\u009E \u00E2\u0080\u009E \u00E2\u0080\u009E 10\t\n1\n3\n4\n\u00E2\u0080\u009E \u00E2\u0080\u009E \u00E2\u0080\u009E 47\t\n7\n6\n13\nWest Kootenay, Trail\u00E2\u0080\u0094\u00E2\u0096\u00A0\nSchool District No. 9\t\n\u00E2\u0080\u009E 48\t\n6\n7\n13\n2\n1\n3\nSkeena, Prince Rupert\u00E2\u0080\u0094\n\u00E2\u0080\u009E 11\t\n3\n9\n12\nSchool District No. 50\t\n\t\n2\n2\n\u00E2\u0080\u009E 12\t\n1\n1\n\u00E2\u0080\u009E 52 \t\n11\n2\n13\nSouth Okanagan, Kelowna\u00E2\u0080\u0094\n\u00E2\u0080\u009E 54 \t\n5\n3\n8\nSchool District No. 14.._\t\n2\n..\n2\n\u00E2\u0080\u009E 80\t\n6\n3\n9\n\u00E2\u0080\u009E 15-\t\n7\n3\n10\n\u00E2\u0080\u009E 88\t\n4\n5\n9\n , 17\t\n1\n1\n2\nPeace River, Dawson Creek\u00E2\u0080\u0094\n, 23\t\n6\n1\n7\nSchool District No. 59\t\n13\n6\n19\n\u00E2\u0080\u009E 77\t\n1\n1\n2\n\u00E2\u0080\u009E 60\u00E2\u0080\u0094\t\n3\n2\n5\nNorth Okanagan, Vernon\u00E2\u0080\u0094\n\u00E2\u0080\u009E 81 \t\n2\n1\n3\nSchool District No. 19\t\n1\n2\n3\n\u00E2\u0080\u009E 83\u00E2\u0080\u0094\t\n2\n2\n 22\t\n1\n3\n4\nGreater Victoria Metropolitan\n\u00E2\u0080\u009E 89\t\n2\n3\n5\nBoard of Health-\nSouth Central, Kamloops\u00E2\u0080\u0094\nSchool District No. 61\t\n31\n17\n48\nSchool District No. 24\t\n6\n4\n10\n\u00E2\u0080\u009E 62 \t\n5\n2\n7\n 26\t\n1\n1\n\u00E2\u0080\u009E 63\t\n2\n3\n5\n\u00E2\u0080\u009E 29\t\n5\n5\n 64.\t\n2\n2\n4\n , 31\t\n2\n1\n3\nCentral Vancouver Island, Na\nCariboo, Williams Lake\u00E2\u0080\u0094\nnaimo\u00E2\u0080\u0094\nSchool District No. 27\t\n6\n3\n9\nSchool District No. 65\t\n6\n3\n9\n\u00E2\u0080\u009E 28\t\n4\n9\n\u00E2\u0080\u009E \u00E2\u0080\u009E \u00E2\u0080\u009E 66-\n3\n2\n5\nNorthern Interior, Prince\n\u00E2\u0080\u009E 67\t\n1\n1\nGeorge\u00E2\u0080\u0094\n,,68\t\n7\n5\n12\nSchool District No. 55\u00E2\u0080\u0094\t\n1\n1\n2\n\u00E2\u0080\u009E 69 \t\n3\n2\n5\n 56\t\n1\n2\n3\n\u00E2\u0080\u009E 70\t\n10\n6\n16\n\u00E2\u0080\u009E 57\t\n27\n13\n40\n\u00E2\u0080\u009E 79 \t\n1\n\t\n1\n 58- ,\n\t\n3\n3\nUpper Island, Courtenay\u00E2\u0080\u0094\nUpper Fraser Valley, Chilli\nSchool District No. 71\t\n3\n4\n7\nwack\u00E2\u0080\u0094\n 72\t\n3\n5\n8\nSchool District No. 32\t\n3\n6\n9\n\u00E2\u0080\u009E \u00E2\u0080\u009E \u00E2\u0080\u009E 85\n3\n3\n, 33\n13\n14\n27\nSchool districts not covered by\n 34\t\n8\n11\n19\nhealth units\u00E2\u0080\u0094\nBoundary, Cloverdale\u00E2\u0080\u0094\nSchool District No. 49\t\n2\n1\n3\nSchool District No. 36....\t\n35\n39\n74\n 84\t\n1\n1\n\u00E2\u0080\u009E 37\u00E2\u0080\u0094\t\n7\n13\n20\n, 87\t\n1\n1\n2\nSimon Fraser, New Westmin\nUnorganized\t\n4\n1\n5\nster-\n18\n22\n24\n42\n48\n27\n2\n11\n38\nSchool District No. 40 ,\n2\nCentral Fraser, Mission\u00E2\u0080\u0094\nTotals\t\n807\n770\n1,577\nSchool District No. 35\t\n8\n9\n17\n\u00E2\u0080\u009E 42\t\n9\n14\n23\n\u00E2\u0080\u009E 75\t\n6\n8\n14\n\u00E2\u0080\u009E 76 .\n2\n2\n4\n IN-PATIENT SERVICES\nL 113\nz\no\nt/>\nm\n\u00C2\u00A7\nq\n<\n&\no\nQ\n()\nX\nH\nW\ns\n><\nca\n_,\npa\nno\n\u00E2\u0096\u00BAJ\nvn\n<\nr\u00C2\u00BB\nu\n.\u00E2\u0080\u00941\nZ\no\nCO\nw\nX\n\u00E2\u0080\u009E\nu\nkJ\ne_\n<\n<\n\u00C2\u00A3\n\u00C2\u00A3\nc\nc/->\n0\no\nH\nffi\nr~\"\nf*\n^O\nw\nON\n>\n<*\n___\nM\n>\nhJ\nX\np-\no\nH\n<\noi\nX\nZ\nw\nO\nco\nm\na\nW\nz\n\u00C2\u00A7\n<\n<\nid\nc.\nPi\nO\na\no\nz\nw\n<\nO\noo\n<1\n\u00C2\u00A3\nO\non\n1/1\ns\nQ\n<\nH\ni/i\ne<\nfe\nw\nI-I\nm\n<\nOO Tt t-h CN t\u00E2\u0080\u0094 rH\ncn\nON\nI-JOJ. pUB-i)\nNO OO\nu-i\n<_Ti OO\noo\nrn\n*H\n\"\nrH\nu.\nNO \u00C2\u00BB>H\nr\u00E2\u0080\u0094\nON cn rH j !\n3\ncn tn\nr-\nr-i tt r- CO tN\nCN\nS\n>n\nCN \"*\noc\nTt Tt\nON\n\u00E2\u0096\u00A0__\n\u00E2\u0096\u00A0!)\u00E2\u0080\u00A2 193 ! !\nT-t\ns s\ncl\noO\nS\nt- ! *t ; :\" i\nrH\n1-1\noo : ^ i i\nrN\nTt i o : ! j\nTt\ncs j j\ncn\nH rt j j 1\nV.\ns\nr-\nOO\nh jri ; :\nCi\nrH rH j j\nCN\nsO\nfN\nCO\nu-\nrH j tN |\n-\nir* ; On cN : i\nPL.\nfN ! tn\nii*.\nm ! tn | !\ne_\ns\nCO CN \u00C2\u00A9 CN CN\n-+\ntn cn cn ; co i\ncn\nrH cn\n\u00E2\u0096\u00A0ri\ncn cn !\nr>\nON\n\u00C2\u00A9 ; oo CN ;\no\nI-\" I Tt TH i \" i\nCN\nc-J\nt\n3\nH.\ncn ! cn\np-\nr> | m i ;\n^\nON\ns\n\u00C2\u00AB h* i\nE\"-\nTt ^\nOO\n\u00C2\u00ABt\n\u00E2\u0096\u00A0*}\nci\nCU\nsQ !WNtH\nTt ! cn\n^\nO ! t> cn ; i\noo i tn\n$\n1\ns\ncn ^t\noo\ntn xr~ I\nTt\nON\ntn\n00\n<\nPL.\n^t ; --*\nOs\ntn so | 1\nCN\nVN.\ns\nNT\nP\ncn tn\nOS\nw-i r-\nrH\nTt\nm\nNO i O0 rl ! !\nm\nu.\n\u00E2\u0096\u00A0-t m j\n00\nm ; Tt j i\ns\ncn \u00E2\u0096\u00A0\u00E2\u0096\u00A0*\nON\n*n Tt\nON\nm\nTf\nTt rH g rH ; 1\nv\u00C2\u00A3>\np-\ntn ! tn\nON\nr-\n5\ncn Tt\nOC\nTt in\n4\nCN\np.\n\u00E2\u0096\u00A0-t cn !\n00\nCN ] CN |\no\nOn\ncn\nS\n\u00E2\u0096\u00A0-t m\nrN\nON\n\u00C2\u00A3-\"\nB.\nrn j cn i\nm\nH |j |\nCN\n2\nrH cN V. fN NO\n^\n\u00E2\u0096\u00A0rt Tt r> CN tn \" !\nri\n*\"\u00E2\u0096\u00A0\nCN CN! th\n\n.-W r-\nH\nJH O\nE\n43 T.\n_, B\nS c\nc\no\n<\nInfo\nOrd\nInvc\nMag\nCou\nTnfn\nI\nc\nI\n L 114\nMENTAL HEALTH BRANCH REPORT. 1967/68\nX\nw\nr/_\na\nz\n<\np\no\na\n\u00E2\u0096\u00A0\nW\nO\n<\nO\nz\n<\n\u00E2\u0096\u00BAJ\n<\nH\nZ\nW oo\n5 vo\n>- <-<\nca \u00E2\u0080\u009E\n\u00C2\u00AB ^H\nW cn\n\u00E2\u0096\u00BAJ \u00C2\u00BB\n<\nQ\nZ\no\nvi\nco\nW\ni-T\n<\nO\nE\n&\n>\nat\nw\n>\nM\no\nH\nca\nZ\no\n\u00C2\u00A7\nQ\n<\nH\nto\nw\n\u00C2\u00AB\nEh\nin vo m rt (*\u00E2\u0096\u00A0\nrejoj. puEjy\n\u00E2\u0080\u0094 r-\ncn\nrHfO IrHfNOCOONOCO\n3\nn,\nr> co\nrH cn\n&\nTtTtONONr^T-HCOONr-\n\u00C2\u00A9incNvovorHcNinTt\nfN irH :rHrHCnrHTtr>r~-CO\nS\nrH NO Tt fN\nCN rH rH NO\n1 I ! I 1 1 ; 1\nj ! | CN 1 rn ! rn 1\n1|\nA\n\u00C2\u00A30\ns\ni\n1 r-1 ' 1 ' rH\nrn ' rH rH |HH 1\n*?\nPL,\n1 1 1 i\nVO\n>!\n![| {[I\n1 1 1\nIII i i i ! ! II\nri\nPh\nrH rH | m m ! 1 rH Tt\nIII 1 j 1 1 I rH | | | I\nVO\n53\nin\n1\nPL!\nCN j ! rn rH j j fN\n^H ! ! ^ ! IHHH\n!!! |H IW 1 |Hf1 I rH o\n111 IJIIICOrHNOICN\n*?\nPL,\nIII j *\"*\nill 1 ! ! i 1 1\n\u00E2\u0096\u00A0A\n.\nCN ! CN 00 NO ! ! NO\nrH rH rH | CO 1 1 ! O\nrHll [ CO 1 1 | 1 TH NO CO 1\ncn\ns\n1 ili'-'\n\u00E2\u0096\u00A0to\nA\nPL,\nrH ,-H *H CN Tt | rH CN\nCN rH j 1 Tf | | 1 O\nrH j j M IW |rl MM j\nm\na\n*-1 i\n] ! !\nCN ! I ! rn ! j ! ]\nlil j 1 ! ! ! ro ,OH j\nCN\n1\n(L,\n1 i 1 j ! ! !\ni j i | i i'\"\"'\nCN r- cN O On I CN CN\nrH i ! rH j i CN\n. T-H IrHjjjTHrHCNIi\nCN\nS\n\\nl : cN cn Tt : cn\nrH ! rH 1 ! ! ! { !\nIII IN 1 1 1 1 100(1. 1\n$\nPL,\nII i 1\ni 1.1)1!\nIII 1 1 1 1 1 1 1\n.\nCNrHrHONTtrHTtm\nIII ir-rHiiicNTti\nCN\ns\n1-1\nili i 1 1\nii; i I;! i !\n*T\nPL,\nII 1 i\ni 1 i 1 1 i i\niii ! I 1 i i i 1\nrn rn cn cN m : CN\nI j , NO 1 1 ! 1 1 fN 1 1\n2\n! 1\n1 1 1 1 1 1 1 1 1\nill i Mill 1 i\nTt\nPL,\nj\nill | j | j |\nci\nS\ni I I i i i 1 ih j j j s } j j j i ii i 1 i i i i i i 1 i\n\" i Xi\nxi \u00C2\u00BB a\na\nS s w\nu\nT3 .W c3\nox. M\n>,\nC3\ns\n\u00E2\u0096\u00A0S*S o\n3\n3\nCQ\n\"w\no\na\nem\nrt\n3\n\u00C2\u00AB\n1\nS\ni\n\ntj\nO\n09\n\u00E2\u0096\u00A0a\ncj\n\"3 *\nc E\nS3.\n1\nu\nX\nc\nt\ni\nX\n1\n0\n1\nc\n0\n.\"2\n*c\ns\n1-\nP.\nc\nc\nt\ncc\nV\n1-\n0\n*\u00C2\u00A3\nc\nc\nN\nX\n\nu\n4J\na\ni\n_>\n1\nin\n\u00E2\u0080\u00A2a\na\na\nC\na\nL.\nV\n1\nX\nc\n5\nt\n'c\nc\n\u00C2\u00A3\n\u00E2\u0096\u00A0c\nc\nc\n2\nU\n1\nc\n.9.\nCJ u\n9 'I\nM C\na) ca\nu .\na.H\nU c\nV cS\n>\n1/\nca\ni\nu\nc\ncu\nQ\na\n0\nC4\n\"c\nt\nc\n0\n\u00C2\u00A3\n71\nc\n.\u00C2\u00A3\nH\ntr\ng\nB\nT)\nC\nC\nCO\nt-\n5\np\nTJ\ne\nR\n\u00C2\u00AB\n'c\nc\n0\n\u00C2\u00AB\n0\n\u00E2\u0080\u00A25\n>\nP\nc\ng\nc\ni\nc\na\nC\nCJ\n\"t\nc\nt-\nQ\nR\nJe\ni-\ntt\nC,\ny\nt?\nC\n.2\nto\n0\ns:\nO\n>\nC\nc\ni\ni\n>.\noo\n^0\n0\nu\n0)\ns\nCS\nc\no\n6\nu\nTJ\ntH\nQJ\n\u00E2\u0096\u00A05\n\"S\n\u00C2\u00ABH\no\nCQ\n0\nf)\nE\nC\nB\ns\n&\nIh\n-C\nrt\ns\nc\n61\nC\na\nResulting from epilepsy and other convul\nSecondary to allergic and other nutrition\nSecondary or due to blood-forming\nQJ\nc\n0\nCJ\ns S\n\u00E2\u0080\u00A23 t;\n9 \u00C2\u00B0\nU 0)\n3 E\no c\n>. >\nca c.\nTJ TJ\nc c\no o\nCJ C\nCJ 1\nCfl Cfl\nu\nu\nHi\n\u00E2\u0080\u00A25\no\no s\nto -\ni ca\nS 8\nCJ X\n<^i c\nO 0\nCJ QJ\n=3 =1\nT3 TJ\nIh I-i\nO 0\n>. >\na a\nTJ TJ\nC c\no o\nCJ c\nCJ c.\nCfl CC\ntj\na\no.\nC\n\u00E2\u0096\u00A0s\n>\no\n\u00E2\u0096\u00A0a\n4)\nCC\n'o\nc.\n?\nc\nTJ\n\u00C2\u00A7\nc\nc\na\nB\nOJ\nU\nu\n_>\ntA\nI\nC\n0J\n1\na\nc\n\u00C2\u00A3\n(\nc\nc\nt\nTO\nd_\n>\nc\n.c\n1\nB\na.\nt-\n*n\na\nE\nt\nn\n1-\nU\n2\n__\na> >, (.\n>.\n\u00E2\u0096\u00A0h >. s si a\n_.\ns\nc\nft,\nu\nCfl\nCh\nC-\n<\nCh\nC\nP-\n<\nX\nS\nI\n IN-PATIENT SERVICES\nL 115\nco ! WW \u00C2\u00AB catt h m-H-H *_>*\u00C2\u00A9\nov Nn\nI ^j C7\ rH K\n! I ! i !\nI i i !\n! Tf rH rH\nj\ni i I\n: m C^ rH I rH CN\n: | th CN\nIrHrH ! |\nI I TH ! | CO rH\n; i TH I rH CN ! TH rH j\nI I th ;\n< O | ; I I I rH rH CN\nI CN TH I C\n! i ~\nTH fO H\nrH I t> CN rH\n13 ! i\nCO j tN ON I CO CO t>\nI CO rH TH TH Tt I Tt\n| j j;*\n\u00E2\u0096\u00A0I rH TH rH CN CN\nth i i r> i cN\nI I I CN th\nn H s*\ni2 > >\na e\nI!\ntr.a\nsi\n\u00E2\u0080\u00A2s a\n(H O\nV) TJ\n'\u00E2\u0096\u00A03S.\na \"a\nis\n__? \u00C2\u00AB .S3\nq t; w\nQ ft1 o\nIf*\ng .CJ S r\u00C2\u00BB ft\nill ii\nrH ft O U \u00C2\u00AB ,1\n\u00E2\u0080\u00A2J_J ^\nas\n.2 7, ^ '-1 >\n? 1811 \u00C2\u00A7 i\nJg2Sc.5-3\n< so I w p., o \u00C2\u00A3\nSi\nu s &\n\"O __ Q r.\n<_ T3 J_ C\n_\"a_\u00C2\u00AB\nn ft 3 u -> o __\ni. a-a &\u00C2\u00AB5S\nn\na a u\nw O i_\nP g cd\n\u00E2\u0096\u00A0odC\nI \u00C2\u00AB a o\n, =3 '\nT.SJIJ\ni .a -2 2 8\na10 a \u00E2\u0080\u00A2_! a\n3 sa 11\n13 So 0) M \u00C2\u00AB\na a 9.5,\n__\u00E2\u0096\u00A0_\nO-hQ\ny_ -t. r^\nrt -\no> \no\nH\nco\nZ\no\nw\nw\nrJ\nCO\n5\ncd >\n\u00C2\u00A30\n-5\nI CN CN rH\n< co tn co On rH cn i\nrH , rH i>\nrH HOC i Tt NO r\u00E2\u0080\u0094\nH rH CN rH CN in\nno rn \u00C2\u00BBn r- cn\n< CN 00 rH CN VO I\niLOHhm\ncorHTHOmcNcni\u00E2\u0080\u0094\n; no vo cn On r-\ni CN rn rt rH in f-\nOn VO : Os CN\nin--inHini\nr- m i vo *\nL> Tt ; tN CN\nm NO th t~~ tN\nCN rH fN rH I TH Tt\nCN tH m I rH rl cn\nM-rHrHlncOrHrHCO\nIN i-i I/, omn m m \"'\n, rH CN Cn TH Tt T\n! i !\n6\n\u00E2\u0080\u00A2a\nS W -H\n1-1'___ -2\nr3\nCJ\n-0\n_C rC f_j\n\u00C2\u00A7 .a \u00C2\u00AB\n.3 -3 ui\nw co rt\nSo 8\n3 a__\nJr ^\"8\n\no o u\n'9 5 0,0 8 j\ns s\n\u00C2\u00A3 o\nM O u\n'\u00E2\u0096\u00A0fflfl r,\nlav j \u00E2\u0096\u00A0\n8 o .a 2 o o\nBJ\n\u00E2\u0096\u00A0H _H B\nj i-i I*.\nE> Jh 3 o >. c\nU\n>\u00E2\u0096\u00A0\nif\ncm g\n5 o\nTJ r-i\nrt t3\na s\nw rt\n1 >.\no go ..\n!\u00C2\u00A7\u00E2\u0080\u00A2<\n\u00E2\u0096\u00A0\u00C2\u00B0 d,<\nu \u00C2\u00BB :\n-1 4> \u00E2\u0080\u0094 7\n'SBC\nu J3\n0, s -a \u00E2\u0080\u00A2\u00E2\u0080\u00A2\n*_! M SR r\nDo\"\n3 \u00C2\u00A3\nft'H'\ng o S\n-30\n_- T_ -.\nO 0\no _\n_-S.2\n3 Sju\nCJ TJ U\nw| S\n3 -3 ,5\nrt \" w\nca\nrt O) (J b K\" M\n& em/) eu &< < p^\nJO\"\nS1_J\nM Jd u\n11.1\nOrH<\n\u00E2\u0096\u00A03 _,\nII\nIS\n%. 9\n\u00E2\u0096\u00A0o o\nM 60\n\u00E2\u0080\u00A29.9\n\u00E2\u0080\u00A2h S3 cn 00\n.2 9 9\n\u00E2\u0096\u00A0I .6 , ft a\nIi I II\nJ-T o eg >. >.\n( g Ih \"J-j CO CO\n! \u00C2\u00A72-gtoto\n} m 3 y\nOZr-.\n IN-PATIENT SERVICES\nL 117\ncn vo o vo rn \o vo i> t~- rn om r-\n5 \u00C2\u00A3 .a a e o 5 ?\nH So -3 \u00C2\u00AB v* TJ __\ng u o -a a S 3 B\nO 3 i-5 cj ^ K* H \"3\nr5 g'3__aHOr5<\n>, 2a\nco J- CO\nPhOA,\ns II\nla-s\na g\no ft\n._. 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S\n.\u00C2\u00A3\ncc\nt-\nx.\nc\nc\ne\n>\nc\ni\nEo\nA\n*rt\nCJ\n\u00E2\u0080\u00A23\n\n< ON\nO rH\nm \u00C2\u00AB\nS <*\">\nfit\nW\nPQ\n3\nco \u00C2\u00AB\nW CJ\nQd pel\n.Q\nw _.\nd x\n_S w\n9 co\nI-\nCO\nO\nZ\na\nat\nPh Y\nco u_\nw\ni\u00E2\u0080\u0094i\n\u00C2\u00A3\nw\n>\nrt\np,\no\nCO\nH\nZ\n2\nH\n<\nPh\nrn\nPQ\n<\nOH\n20\nr^t^enrHtNoocne*--, cNCNTtinoocNTtrHrHcOcncncn\u00C2\u00BB\n.COrHcjNrHTHcncOCNrHCNrHrHNO rt\n\u00C2\u00A9Tt IrHfNinCNTtTHrHrHtNVOrHCS , f^ cn CN cn\nI Ith I I\nj I !\nj J\n! CN rH rH rH j ; CN\n! I 1 ! !\n\t\n! 11L r i\ni i i\n! ! I\nMl!!\n-..9a1\n\u00C2\u00B0 u 9\nw _ fl\n*o .l. \"33\n.a 8 9\nr Un\ntil\nO cj 3\n\u00E2\u0096\u00A0111\n3\nCC\n\u00C2\u00AB .2\nTJ\n\u00C2\u00BB\np\nxi \u00C2\u00B0\no\n3\n\u00E2\u0080\u00A2_\u00E2\u0096\u00A0_ co cm\ns a o\nCO CJ CO\nC\n3\nr3 r3 r3\nP-\ntO --j\nPh<\n10\nPh\nI o\n' B\nI w o\nllfd\nII \u00C2\u00A71\n! \" St.\nlag\n\u00E2\u0096\u00A0\u00E2\u0096\u00A0sag\nS'ft'S\nc.b3\nao a,\nV. 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H\na a a y\nJlllilii:\n\u00E2\u0096\u00A0a Bj-uJa g,-.\n0\nw\nrJ\na\nPQ\ngo\nZ >o\nW ON\nH rH\nX \u00E2\u0080\u009E\nW -T\n_ tn\nz\nH\nP\no\nPQ\nrJ\n<;\na\nz\no\nCO\nCO\nw\n\u00E2\u0096\u00BAJ\nH<\nH\nCO\nO\nffl\nPQ\n>\nPh\nw\n>\nrt\nPh\no\nco\nH\nZ\nw\nH\n<\nAh\nPQ\nr4\nCQ\nH\np.\nPQ\nca\n3\nw\nCJ\nPQ\nQ\nx\"\nPQ\na\nz\n<\nOH\nP^\nA.\nIT\nooTtoocnrHfNmcNOfN'\nH CO tN COmrHTt THO\nPh\nPC\n~3~\nPh\n~3~\nCN ! rH i : \o cn -y- CN\nPC\n~3~\nCO CO TH TH\ni !\nPL,\nIT\nPL,\ns\nr ! i\nPh\n\"I\"\nPh\n:-3\ni i\n! ! !\n2\nPh\nIT\nP.\nPh\n\"3\"\n_J-B =\ncj rt\nO H\n! ill\n4) co\na S!\nB.\n5'\nrt 5 n \u00C2\u00A3\n- 3 rt & .\n\u00C2\u00A33*\na* ,5\nO _\na a u\nu *5 a.\n3? \u00C2\u00B0 a\nCo a\na '3 a\nSo\"\n\u00E2\u0080\u00A29 a t-\nO O CJ\n>a\n\no\nP\n<\n1\na\nPC\nO\nCO\nPQ\nPQ\nPh\nCS\nO\n<\n<\nPQ\n<\nPh\nO\nr~\nON\nPh\nO\nCO\nfit\n<\nPQ\nt>\nHtf\nr-\nCO\nr-\nVO\nVO\nfit\nVO\nON\no\nOv\n<\nON\n,\u00E2\u0080\u0094i\nrt\nT-H\nOJ\nT\u00E2\u0080\u0094I\n>\nT 1\nVO\nCN\nI\u00E2\u0080\u00941\n><\nr-l\nIT)\nen\ntn\no\nco\n\nB-\n\u00E2\u0080\u009E\nPQ\nrJ\nPQ\nr.\nPQ\nW\nPQ\n<\nPQ\nPQ\nPQ\n-J\n<\na\nz\no\nCO\nCO\n3\nPQ\nCJ\nw\nQ\no S\nco ___\u00E2\u0080\u00A2\nr-l\nz\no\nCO\nCO\n3\nPQ\nCJ\nPQ\nP\nw\nx\"\nrJ\nX\nm\nx\"\nCO\n\u00E2\u0096\u00A0v\nCQ\n<\nPQ\n\u00E2\u0080\u009E\nPQ\n1\u00C2\u00BB\nrJ\nCO\nrt\nCO\nrJ\nco\np\nH<\nH\na\nHH\nOh\na\n<\na\na-\nu\nz\nCO\nz\nz\nIh\nOh\nCO\nO\n<\nr*\n<\nO\nW\n<\n<\nCO\nO\n<\n\u00E2\u0080\u00A2<\nS\no\nTj\n\u00C2\u00A3\nrt\nCO\nrt\nco\nCSC\nrt\nco\ni\nPJ\n>\nPL,\no\n>\nPQ\nPh\no\nPQ\n>\nPh\nO\n3\nH->\nrO\nOS\nPQ\nrC\n>\nX\nPQ\na\nO\n>\nrt\n0\n\u00C2\u00A3\nrt\nO\n>\nrt\nCS\nrO\n(2\nZ\nPh\nZ\nrt\nz\nc_\nPQ\no\nPQ\nPQ\nPQ\nO\nhJ\nCO\nX\nhJ\nPh\no\n\u00E2\u0096\u00BAJ\ns\nCO\nCO\no\nof\nCO\nof\nS3\nI\nO\npq\nCO\nO\no\nPQ\n5?\nO\nX\no\nCO\nO\n3\nZ\no\nz\nz\no\no\npq\nZ\no\nCO\nz\n\no\nz\nQ\nz\no\nQ\no\nz\nQ\no\n-O\no\nrt\no\n\n-5\n-J\nD\nrt\ns\nP\n2h\nPC\nO\nPL,\nPh\na\no\nO\na\nOh\nrJ\n<\nPh\n.2\n-J\nrt\nhn\nT\u00E2\u0080\u0094-\n<\no\nh<\ns\nIh\nc-\n1\nH\no\n1\nc..\n1\nr-l\nTJ\nCN\nPQ\n-J\nPQ\nTf*\nrS\nrH\nW\nr-l\nPQ\n'3\nH-l\n-J\n<\nrJ\nCO\n2\nH\n-r<\nQ\n IN-PATIENT SERVICES\nL 123\njbiox pue-o\ninOiONcon\nCO rH rH CO\nMmniriHOHn\nrH 00 HJ rH r- VO\nX\nPQ\nco\na\nz\n<\np\no\nPr\no\nI\nPQ\nCS\n<\nCO\nO\nZ\no\nrJ\n<\nrt\nZ\nPQ\n2 oo\n& ON\n\u00C2\u00AB rH\nrf^\n< \u00C2\u00AB\na x\nz u\no fit\nCO <\nCO kH\nm <\u00E2\u0080\u00A2\nPL, VO\nCO ON\nO rH\nK rJ\n>\nrt\n3\no\nBh\nPh\nCO\nPQ\nO\nfit\n^\nCJ\nCO\np\nPQ\nPQ\nrJ\nPQ\nso\nth no c- m th m cN\ni th ; m i cn\nt- ON th\nj CN th CN I CN\ni oo th i th i cn\nI Cn TH r- I TH !\nth -rt co cn in\nl th Tt cN m Tt co\nTt CN TH Tt CN\nTt 00 th On rH |\nCOrHrHcnVOrHNOCN\nI CO rH in rH | CN\nI CN rH 00 fN I rH\nrHrHCN ir-T-iOrHCN\nCOTHlnrHONCNNOrH\nI rH CN rH NO I rH\nI CJN ON CN \u00C2\u00A9 \u00C2\u00A9\nTH | tN I CN TH Tt CN TH\nCN iTtt^m IOOth I TtCN\nTt rH I NO ON ! Tt CO\nh r- m cn vo no\nI M i\nrH Tt rH Id\nINmrttfflTtt^H\nCJ cj\ncj'3\na \u00E2\u0096\u00A0_\na a\n>\u00C2\u00BB o\nCO CO\na .. a a a \u00C2\u00AB\nW 9 g rt cd o\nS CO EC O Ph <\ntg .5 \u00E2\u0080\u00A2O (\nelj\nO i> rt c\n-J CO\n3 ~ .\nSit, -\no O i> rt\n53 7 3\na\nrt\nI cNt-CN\nB a s\n003\na\nI L. \"tfl CJ\n\u00E2\u0080\u00A2 S a 2 \u00C2\u00B0\niSlfi\nrt 5? cj.<5\nlis!\nra -^ co cj\njh s cj >>\nrt a) in 5_\nPh CO Ph Ph\n\u00E2\u0082\u00AC 3 1\nt I8\nii-?\na P o.\no \"\" CJ\n9.Sa\n\u00E2\u0080\u00A28 S &\nIh * _\n.SjcE\ns a s \u00C2\u00B0\nOr g _\na 2*\"\"\u00C2\u00BB\n>. a m \u00C2\u00BBs\nS '\u00C2\u00A3 .9 .9 \"o\na es _- v- m\n.2 .a a 1 \u00C2\u00B0\na co cn co\no o 5S w\na^PHPn\nO o\nli a\n3 \u00C2\u00ABtj C\n- O 4)\n3 CO to\nu a 2 2 >\n\u00E2\u0096\u00A0OUJf\nJ a as\nJ 3 CJ TJ '\n- * q C\nCO\ncfl o.\nbit\n3 rt c.\n42 M 3\nT3 in ^\n3 O TJ\no a\nCJ O CJ\n4) 4) CJ\nCO CO CO \u00C2\u00A3\n5.1\n o a. -\n._i-2\nCJ rH C3\nO r, C. CJ\nOB'..\nco \"\nPh\n!\u00C2\u00AB j&a\nI PP <\"\nhh-a a\nffi ftO\n L 124\nMENTAL HEALTH BRANCH REPORT, 1967/68\nm\nTt CN VO \u00C2\u00A9\noo\nr-\n__\nON\nan\n_H\nin\nCN rH\n__\u00C2\u00BB\nrn\nm Tt CN Os OS CN t-\nin\nIEjox ptreio\nir\nrH CNrH inONrHrH NO On\nm CN rH NO TH\ntn CO CN CN CN\nTt\nCN\ncn1\nrH\nCOCNCNin TtVOrHt~->nO\ IrH 00 H rf\nno vo cn Tt th cn\n1 1 CN r> t* O CM> cn\nl>\nPh\nt-\nCN t-i Tf CO\n*rt\nCO\nin\nTt\ny-i\nTt m Tf TH\nCNTtONrHrH r- OO CN\nvo vn oo vo co c-\ncNrHcor>ino\\u00C2\u00A9inTt\n00\n3\ntH\nvo\nrH\nPC\nIII! .iit.il \" 1\ni i l l li\ni 1 i 1 ill\nCN\n3\nm\n| *\"H\n,-<\n\u00C2\u00ABl||\n1 i i\nCN\nI'll 1 1 1 1 1 1 i 1 rH |\nCN i rn | ||\n7\nPh\n~3~\n1 1 1 1 1 1 1 1 1 1 1 1 1\n1 iii\nIII I-I\nCO\nTt\nCN\nNO\niiii i l.titl i\nii ii\n111! 1 1\nm\ni T-I I | , |\nJ : rH rH | ! TH 1\nin\n2\nso\nPL,\nCf\noo\n3\nON\n; j th cn rn | ; th | i i j ii\n! 1 1 1 ill! El\nCOCO j j j j\nII i i\nI |CN jcnCOTH jrH\nill! i\nON\nVO\nNO\n1 1 ' rH rH rH 1 ! |\nON\nPh\ncn\n7\ntn\nm\n3\n\u00C2\u00A9\n(N\n| I th CN I j j CN 1 | 1 rH | CO\nm CO j | 1 rH\ni I 1\n\u00E2\u0096\u00A0! 1 1 1 1m *H \"* 1 i\n\u00C2\u00A9\ni \u00E2\u0096\u00A0 rH rH ' rH | rH ' ' ' ' 'rH\n5\nPL.\nCN\nII 1 1 1 1 1 1 1\n1 i i\n1 1 1\n1 I I 1 1 1\nIII II 1\nin\n3\nin\nCN\nm\n*\"\u00E2\u0096\u00A0\n1 1 1 1 1 III 1\nII II\n1 1 1 1 ' 1 1 .11\n^\nON\n\u00E2\u0080\u0094\nrH\nlljj icNrHcncNii; Ttcn\nCN rH | | ||\nNO\nCO\na\na\na\no\nPh\nTt\ni 1 i 1 ... i ili\nII II\nM i 1\n3\n3\n| j jrH rHCO ICOCO jrH j rrtCO\nCN rH | | | CN\ni ii r ! r i\nr--\nNO\nl>\nm CN 1 1 !H\n1 1 TH NO 1 1 1 CN 1\nVO\nJ\nPC\nm\n1 i i\nI i ill i\nCN\ns\nm\nON CO rH ! |j\nin\nTt\n*H\nrH\n\u00C2\u00A3\n00\n<\nON\n7\nPh\nCN\nTt\n| | I rH ICN jCNrHTH jrH TtCOrH\nill i 1 1\nVO 1 rH | rH 1\nI 1 1\nII 1\n1 1 t ON 1 rH rH | |\ni 1 I ! II\n00\n\u00C2\u00A9\nCN\nin\n3\nm\nCN rH rH 1 rH TH\ncn\nCO\ni I ! i ! i ! \"\n*\"\"' 1\nTt\nCN\n-t\ns\nrH\nPh\nTt\nIII 11 1 !\n1 1 1\n00\n3\nC<\nO 1 th | 1 rl\nin\nCN\nII II II\nI.J 1\nrH | rH |\nTt\n*?\nPh\nCO\ni 1 1 iH ||\nI 1 II\nIII 1 II\nIII : 1 1,1\nin\nin\n3\n\u00C2\u00A9\ni I i (NcN if- cncn cNcn\u00C2\u00AB\u00E2\u0080\u0094.\n_> 1 rH j rH |\nrH | I Tt rH i m CN 1\nNO\nCN\nrH j *~*\n1 1 1 m 1 1 CN rH rH\no\n3\nPQ\nTt\n1 1 . i !\nIII '\u00E2\u0096\u00A0 1\nIII : ! 1\nT*\n3\nOO\nCN\ncs\n| 1 \u00C2\u00AB 1\n1 I 1\n1 | ' i\nCN\nV\nPb\nMi 1 II iii\n1 1 1 CN II\n111 11\nMM i 'II\nvp\ns\nir\nI 1 IrlH ItNlO 1\nTt\nlit 1 1\n\u00C2\u00A9\nj j i i | | j j j | 1 j ii\n; j i cn i j\ni 1 1 1 1 1 \u00E2\u0080\u00A2 I 1\nTt\n2\nPh\n~3~\nIii i i\n1 1 1 !,!l 1 1:1.1\nIII i II I.I JJ 1\ni i : cn i j\nMl : I 1\n.JJ i lir r! !\nVO\n.A\ntj\n4)\nCJ\nm\n^\ni\nCJ\n3\nCJ\ns\nu\nco\n3 r\ni\n3\nrt\nCJ\n3\nCJ\nel\n3 O\na\u00C2\u00AB\n3\nrt\n3\nlea\n4)\nIh\n*rt\nrH\n3\n.2\nrt\n\"co\nto Ih V O\n-SS_\nooa .3 ^\n-o6g\nCO\n4)\nrt\nr3\nU\nC\n\u00E2\u0080\u00A2o\n&\nIh\nU\na\n1\no\nS rt a\nrt\n-3\ns\n\u00E2\u0096\u00A03\na\n1\nV\nc\nc\nu\nR\ncu\n1\nCL\nr-\nC\na\n'C\n_u\nc\n-.\n3\n4.\nz\ns\ncc\na\n\u00C2\u00A3\nll\n53 a\n- o c\nIh \u00E2\u0080\u0094\nI!\no c\n$v\n>>\nto\nPh\n\u00C2\u00A3\nt.\nCL.\n<3\nff\nV\nE\nC\ni c\n\u00C2\u00A3\n-. >\nV\nc\nE\nc\nCV\nII\nr, a\n\u00E2\u0080\u00A281\n\u00E2\u0080\u00A2h ?\n,ll\nii\nII\na c.\no \u00E2\u0080\u00A2=\n\u00E2\u0080\u00A2B P\n(Sc.\ni\n1\n\u00C2\u00A7\non\n-i --\no\nP.\nT-H X\n\"5_,---\nIf\nir-\na\nPh\n\u00E2\u0080\u00A2_\n1\nI\np.\n1\n1\ni\nx\nS\nSi\n1\n\u00E2\u0080\u00A2-\nE\n<\n1\nCC\n<\nP\n'>\n1\nX\n1\nS\nCL\ncp\n\"C\n1\n1\nc\n>\nii\n\np-\n4\n\<_\n1\n\u00C2\u00A3\n- -\ns\nc\n-\u00E2\u0096\u00A0\n1\ni\n:\nI\n!\ni |\n:\nx\n1 \nX\nc\nI\nDrC\nc\n\u00C2\u00A3\nc\nc\n*C\nP.\ni\n_4> 4\n\"G K\nc3 *-\nTJ X\n'3l\na\nCJ\n3\nX\nI\nu\no\nrt\nrt\nr3\nu\nT3\nCJ\nss\n\"cj\nOJ\np.\n3\n3\nTJ\n\u00C2\u00A7\nIh\n4>\no\nu\nX\n]4\ni-i\n\u00C2\u00A3c\nSB\n3 %\nDC <\nz\n<\n'l\n1\n\u00E2\u0080\u00A2|\no\n;\n_\ni\ni\nI\n,i\n0\nli\nll\n!t\n\u00E2\u0096\u00A0 c-\n\t\nj\nj V\n\x\n3\nc\nt\ncc\nr\n\"5\n\u00C2\u00AB.\n<\n\u00C2\u00A3\n\u00C2\u00A3\n\u00E2\u0080\u00A2c\nE\ni\nf\n.-\nE\nr\nX\nL\nC\nCL\n\u00C2\u00A3\nc\n\u00E2\u0080\u00A2c\nc\n^ >\ncr\n,c\ntt\nc\n'\u00C2\u00A3\nc\nV-\nX\nc\n>\nc\nc\n3\n\u00E2\u0096\u00A0\u00E2\u0080\u0094i\nIh\nO\n-4H\nTJ\nU\nCJ\n3\nI*\nlg\n\u00C2\u00A7;\"\"\nia .2\nt\u00C2\u00A3 3\n\u00E2\u0096\u00A0ll\nOO\ntf\nI\n IN-PATIENT SERVICES\nL 125\nX\nPQ\nCO\nO\nz\n<\nrt\nco\nPh\no\nx\nrt\nO\nz\nPQ\nCO\nO\nZ\no\n<\nrJ\nrt\nZ oo\nPQ so\n\u00C2\u00A32\nCQ i\u00E2\u0080\u0094I\n\u00E2\u0080\u009E CO\npq\" a,\nH CJ\n<\nQ\nZ\no\nco\nCO\nw\nO\nrt\nH ON\ns _.\n\nrO\n|\n6\n\u00E2\u0096\u00A0a\nH-\u00C2\u00BB\nO\n>\nO\n\u00E2\u0096\u00A0s\nrH\nO\nVJ\nCO\na\nO\np\n-t-\u00C2\u00BB\nC3\nPQ\n>\n\u00C2\u00A33\nT1\ni\ni\nVO\nTJ\nrH\n(B\nPQ\nc_\nHH\nr-\nPQ\n<\np\nH\na\nCO\no\nz\n<\n^\nPh\nP\no\nPh\nO\nPQ\ncs\n<\ntn\ntn\nO\nz\n0\n<\np\nrJ\n<\nrt\nZ\nPQ\nr>\nCO\nvo\n>H ON\nPQ\n1\u00E2\u0080\u00941\nay\n\u00C2\u00AB,\nPQ\n1\u00E2\u0080\u00941\nr-l\nen\n<\na\nX\nz\no\nr/l\nCJ\nPh\n3\nCO\ns\n0\nr-l\nrt\n<\nrt\nr--\nBh\nvo\nCO\nON\n0\n1\u00E2\u0080\u00941\nX\n1\u00E2\u0080\u00941\n*\nr-l\nPQ\nfit\n>\nPQ\nfit\nPQ\n<\n>\nX\no\nz\n2\np\nCJ\nCJ\nO\nCO\ns,\n\u00C2\u00A7\nPQ\nP\nPQ\n>-)\nS3\nH\n\u00E2\u0080\u00A2a \u00E2\u0080\u0094\n3 rt\n00CNTtTHTtTtlninTHrHCNCNrHVOCNr--THCN THrHrHCN rH\nOH\nt>\ng\no\nPh\nCN | 1 t-i | \u00E2\u0096\u00A0 |\n1 rH\nr^-\n3\nTH TH Tt f- rH \" I\nt-\nIT\n1 TJ\n00\nair\noo\npp\nCN\ntF\n3\n\"\" i j\" Ist \;:i ijl\"!\ni Tm i i\nON\nin\nrn i th cn 1 1\nVO\ncu\n__.\n3\n\" 1 i I m I i\no\"\n1 TH Tt 1\nNO\nPC\nMil . 11 * MM*\nrH\n3\n^.rH.rHrn |rH. |CN j 1 | j j j rH\n,i : . i i i - * j M\nTH TH TH CN 1 j\n| 1\nVO\nOn\nm\n1\nin\npp\n| H j\nm\nm\n3\nj j ii\n1-1\nTt\nin\n\"\" PP\nth | j | | J | rH Cn. 1 1 ! 1 1 I rH 1 | 1 1 1 1 |\ni j i j j I INI. L | 1 i ! |\nm\n\u00C2\u00A9\ncn ! i | | . ; i i i | i i , 'i j\n1 1-t 1\n3\n| I M -1 !\u00E2\u0096\u00A0 i 1 ,!'i ii 1 I )\u00E2\u0096\u00A0 1\n1 1 M 1\nON\nin\nCh\nH | i | j i | | i i i i i M !\nI I *-1 *\"\" I i\nTt\nCN I 1 1 1 1 ; j i rH | [ | j ,| i\nj | | rH rH\nm\na\ncu\nTt\nHH\nTt\nPh\n\"iii!! r-| n i r\n1\" i | r h\nNO\n&\n\u00C2\u00A9\nM. j | | 1 I j IH-lm 1 .1 I |\n1 rH\n\u00E2\u0096\u00A0n\nO\nvj\n._\n[\u00E2\u0080\u00A2 j | 1 1 j 1 i [III\n| M I '1\n00\nON\n\u00C2\u00A3\n\"\" 1 I i II ! 1 1 ! ! 1 j 1 !\ni 1 i ! 1 1\nrH\n<\n1\nm\nl ' -H !\nCO\n3\n| 1 ! j |\nTt\np.'\ni iii! i\nA\ncn\n3\n1 I' 1 1 1 I I 1 I ! I I I\ni Mil i\nCJN\n7\nPh\nI 1 1 1 1' 1 1 1' f 1 *\"*\" i 1 1' i T [' i MM 1\nrH\nCN\nid\n1 1 1 1,1 1- IN \u00E2\u0080\u00A2 1; 1 I j, |\ni 1 M i i\nrH\nPC\n1 1 1 1 11 11. N 1 1 1 1 1\n1 1 II i\n3\nCS ! I ! ! : ! ! ! | J ! ! 1 |\nCN\nCN\nII 1 I i 1 1 I \u00E2\u0080\u00A2!. 1 i 1 1 1\ni 1 ! 1 1\n0\\nin\npp\n1 ! II i 1 1 I Ml ! II ! ! II MM 1\n1\n3\nM II i I Ii i .1 II II i i 1 1 1 1 1 1 !\nHt\nPh\nI I j M j M Ml 1 1 1 1 1 II 1 1 t-i 1\nci\n3\nf|\n4)\n^\nV\nCrO\nIh\nF\nr3\nr3\nc\nc\n.s\nCQ\nE\nxt\n3\n3\nO\nrt\nrH\n3\nCJ\nH\nTJ\nCJ\na\nIh\n4)\n\nIh\nCJ\n\u00E2\u0080\u00A2n\no\nrH\n>\nxi\n4)\ntO\na\nIh\n3\nO\n>\nt3\na\nB\nS\na\n3\ni\nc\nrt\nC\n-3\ntf.\nCi\n0\nt?\nX\n.2\n'-H\nu\n6\nrt\n\"3\nIh\ntO\n4) 05\nw \u00E2\u0096\u00A0-\nemonstrable\nd psychoses\nthout mentic\nCJ\n3\nis\no a.\n\u00C2\u00A3\nc\nc\nCJ\n*o\nci\nIh\n\u00E2\u0080\u00A28\nxs\n4>\naC\n4> 4\na e\nO 0\ntH\nO\nIH\nTJ\nU\n4)\n3\n5\n4J\n3\n3\na\n^ C3 \"B 9> rS H =\nTJ TJ\n3\nTJ\nc\n3\nCJ\nrH\n-3\nP\nC\n^\na\nc\non\n4J\n>\n0\n4\ni\nCJ\nV\no\n3\n0\n*cj\ns\nrt\nC\n|\nt\nc\n1\ni-\n8\n\u00E2\u0080\u00A2a\ni\ne\nC\n3\nrt\nIi\nrt\nP-\ny\nC\nr3\ntr\nP\n1\nCJ\nt/_\nc\nX\nu\n>\np\n*\n3\nCU\na\n4\nt-\nP-\na\n1\nIf\nCfl\nc\n\u00E2\u0096\u00A0s\ng\nor\nPi\n0\nrC\nor\n0\nCJ\n\"c\nc\n<\nX\nC\n-r-\nc\ner\ncr\nC\nrC\nu\n>\nP-\nCJ\n_\n\u00C2\u00A7\n\u00E2\u0096\u00A00\nt\nr.\nS\n\u00C2\u00A3\nc\na\n.c\nt\nrt\nqj\nr.\n>\n1\nu\nV\nV\nu\np\n1\nT\nu\nc\nt-\n3\n2\nE\n\u00E2\u0080\u00A25\na\ne.\nc\nc\nr-\nX\n0\n1\nt\n3\nC.\nC-\n!\ncr\ncr\n--\nS\ns\n'5\nc\nI\n2\n\u00C2\u00A3\n\u00E2\u0080\u00A2r\n0\na\ns\n<\nt\nT\n\u00E2\u0096\u00A0a\nCC\nc\n3\ni-\n1-\n_\na\n0\n\u00C2\u00A3\nc\n'u\na\n\u00C2\u00AB\n\u00E2\u0096\u00A0a\nr.\n_\nCJ\nft\nCO\ntf\n\u00E2\u0096\u00A0S6\nC.-E\nIH 0\nv y\na h-\no\n>\nIt\n\\nX\n0\n3\nC\nu\nX\nQ\n>\nif\nS\na\nu\nrC\nt\n3\nC\nV-\nJS\n>\ncc\nC\n5\n1\nm\n-3\n8\n.2\n1\n18\no\nC\nh\n L 126\nMENTAL HEALTH BRANCH REPORT, 1967/68\nX\nPQ\non\n..\nQ\nX\nZ\nC/_\n<\nQ\nr*\nZ\n<\n<\nrt\n(/.\n0-\nPP\no\nP\no\nfit\ntn\no\nrt\nO\nZ\nPQ\nPQ\no\n<\nrJ\nX\nrt\nr-l\n<\nCO\nO\nZ\nPQ\nP\no\nPh\nJjj\nO\nP\nPQ\n\u00E2\u0096\u00BAJ\n<\nrt\n7\noo\nCO\np\n<\nUoo\nPQ\nno\n>-, vo\ns\nON\n1\u00E2\u0080\u00941\nS \u00C2\u00B0N\nrH\nrH\nl>\nPQ \u00C2\u00BB\n\u00C2\u00AB\nC.\n1-4 rH\n3 ^\nPQ\nPI\n+-*\ne \u00C2\u00AB\nr-l\nCJ\nBh\n<\n3.\n88 3\nz\no\n2\nPh\nWr>\nCO\nCO\no\na\nrt g\ntil\nrt\nO\n< H\n<\nrt\nVO\nON\nrH\nT_>\nCD\na\n'3\nPh vO\n\u00C2\u00A72\nPU\nCO\nn\nrH\nrO\nO\nPQ -1\nX\n\u00E2\u0096\u00BAJ\n2\nOh\nPQ\n<\nc_\nPQ <\n>\nG\n>\nfit\nPQ\nrt\nz\nrt\nz\nHH\n\nCS\nz\no\nz\nO\nPh\nPh\np\np.\nCD\nCJ\n3\nrC\nCJ\np\no\nu\nPh\nr)\nO\nCO\no\na\nO\nS3\nrt\nCO\n<\nP\nPQ\nrt\nca\nP\n<\nPh1\ne\n|\n9\nO\nON\na\nr^\nOO\n\u00E2\u0096\u00A0d\nPQ\nCD\nn\nPQ\nc_\n<\nrJ\nH\nPQ\nCD\n,<\np\nH\n\u00E2\u0096\u00A0\u00C2\u00B0-3\n2\u00C2\u00A3\nOH\nTH TJ Tt rH\nNO\nIVOrn lCNCNcnr^rHy-.CNTtCNcN\nr^\nPP\nl-\ncS\nCNOVTHTHTtTt 1 O VO V. t (S m Tf\nt-\nSS\nIs\ngo\nIrH | j ON ! tn I(Nth 1 | |\n00\npp\n1 II | |rt | III\ns\nIr-* j l\u00C2\u00AB 1 ;mrHrHTH jrH\nTt\nOn\npp\nICNrH iTtrHrHTt IrH |CN\nVO\nNO\nrn\nTt\n7\nP,\nj|llTtlcNTtljljll\nEMI 1 Mill!\no\n6\nVO\nil\nr_l\nON\n\"J\nPP\n;il|cNrH|(s;;;|\nm\nHH\na\nPP\n||||CNI|rH|THTH|||\nm\nA\nSh\nI'll Mil! 1\n\u00E2\u0080\u0094:\nON\nT\nin\nPP\n1 | j 1 | | jrHrHrH jrH\nTt\nrt\ns\n1 II 1 1 1 1 1 1 1 1 !\na\n3\npp\njcn i Ith j ; i | j ithcn) ]\n1 |i | i j | | | j\nNO\ns\ni M M\nz\non\n\ncn\no\nJ\n\u00E2\u0080\u00A2ri a >\nb M\nc-\nCO\na\n\f\ndise<\nnera\ndise\nand\n4) >!\nCJ\n1\n3\nr^\nX\nX\nu\nR\nc heart\nnd dege\nh heart\narteries\nw cj b\nrt > ?\n4> 33 6\na cj -g\n\u00E2\u0084\u00A2 ao 3\n\"3\nc\n!\n-vascular\nrheumati\nclerotic a\nnsions wi\nseases of\nnia.\t\nspiratory\nof the di\nof the ge\nseases\t\n-3\nci\n\u00E2\u0096\u00A0s\na\nIS\n3\n>\n_\ni\n1\nc\nPh\nrC\n.\ns\n-3\ntH\nCJ\n-3\n0\no\ne\n3\n4)\n3\nPh\nIh\ncj\n-3\n0\n0.\nCJ\nf\nS\n~\ncr\n5\nTJ\nN\nCJ\nX\n0\n3\ncu\niZ\n'u\nU\n<\nM\nTJ\n\"3\nX\nPQ\nP/3\nQ\nZ\n<\n<\nrt\nc/_\nPh\no\np\nrt\nO\nZ\nPQ\nhJ\nX\nrt\n<\nPQ\nP\nPh\nO\nPQ\nCO\nP 00\n< \o\nU ON\nw\n\u00E2\u0096\u00BAJ\nz\nCO r=<\nw\nit-T TJ\nid \u00C2\u00BB*\nM ON\npp '-1\nCO\nO rH\nX M\nri 2\nPh\nPQ\n>\nrt\no\nz\n2\n\u00C2\u00AB\nP\nCJ\nCJ\nO\nCO\nX\nrt\n<\nPQ\nP\nO\nCN\nPQ\nl-l\npa\n<\n IN-PATIENT SERVICES\nL 127\nTHE WOODLANDS SCHOOL, NEW WESTMINSTER\nH. J. Brooks, M.B., Ch.B., D.C.H., Acting Superintendent\nReport for April 1, 1967, to March 31, 1968\nThe year brought a further extension of the concept of unitization, and each\nunit became responsible for the administration of its own waiting list. The decision\nwas also taken to bring the supervisory staff of the Psychiatric Unit together in one\narea located close to the wards served by the unit members.\nThe value of unitization continues to be seen in the more precise evaluation of\nthe patients' needs, resulting in the provision of the most suitable training for each\npatient. These changes were possible ony through the enthusiasm and initiative of\nall unit staff members.\nMajor renovations to the buildings in Centre Block continue. Wards 60, 61,\nand 62 (H, E, F) were completed in August, 1968, and will house patients from\nWards 59, 58, and 74, which will be renovated in their turn.\nWork done by the out-patient department continues to increase. One hundred\nand thirty-three patients were seen during the year, and the numbers waiting for\nout-patient appointments are increasing.\nPlacements in the community continue to show an increase over the previous\nyear. There were 33 patients placed in boarding homes, of whom five were returned\nas unsuitable; seven foster-home placements, of whom three were returned; and\nfive patients were transferred to nursing homes. The development of group homes\nto cater to children who, because of low intellectual and physical functioning, prove\nunsuitable for foster-home placement would help greatly in providing vacancies for\nthe severely retarded. This is the area in which pressure for admission is greatest.\nThe general level of health of pupils-patients improved during the year, and\nthis improvement should continue as training programmes focus more on self-care,\nambulation, and environmental improvement, and as sanitary facilities are improved. The group of pupils-patients who will need an increasing amount of programme planning are the profoundly retarded. These children are largely unsuitable\nfor community placement and remain in The Woodlands School.\nIt was suggested by Hospital Unit members and a C.N.I.B. representative that\na ward for the blind mentally retarded at The Woodlands School would be a most\nimportant step forward. A report on this is being studied.\nDr. Dufresne, representing the Royal College of Physicians and Surgeons of\nCanada, reported favourably on the School as suitable for the training of pediatric\nand psychiatric residents.\nIn order to continue with our programme of unitization, it is hoped that we will\nbe able to divide the duties at present performed by the Director of Education and\nTraining between the Director of the Training Unit and the Director of Education\nand Training. This would require the creation of a separate post of Director of\nthe Training Unit.\nWe obtained the lease for Gold Creek Camp from the Corrections Branch and,\nwith the co-operation of the Public Works Department, hope to use the camp on a\ndaily basis throughout the summer.\nThe American Association on Mental Deficiency held its annual convention in\nNew Westminster in October, 1967, and members of all disciplines at The Woodlands School took an active part in the presentation of papers and demonstration of\ntraining methods. Members of the Hospital Unit were co-authors of three papers\npublished in various scientific journals.\n A boy, a bike, and a clear corridor to chase along is a sure-fire recipe for hoots of fun.\nThis young fellow is no exception, and it is all part of the physiotherapy treatment at The\nWoodlands School.\n IN-PATIENT SERVICES L 129\nThe institution of the ward activity training programmes is proving of great\nassistance in that the programme is fitted to the child's needs and capabilities, rather\nthan fitting the child to the programme. With the creation of the post of Rehabilitation Officer, valuable assistance is being given to pupils in obtaining suitable\nemployment outside The Woodlands School, and in exercising supervision over the\n25 pupils who have obtained such work. It is also hoped that this will help in the\nmuch-needed education of employers in accepting the retarded as employees and\nrecognizing the qualities that make them such useful employees.\nMembers of the Volunteer Services contributed over 9,000 hours of service to\nThe Woodlands School. This total does not include the many hours given by the\nProvincial Auxiliary, nor by separate groups.\nReport for April 1 to December 31, 1968\nA most welcome event which occurred during the review period was the\npurchase of Our Lady of Fatima School, Maillardville, as a residential centre and\npre-placement facility for 50 trainable pupils. We have submitted staffing requirements for this establishment and also for the extra staff which will be required at\nThe Woodlands School following the move of 50 trainable patients and their replacement in The Woodlands School by patients from the waiting list whose intellectual level will be much lower, and who will require more supervision and training.\nOperating cost estimates and details of renovations required have also been submitted together with a list of furnishings. We expect to occupy the facility early\nin 1969.\nWe were able to use Gold Creek Camp during the past summer on a daily\nbasis. Structural alterations and repairs are required at this camp and surrounding\narea, and unless this action is taken before next spring, our use of this worth-while\nfacility will be very limited.\nThe patients' cafeteria has been refurnished, and this has done much to\nimprove the environment and hygienic operation of the area.\nPhase II of the renovations to the Centre Building has started, and we hope it\nwill be completed by March, 1969. Structural alterations to Ward 84 have been\ncarried out following inspection by an official of the Public Works Department.\nWhile the renovations were taking place, the pupils were housed in the Recreation\nBuilding.\nThe possibility of placing patients from the Hospital Unit in extended-care\nfacilities has been investigated and is being pursued. Dr. MacKay, consultant to\nextended-care facilities in British Columbia, visited The Woodlands School at our\ninvitation and agreed that the majority of patients in the Hospital Unit are eligible\nfor these facilities, and we are at present submitting applications for admission to\nseveral such institutions.\nDirectly or indirectly, we are following up all the patients suffering from\nphenylketonuria in the Province; we often supply the special dietary requirements\nand supervise the treatment.\nThe appointment of a Rehabilitation Officer has proved worth while. During\nthe period April to December, 1968, the number of male pupils working full or\npart time in gainful occupations varied between five in December, 1968, and 54 in\nOctober, 1968, while their combined monthly earnings varied from $1,016 to\n$3,718. The corresponding figures for female pupils were five in December, 1968,\nand 25 in September, 1968, and $377.36 to $1,914.00. This employment gives\npupils a feeling of achievement and increases their motivation and demonstrates\nto the community the varied abilities of the retarded.\n5\n L 130\nMENTAL HEALTH BRANCH REPORT, 1967/68\nThe demand for out-patient services continues, and the average waiting time\nfor an appointment is about two months. During the next year we hope to assess\nthe work done by the Out-patient Department, together with the staffing needs\nand the need for follow-up services, so that we may improve our service to the\ncommunity.\nWe have recently instituted a multi-discipline in-service training programme\nwith the object of improving communication between departments and informing\nall staff members of the actual work done by each unit and department. This\nprogramme consists of a panel of speakers giving short explanations of the work in\nwhich they are involved, followed by question-and-answer periods. We will evaluate\nthis programme when it has been in operation for a sufficient length of time to make\na useful decision.\nThe increasing involvement of unit staff in the care, training, and treatment of\npatients is being brought about through the medium of clinical team meetings, and\nwe hope to improve community involvement in care of the mentally retarded by\nincluding parents in as many of the ward activities as possible. We are finding that\nan increasing number of admissions to the Psychiatric Unit are severely disturbed,\nand this throws extra burdens on ward staff, where the staffing pattern has been\ndesigned for chronic care rather than the acute type of case which these disturbed\npatients present.\nThe increased rate of placement in the community by the Psychiatric Unit has\nallowed an increased rate of admission, and it is the object in this unit to return the\nindividual patient to the community as soon as the basic need of the individual has\nbeen met and the patient's presenting problem solved. This emphasizes the need for\nincreased psychiatric help in this unit.\nPhysiotherapist treats a spastic child in the therapeutic pool at The Woodlands School.\n IN-PATIENT SERVICES\nL 131\nThe problem presented by the increasing numbers of disturbed pupils being\nadmitted is also reflected in the Education Department, where the presence of these\npupils in classes numbering 15 to 18 pupils makes the teacher's task very difficult.\nWe reintroduced industrial education for those under 17 years of age in September,\n1968; it is too early to evaluate the value of this programme.\nIn the area of pupil health we are introducing on each ward a simple programme for the improvement of oral hygiene and ensuring the continuance of such\na programme. We hope also to install general anaesthesia equipment in the Dental\nDepartment so that routine procedures can be performed at The Woodlands School\nrather than going to the expense and inconvenience of transferring the patient to\nRiverview for such treatment.\nI would like to acknowledge the help and co-operation I have received from all\nstaff members at The Woodlands School while I have occupied the post of Acting\nSuperintendent, and thank them for the loyalty and consideration they have shown.\n L 132\nMENTAL HEALTH BRANCH REPORT, 1967/68\nSTATISTICAL TABLES\nTable 1.\u00E2\u0080\u0094Movement of Population, The Woodlands School,\nNew Westminster, April 1, 1967, to March 31, 1968\nMale\nFemale\nTotal\n746\n41\n11\n531\n67\n3\n1,277\nOn extended leave, carried forward from 1966/67\u00E2\u0080\u0094\n108\nOther \t\n14\n798\n601\n1,399\nAdmissions\u00E2\u0080\u0094\n64\n9\n37\n40\n5\n23\n104\n14\n60\n110\n68\n178\n908\n669\n1,577\nSeparations\u00E2\u0080\u0094\n64\n10\n7\n1\n59\n18\n30\n11\n9\n83\n9\n94\nDied \t\n21\n16\n1\nOn extended leave and still out\u00E2\u0080\u0094\n142\nOther. \t\n27\n159\n142\n301\n+3\n749\n-4\n527\n1\n1,276\ni Includes 2 male and 4 female transfers from The Tranquille School, 3 male transfers from Riverview\nHospital.\n IN-PATIENT SERVICES\nL 133\nTable 2.\u00E2\u0080\u0094First Admissions to The Woodlands School by Health Unit and\nSchool District of Residence and Sex, April 1, 1967, to March 31,\n1968.\nHealth Unit and School District\nMale\nFemale\nTotal\nHealth Unit and School District\nMale\nFemale\nTotal\nSelkirk, Nelson\u00E2\u0080\u0094\nMetropolitan Board of Health of\nSchool District No. 7... -\n1\n1\n2\nGreater Vancouver\u00E2\u0080\u0094\nWest Kootenay, Trail\u00E2\u0080\u0094\nSchool District No. 38\t\n4\n1\n5\nSchool District No. 9\t\n1\n\t\n1\n\u00E2\u0080\u009E 39 \t\n13\n13\n26\n\u00E2\u0080\u009E 11 \t\n1\n1\n2\n 41- \u00E2\u0080\u0094-\n6\n3\n9\n\u00E2\u0080\u009E 12\t\n1\n1\n\u00E2\u0080\u009E 44.\u00E2\u0080\u0094\t\n1\n1\n2\n\u00E2\u0080\u009E 13\t\n1\n\t\n1\nCoast-Garibaldi, Powell River\u00E2\u0080\u0094\nSouth Okanagan, Kelowna\u00E2\u0080\u0094\nSchool District No. 46 _\t\n1\n\t\n1\nSchool District No. 14 \t\n1\n1\n2\n 47 ...\n2\n2\n\u00E2\u0080\u009E 15. \t\n\t\n1\n1\n\u00E2\u0080\u009E 48 \t\n1\n1\n\u00E2\u0080\u009E 23\t\n2\n\t\n2\nSkeena, Prince Rupert\u00E2\u0080\u0094\nNorth Okanagan, Vernon\u00E2\u0080\u0094\nSchool District No. 52\t\n1\n1\nSchool District No. 22\t\n1\n\t\n1\n , 54\t\n2\n......\n2\nSouth Central, Kamloops\u00E2\u0080\u0094\nSchool District No. 24. \t\n,. 88 .\n2\n2\n2\n2\nPeace River, Dawson Creek\u00E2\u0080\u0094\nCariboo, Williams Lake\u00E2\u0080\u0094\nSchool District No. 59\t\n1\n1\n2\nSchool District No. 28.\t\n1\n\t\n1\n\u00E2\u0080\u009E 60 -\n1\n1\nNorthern Interior, Prince\n\u00E2\u0080\u009E 81\t\n1\n1\nGeorge\u00E2\u0080\u0094-\nGreater Victoria Metropolitan\nSchool District No. 56.\t\n\t\n1\n1\nBoard of Health-\n\u00E2\u0080\u009E 57\t\n1\n1\n2\nSchool District No. 61\t\n6\n1\n7\nUpper Fraser Valley, Chilli\n , 62\t\n2\n2\nwack\u00E2\u0080\u0094\n, 63\t\n1\n1\nSchool District No. 33. _\t\n3\n1\n4\nCentral Vancouver Island, Na\n\u00E2\u0080\u009E 34\t\n1\n1\n2\nnaimo\u00E2\u0080\u0094\nBoundary, Cloverdale\u00E2\u0080\u0094\nSchool District No. 65 .\u00E2\u0080\u009E\n5\n5\nSchool District No. 36\t\n5\n4\n9\n , 66\t\n1\n1\n, 37--. -\n1\n1\n2\n\u00E2\u0080\u009E 70\t\n3\n3\nSimon Fraser, New Westmin\nUpper Island, Courtenay\u00E2\u0080\u0094\nster\u00E2\u0080\u0094\nSchool Distict No. 72\t\n1\n1\n1\n, 43 .,,,\n1\n1\nTotals\t\n73\n45\n118\nCentral Fraser, Mission\u00E2\u0080\u0094\nSchool District No. 35\t\n1\n1\n2\n\u00E2\u0080\u009E 42\t\n2\n1\n1\n3\nTable 3.\u00E2\u0080\u0094First Admissions and Readmissions to The Woodlands School by\nMethod of Admission, Age-group, and Sex, April 1, 1967, to March 31, 1968\nAge-group (Years)\nMethod of Admission\nUnder\n1\n1-3\n4-6\n7-9\n10-14\n15-19\n20-29\n30-39\n40 and\nOver\nGrand\nTotal\nM.\nF.\nM.\nF.\nM.\nF.\nM.\nF.\nM\nF.\nM\nF.\nM.\nF.\nM.\nF.\nM.\nF.\nM.\nF.\nFirst Admissions\n1\n1\n4\n7\n6\n1\n3\n8\n14\n4\n9\n1\n8\n4\n6\n3\n3\n3\n1\n1\n2\n3\n1\n2\n1\n35\n37\n2\n16\n27\n3\n1\n1\n5\n5\n5\n5\n51\nTemporary... ~\t\n64\nTotals\t\n| 1\n6\n5\n10\n6\n13\n4\n22| 13\n13\n9\n6\n4| 3| 1\n_| 2| 73\n45\n118\nReadmissions\n\t\n1\n2\n1\n1\n1\n1\n8\n3\n2\n6\ni\n4\n1\n2\n7\n4\n2\n1\n1\n4\n3\n\t\n1\n\t\n2\n8\n27\n1\n7\n15\n3\nInvoluntary \t\nTemporary \t\n15\n3\n42\nTotals.. \u00E2\u0080\u0094\n3\n\t\n3\n2\n10\n3\n8\n5\n10\n4\n3\n8\n1\n37\n23\n60\n L 134\nMENTAL HEALTH BRANCH REPORT, 1967/68\nTable 4.\u00E2\u0080\u0094First Admissions and Readmissions to The Woodlands School by\nMental Diagnosis, Age-group, and Sex, April 1, 1967, to March 31, 1968\nMental Diagnosis\nAge-group (Years)\nUnder\n1\nM.\n1-3\nM.\n4-6\nM,\nF.\n7-9\nM.\n10-14\nF. M,\n15-19 20-29\nM.\nF.\nM.\nF.\n30-39\nM. F.\n40 and\nOver\nM.\nF.\nTotal\nM.\nGrand\nTotal\nFirst Admissions\nEncephalopathy due to\npostnatal cerebral infection\t\nEncephalopathy due to\na virus\t\nEncephalopathy due to\nbacteria \t\nBilirubin encephalopathy\nEncephalopathy due to\nprenatal injury\t\nEncephalopathy due to\nmechanical injury at\nbirth \t\nEncephalopathy due to\nanoxemia at birth\t\nPostnatal anoxemia\t\nCerebral lipoidosis, juvenile -\nGargoylism..\nIntracranial neoplasm\u00E2\u0080\u0094\nHydrocephalus, congenital\t\nMicrocephaly, primary..\nMongolism \t\nMental Retardation\nOther, due to unknown\nprenatal influence, no\ncerebral defect \u00E2\u0080\u0094\t\nEncephalopathy associated with prematurity..\nEncephalopathy, other,\ndue to unknown or\nuncertain cause with\nthe structural reactions\nmanifest \t\nCultural-familial mental\nretardation \t\nPsychogenic mental retardation associated\nwith environmental deprivation.\nPsychogenic mental retardation associated\nwith emotional disturbance\t\nMental retardation associated with psychotic disorder\t\nMental retardation, other, due to uncertain\ncause with the functional reaction alone\nmanifest \t\nCombination of at least\nthree of above conditions \t\nTotals..\n10\n22\n13\n13\n1 1\n1\n10\n21 73\n45\n3\n1\n1\n1\n1\n1\n1\n14\n26\n6\n25\n3\n15\n118\n IN-PATIENT SERVICES\nL 135\nTable 4.\u00E2\u0080\u0094First Admissions and Readmissions to The Woodlands School by\nMental Diagnosis, Age-group, and Sex, April 1, 1967, to March 31,\n1968\u00E2\u0080\u0094Continued\nAge-group (Years)\nMental Diagnosis\nUnder\n1\n1-3\n4-6\n7-9\n10-14\n15-19\n20-29\n30-39\n40 and\nOver\nTotal\nGrand\nTotal\nM.\nF.\nM.\nF.\nM.\nF.\nM.\nF.\nM.\nF.\nM.\nF.\nM.\nF.\nM.\nF.\nM.\nF.\nM.\nF.\nReadmissions\nEncephalopathy due to\npostnatal cerebral in-\n1\n1\n\t\n1\n1\n\t\n......\n\t\n1\n1\n1\n1\n2\n1\n1\n1\n1\n1\n1\n2\n1\n2\n1\n1\n2\n3\n1\n~~\n1\n\u00E2\u0080\u0094\n\u00E2\u0080\u0094\n1\n2\n1\n1\n1\n1\n7\n10\n5\n2\n2\n4\n1\n1\n1\n2\n10\n7\n1\n2\nEncephalopathy due to\n2\nEncephalopathy due to\nprenatal injury\t\nEncephalopathy due to\nmechanical injury at\nbirth ... ..\n.......\n\t\n2\n2\nEncephalopathy due to\nanoxemia at birth\t\nCerebral lipoidosis, ju-\n\t\n\t\n\t\n\t\n\t\n1\n1\n3\n4\n2\n1\n1\n1\n3\n2\n1\n4\n1\n9\nMental Retardation\nOther, due to unknown\nprenatal influence, no\n\t\n1\n\t\n1\n1\n2\n20\nEncephalopathy, other,\ndue to unknown or\nuncertain cause with\nthe structural reactions\nmanifest \t\nCultural-familial mental\n12\n2\nMental retardation associated with psycho-\n1\n1\n\t\n2\nMental retardation, other, due to uncertain\ncause with the functional reaction alone\n4\nCombination of at least\n1\nTotals\t\n3\n3\n2\n10\n3\n8\n5\n10\n4\n3| 8\n1\n\u00E2\u0080\u0094 I 1\n1\n\u00E2\u0080\u0094\n37\n23\n60\nTable 5.\u00E2\u0080\u0094First Admissions to The Woodlands School by Religion and Sex,\nApril 1, 1967, to March 31, 1968\nDetailed information for the above table may be obtained on request.\n L 136\nMENTAL HEALTH BRANCH REPORT, 1967/68\nX\na\nco\nQ\nZ\n<\nD\nO\nfit\na\ni\nw\no\n<\ntn\nO\nz\no\n<\nz\nm\no vo\no _,\nCO ,-,\nQ\nZ\nPfi\nM\nCQ\n\u00C2\u00A7\nw\no\nw\nQ\nE-t\n<\npa\no\nz\nw\nQ\n33\n(2\nz\no\nH\nn\nPh\nTt rH (S\nON\ns\n<\u00C2\u00B1\n~S_\n. Tt c\nt-i in tn tn\n-*\na\n3\nOs\n: tn tn t> cs co i/i so so ;\n\"n\n00\nO\n00\n<\nPh\ntn Tf rH\nCO\n*n\ns\n*\"1\nrH \u00C2\u00A9 Tf cn\nON\n3\nTf CN Tt\nPh\n7-7 SO CS\nCS\ni\no\ns\ntn Tf r*\nCM SO Tfr rH \0 CS rn\nv\u00C2\u00A3)\nrH 00 cs cn\nr-\n, co i-\n0O CS i i-f Os CS\nsO\nT\nr-\nPh\nCO\nm\ns\nCN rn cN CN CS i f- SO CO rn\nso\n! CO rH\nSO\nCS rH ,-H SO \Q :\nS\nPh\n^ | |\nCS\n4\ns\nCO tH\n\" \" II\nCO\n\u00C2\u00BB-t 1 rH ! !\ntn\nPh\n! i\nI 1\nS\n1 *\"\u00E2\u0096\u00A0*\n\"\"*\n\" \"* II\n\u00C2\u00AB-t\nS3\nPh\ns\n1. 1 1 1 1\no o\no\n0\no *j c\n\" o.S\nu\ncj\n.3\n3\n3\n= _\"\no\n\u00E2\u0096\u00A0rt\n\u00E2\u0080\u00A2a\n\u00E2\u0080\u00A2a\n\u00E2\u0080\u00A2o\n*o\n\u00E2\u0096\u00A0aSS\nto\nCO\nCO\n\u00E2\u0080\u00A2 Es\n\u00C2\u00A7\u00C2\u00AB,'_!\n0\nO\n.2 3 g\nCi\nso.\n\u00E2\u0080\u00A2a\n\u00E2\u0080\u00A2a\n-rt\nC\nE 2 <>\ns \u00C2\u00A7 a\no\no\n\u00C2\u00B0 SI B\nCJ\no\nTJ\nTJ\na \u00C2\u00BB-\na\nB\nft\u00C2\u00A3 rt\nrt\nrt C\nra\nrt\niated with\ncerebral in\ni diseases\nto\ncu\nto r\nu S\ns\nco\nCD\nu\n0\nc\n00\nrt\n3\n\"3\ns\nu\nrt\na\n\u00E2\u0080\u00A2a\n43\nrt P\n43 f\nrt\n42\nrt\na\nCO\nt3\n43\nb dise a\nwith str\nin caus\no\n\u00E2\u0096\u00A08\n03\n43\nal, assoc\nostnatal\nated wit\nXJ 4_\nd wit\ngrow\nd wit\nd. wit\nnce__\nd wit\nause\nncert;\n\u00C2\u00ABr4\no\nate\ngen\niate\niate\niate\nflue\niate\nn c\n0 UJ\ng\n43\nn assoc\nnatal in\nn assoc\njncertai\nn due t\nCO\nS-s So g\n-3\nq a _\nw X) o\nrt ,y rt rt rt\nc & c 53 a\nU\nalopathy,\nalopathy\nretardati\nrt-.rt'Srt-tnrt^rtOrt'cO M\n\"2 o*S 2*8 r?*2 c*H cs \u00C2\u00AB |\nrt-HrtajrtSrtiSrt^rtCo o\ntal ret\ntraum\ntal ret\ndisord\ntal ret\nnew g\ntal ret\nunkno\ntal ret\nunkno\ntal ret\nalone\nbinati\nT\na d. rt c\nouti*\nc c a a a a e\nCl c\n0J\n3\n2\nS\nI\ns s\nc\nu\n IN-PATIENT SERVICES\nL 137\nX\na\nco\nQ\nZ\n<\nOh\"\n-3\no\npc;\no\ni\npj\no\n<\nO\nZ\no\n\u00E2\u0096\u00BAJ\n<\nH\nz\nw\nm\nCO\nc-1\no\nX\no\nz\n3\n2\n<\no\nPQ\no\nz\n3\n5.\nw\n>-)\no\no\nX\nu\nto\nCO\nQ\nZ\n<\n8\nCL)\nPh\nO\nCO\nH\nZ\n-\n<\nPh\nW\n-J\nca\n<\nxt~\ncocSTtCSCSfOOro\nOS\nOH\nrt\nPh\nCS rH fn\noo\n,o\n3\nH\nCS rn\nin\nPh\nH | 1 | CS | CO\nso\n3\n] ! rH CS :\nCO\nOs\nfC\nj j | | j | OS 1\n1 1 i i ! i !\nOS\nVO\n3\nOS\n1\nPh'\nrH 1 | ; CS rH SO\n\u00C2\u00A9\nl-O\n3\nOS\nTt\noc\nPh\nI'll i\n\"\n3\n| *H O. rH CS CS\n1 ! 1\n00\nOS\nCO\nPh'\n; j co co cs\n00\n3\nCO\n\u00C2\u00AB\nrH\ni\n1\ncs\nPh\n*\"\u00E2\u0080\u00A2\n3\n! j 1 rt [ *\u00E2\u0096\u00A0* 1\nTf\nQ,\n3\nO\nIh\n60\nI\nC50\nOS\nin\nPh\n| rH j j rH CS CS 1\nSO\n3\nI ! CS | r-i\nCO\n<\nTt\nPh\u00C2\u00B0\nj j ; j \u00C2\u00A9 | : :\n\u00C2\u00A9\n<\u00C2\u00B1\n3\nCO\nrH\n*\"H\n! ! ! ! CO 1 J i\nCO\n2\nPh\n!)li ili\n3\nj j ; Tf cs\nSO\nr-l\nrH\n5\nPh\n[fill 1 I\n3\nrH | j | rn rH II\nCO\n7\nPh'\n1 1 1 j 1 1 1 1\ni\n3\ni i 1 : cs | | ]\nD\n[||| III\nS\nPw\n1 1 1 1 1 1 1\n1\n\u00E2\u0096\u00A0a__\n3\no\n0\n0 0\nO\n9 s e\nMS\n\nrt O\nco \u00C2\u00A3\nCD p\nrt\nCD\n\u00C2\u00AB a as\nS3\u00C2\u00A7S\nrt\nrt 3\nrt H _3\nO\ns\n60\nrt\nS\n(D\nTJ\n43\n4)\nTJ\n43\nTJ\n43\nith dise\nwth, or\nith dise\nth dise\nwith s\nain cai\nrt\nTJ\nis\nTJ\niated w\ngent -.\niated w\n>m, gro\niated w\n3uence\niated w\nn cause\nd uncer\n-_>\nc\nId\nS\n3\n15\n\"8\nassoc\nical a\nassoc\naboli\nassoc\ntal in\nassoc\ncerta\ndue t\no\nrt\no\nrt\n\n<\nH\ntV\nQ vo\nW Ov\nQ rl\nz ,.\nPh1 rH\nh <^\nHJ\ncq\nW\nz\no\nH\nP\nOO\no\no\no\nCO\nco\nQ\nZ\n<\n\u00E2\u0096\u00BAJ\nQ\nO\nO\nBJ\nX\nH\nBh\no\nCO\nH\nZ\nPJ\nH\n>\n43 r.\n3\nO\nIh\nO\n3\n3\nrt\no S\n4*\ns\nrt 2 \u00C2\u00A7\nJ2\n3\n3\nO\no\nrt\n5^2\n3\nO\n0 O \u00C2\u00A7\nw w TJ\nCD\n3\nrt\nCD\nV. CO \u00C2\u00B0\n3 S3 S\nB\nO\n.9\no o -a\n\u00E2\u0080\u00A2a\n3\no\n3\nDC\nrt\ncondi\ncondi\nnd co\nc\no\nCJ\n\u00E2\u0080\u00A2rt\n3\nCD\n43\n0\nTJ TJ rt i 3 \"\u00C2\u00A3 _,\nc 3 : rt o -5\n\"rt\nrt rt -o\nCD\ncG 3 S\n3\nCD\n5\ni disease\nIi disease\nith disea\nwith diseas\nreactions ma\nertain cause\n#\u00C2\u00A3 \u00C2\u00A3\n5 &TJ\nTJ U\n2 rt S\nrt \u00C2\u00A3\n'5 3 o\n.3 .2 '3\n% % \u00C2\u00B0\n0 O co\noo^\nco co rt\nrt rt\nrtS-o\n3 3 5\nCue\netardatio\netardatio\netardatic\netardatio\ne with th\netardatio\nTotals....\n_ - - w - p r=!\nrt rt rt g rt \u00E2\u0084\u00A2 rt\n3 3 3 3 fl\n35\n3\n3\n5\n>\"\n<\nH\nCO\nPh\nO\nX\nH\no\nz\nPJ\nHH\nCO\nCO\nO\nZ\no\n<\nQ\nhj\n<\nH\nZ\nPJ\n2\n>H\nco\nX\n& rH~\n\u00E2\u0080\u00A2\n3 \u00C2\u00AB\ng pa\n-i 3\na.\n3\ncy\nrH\n0 PJ\nc\no u\no\no w\n\u00C2\u00A3Q\n\u00E2\u0080\u00A2a\n5\nca\nPJ X\nx a\nH co\n-O\nBh S\no\no z\n<_>\n<\n_o\nCO\nX\n!>>\nO\nc_\nO\nid\nm\n\u00C2\u00AB\nz\n-D\no\ncd\nz\na>\no\n>\n<\nO\nX>\nC_\n-J\np\nPh\nO\nOh\n>-l\n<\nH\nO\nH\nw\n_j\nCO\n<\nd\nc_\n6\nUt\n<2\na\n\u00E2\u0080\u00A2a\nID\n'3\n4)\nQ\n IN-PATIENT SERVICES\nL 139\n-\nP\no\nfit\no\nI\nPJ\no\n<\ntn\nO\nZ\na\n<\nrJ\n<\nH\nZ\nPJ\nPQ\n-J\no\n\u00C2\u00A7\ni~\ne x\n2 o\n> <\npj ^\ntn o\nz r-r\nHH V^Q\nO Ov\nz rt\nI'i\n8 5\no<\nCO r.\n\nPJ\nkJ\nm\n<\nOH\n\u00C2\u00AB >\noO\nP\nth ! in rH o. oo cs \u00C2\u00BB\nrH (N| rn CS\nCSrHrHCSrH HH.p-l\nCS SO rH rH o CS\nrtrtrttNHHHrl^ CSrH rH\nrH rH : m CS\nI I cs I jcs\nI i\njrH,-. OO\n.S\"S\n\u00C2\u00BBa a s i\noooiooo>\n\u00E2\u0080\u00A233330333\nOJ\n43 43 43\na a a\ntl\n0\n0\n0\n43 43 43\ny\ncj\n0\n43 43 tb *S 43\n. 43 43 43\n\u00E2\u0080\u0094> to\n\u00E2\u0096\u00A0a \u00E2\u0080\u00A2\u00E2\u0080\u00A2%\n-32\nrt 2\na-3> S\n0 ^ Jo\n__,\n\u00C2\u00AB\nd>\n3\nU\n00\nO\n\"rt\n: 5 o\ns.y\na * '\n3 3 3 3 .3, 3 3\nCD tj M\n3 CD rt\nWUO\nS43 0 \u00C2\u00A3t\nU & fcj cy\nIh (j .3 Ih\n2 1 S3\ncu S q\nSB33\nrt rt\na a\n-2 \u00C2\u00B0\n\"rt ~rt\n43 43\na a\na> \u00E2\u0080\u0094 \u00E2\u0080\u009E *\n3 2 3 3-\nrH 3 \u00C2\u00B0 9\nc. u 5 \"'\n, ^ r- rt rt\n' 33 3 TJ TJ\n*t C ,, Ih (-\nS S .S rt rt\n\u00C2\u00AB \u00C2\u00AB+h B CD cd\n3 j- -\nop-33\n3 _-\n:.s\n\u00C2\u00AB.\u00C2\u00AB\nI 6\n5 I :\nE.O.J\na n a\n! rt \u00E2\u0084\u00A2\nj J-'S\n00 9\n7 co 4*1 \u00E2\u0096\u00A0\nSi 13'\na H\n) (D cD .>, >._3\n: 43 43 43 H\nj rt rt rt g\nx a a a.&\n: o o o3\nj \"rt \"rt \"rt -rt\n: 43 43 43 \u00C2\u00A3\nx a a an\n. ii CD CD cD\n) o 0 0 c\n: 3 3 3 CD\nj WW WU\nt1 cd ' rt 4- 1 rt\nCfl\n\u00C2\u00AB\n_tj> O r- rt a (D rt\nH\nCerebra\nMultipl\nMongol\nMental\nEnceph\nma\nMental\n L 140\nMENTAL HEALTH BRANCH REPORT, 1967/63\nrs\n2S\nrH\nOH\nrH TH ; rH T-I CS IT!\nTH\n5\nPh\n1-1\nCO\nO\nZ\nO\n<\nP\nH\n3\n1 1\nX\nPJ\nCO\nQ\nZ\n<\npj\nCO\nQ\nZ\nPJ\nrH rH ! | | } !\nMill\nCN\n\u00C2\u00A7\u00C2\u00B0\n5\ni r 1111\nO\nPh'\ni i !\" i i\"\nCS\n<\n<\np\n2\ncn\n<\nH\nCO\n3\nMl 1 1 1 1\nZ\n! ! 1 i i !N\nCN\nPJ\no\nfit\nCj3\n3\nO\ncs\nPh\n'Mil!\nPJ\no\nS\n3\nt j j | t |-H\n,H\n><\nPJ\no\n<\n1?\nH\nO\nz\nOs\ntn\nPh\nIII::\"\n*\"*\nhJ\n1 1 IH 1 jT\n!_*.\nSCHOO\n, 1968\nH\n<\nPJ\no\nb\na\n3\nO\nrH\n3\nIII II\nPJ\n\u00E2\u0096\u00A0*\nBh\u00C2\u00B0\n1 ! : i H ^h j\nIII! I\nCS\n\u00C2\u00A9\n3\n1 ! t i 1 i cs cs\nrring in The Woodlands\nril 1, 1967, to March 31\ng.\n>\nZ vo\n< OV\nhJ i\u00E2\u0080\u0094<\na \u00E2\u0080\u009E\no __r\no\nPJ Ph\no\nto\nd\n'3\n< z\nPJ <\no\n43\nPJ J\ns __\n0\nCD\no\no\n4-\n< co\nS\n5^\nO\nrt\ns\n\u00C2\u00A7\nz\n5?\n6\n5 Ph\n5 \u00C2\u00B0\nz\n2\nPh\nP\nCJ\nu\nO\n-a\no\n--H\nft X\npj (i\nCO g\nPJ Z\nO PJ\nfit ,_1\ncd\n\u00E2\u0096\u00BA\nO\n43\nrt\nCD\nQ\n\u00C2\u00AB\no\nrt\n43\na\nS\n>>\nz\n3\nPh\np\nu\nCJ\ncd\nH->\nCU\n>\nO\n<\nS3\nu\nCO\nP\n\n1\nc_\ns\ntH\no\nCN\ni\u00E2\u0080\u0094i\nPJ\n-J\n.s a\nTJ M\n3 a +J\n\u00E2\u0080\u0094 3 t.\ncj cd n\n3 on cu\ncc\nC\n1\nCO\n\u00E2\u0096\u00A0J.\n6\ntH\no\ni\u00E2\u0080\u0094t\npj\nCO\n<\na\n\u00E2\u0080\u00A2 rH\nrs\nCO.\n<\n-h o 43\nco'^ tD\n3TJ 43\n\u00C2\u00A7 3 B\nt-\n>\nrt\nB,\nrt ?.\ntf\nPJ\nhJ\nCO\n<;\nH\n.a\nB\nH\nC3\n-!j\u00C2\u00A7i.5\n14-C rH .23 -H\nt_\nQ\n3\nc\n\"ci\n2\n|\ns-\nCU\n<\n1\nhi\nCD\n4=\n0\nc\nc\njj\nd\ne\na\n\u00E2\u0096\u00A07\n1\nc\n1\n_\nc\nC\nIh\nJ-\n+3\nOO\n33\nP\n IN-PATIENT SERVICES L 141\nTHE TRANQUILLE SCHOOL, TRANQUILLE\nJohn Bower, M.D., D.P.M., Acting Superintendent\nReport for April 1, 1967, to March 31, 1968\nFor the first time since it was established in 1959, The Tranquille School had\nno increase in its resident population during the year under review.\nAs a result of a major policy decision, applicants for admission during the year\nwere selected directly from the waiting list. As far as possible, applicants were\nchosen whose residence was in the Interior of the Province. In order to facilitate\nproximity to next of kin, transfers by exchange between Tranquille and The Woodlands School have been increasing in number.\nThe School was also permitted to use Tranquille Farm as a training area for\nboys, with the plan of eventual placement in farms in the community.\nThe health of the students is reflected in the absence of any epidemics, the\nabsence of dysentery, and the absence of infectious hepatitis. There was an average\noccupancy of the 10-bed hospital ward of 6.61. Two deaths occurred during the\nyear, giving a mortality rate of 2.9 per 1,000. All cases requiring surgery are sent\nto the Royal Inland Hospital, Kamloops, for the operation; all medical cases are\nretained in the hospital ward for treatment. A family doctor practising in Kamloops\nvisits this ward daily and also takes sick parade.\nThrough the continued co-operation of Dr. Ian Findlay and the staff of the\nSouth Central Interior Health Unit, immunization is performed against diphtheria,\ntetanus, and poliomyelitis.\nTRAINING PROGRAMME\nWe accept the philosophy that the retarded person is entitled to those experiences which will enable him to adjust to life in his community whether that community is within the School or outside. Our programme, based on milieu therapy,\nis geared to serve the needs of three major groups of retarded:\u00E2\u0080\u0094\n(1) The group who will always be limited to self-care and home training\nprogrammes.\n(2) The group who can be trained in our intramural employment programme.\nThis is carefully structured under the direct supervision of job placement\nofficers, with employment in 16 areas. As of February, 1968, permission\nwas received from the Department of Agriculture and a training crew was\nplaced on Tranquille Farm.\n(3) The group who can be trained for employment in the community. The\nprogramme is flexible, with the persons taught acceptable work habits\nrather than a specific job. No undue emphasis is placed on the knowledge\nof reading and arithmetic.\nRecreational Therapy.\u00E2\u0080\u0094The programme is held on six days and four nights\nevery week because physical development and the achievement of motor skills is\nnecessary to the physical health and well-being of all individuals, normal and subnormal, and is the basis of all learning. All mental levels participate in the comprehensive programme, which includes individual and small- and large-group activities.\nThe average monthly attendance is 5,280, with complete integration of the sexes.\nThe School participated in the Centennial athletic programme sponsored by the\nCanadian Association for Retarded Children under the direction of the Chief Recre-\n L 142 MENTAL HEALTH BRANCH REPORT, 1967/68\national Instructor; 15 gold medals, 55 silver medals, and 165 participation medals\nwere won. During the summer months the scheduled events moved out-of-doors\ninto our large playing-fields; baseball and other such competitive games in Fortune\nField; large muscle activity in Hayes Park, and activities involving play equipment\nin Cooney Park.\nKamp Kiwanis, situated in the Cariboo Hills, is our summer camp established\nby the Kiwanis Club of Kamloops. It provides a week's summer holiday for students, who live an outdoor life in this lovely valley on Tranquille Creek. They also\nenjoy the unique experience of catching trout on barbless hooks, placing them in a\nlarge container, and releasing the fish at the end of their holiday to be caught by\nthe next group of students.\nOccupational Therapy.\u00E2\u0080\u0094A programme is arranged for all mental levels; it\nincludes a wide range, varying from diversional activities to the production of\njewellery made in the lapidary shop from semi-precious rocks found locally. Hand-\nweaving of material, rugs, basketry, rock mosaic pictures, embroidery, knitting,\nleathercraft, and woodworking are all produced.\nPhysiotherapy.\u00E2\u0080\u0094For the first time, from October, 1967, physiotherapy services\nfor the doubly handicapped individual were provided, with a therapist attending once\nweekly. The prescribed movements were carried on by Mr. J. Lynes, Chief Recreational Instructor, during the week.\nScouts and Guides.\u00E2\u0080\u0094The First Tranquille Scout Troop has Camp Blackthorn,\nwhere during most summer week-ends they live in tents and put into practice the\nscouting lore learned during the active winter programme. A large log cabin has\nbeen almost completed, with all work done by the boys under supervision of their\nScoutmaster.\nCOMMUNITY EMPLOYMENT\nBased on the training received in the intramural employment programme and\nwith a community made receptive by education, employment in the community for\nstudents has become a successful programme. Supervision and counselling of employer and employee are given by a specific member of the social service staff. It\nis a measure of his ability that students who have been as long as 41 years in an\ninstitution are working in the community with residence in a boarding home. Students who still reside in the School are brought daily to their jobs in the School bus.\nMost jobs are in the Greater Kamloops area, with Vernon and Kelowna included.\nSCHOOL EVENTS\nCarnival Day with bands, floats, and circus atmosphere; May Day with the\ncrowning of the queen and track events; Pine Crest Barbecue with its gargantuan\nfeast for 500 persons and the steer fed by Pine Crest boys; Christmas Day with its\nhappy melange of nine Santa Clauses, 400 paper-hat-crowned trainees sitting down\ntogether to a turkey dinner with all the trimmings, and new gifts\u00E2\u0080\u0094these have all\nbecome a part of the Tranquille picture.\nRESEARCH PROJECTS\nTwo studies were made into possible chromosomal aberrancies\u00E2\u0080\u0094one into the\nrelationship between Kleinefelter's syndrome and Down's syndrome and one into\nsex chromatin abnormalities in the mildly retarded. The third study, a long-term\nproject, is on the effect on the social skills of 104 profoundly retarded students transferred to The Tranquille School to occupy the Sage Building.\n IN-PATIENT SERVICES L 143\nDENTAL DEPARTMENT\nA dental suite has been constructed on the fourth floor of the Greaves Building.\nIt includes the dental X-ray unit and darkroom and an operating theatre for dental\ntreatment under general anaesthesia. With three dentists on staff, an oral examination\ncan be made once every six months. A detailed dental report is received monthly,\nas of December, 1967. After one year it is anticipated that interesting data will\nemerge in respect to dental health in genetic conditions and to mental level.\nCHAPLAINCY SERVICES\nThe chapel has been renovated, including a new floor. Pews donated by St.\nPaul's Cathedral in Kamloops have replaced the chairs. The Very Rev. J. C. Jolley,\nDean of St. Paul's Cathedral, and the Most Rev. M. A. Harrington, Bishop of Kamloops Diocese, minister to the spiritual needs of our students.\nNEW CONSTRUCTION\nA new million-dollar structure, the Centennial Building, was opened during\nthe year. It houses the student cafeteria, the staff cafeteria, the main kitchen,\nstores, pharmacy, and staff lounge.\nA new fire-alarm system is in the process of being installed, and a large and\nmuch-needed addition to the laundry is nearly completed.\nPERSONNEL\nSixteen new positions were approved into establishment, to bring the total staff\nto 372. Dr. H. W. Bridge assumed the position of Acting Superintendent in March,\n1967. In January, 1968, Dr. Margaret Neave was appointed Deputy Superintendent. Mr. E. V. Roy Merrick remains as Business Administrator.\nReport for April 1 to December 31, 1968\nThe writer of this report came to head the School, commencing work on July\n1st. With this advent, some reorganization has been necessary and will be proceeding further in the coming year. The former Acting Superintendent, Dr. M. S. Neave,\nhas now assumed the post of Clinical Director, and her large clinical knowledge will\nbe directed to completely medical functions. The writer is acting as consultant in\npsychiatry to the School, and it is hoped that, with increasing staff, it will not be\nnecessary for the Medical Department to be too closely involved in the supervision of\nancillary disciplines, such as social work and psychology.\nClinical conferences have been held regularly, and it is hoped to increase these\nduring the coming year. These are conducted on democratic principles with much\nancillary staff participating, and it is felt that this is increasing both the usefulness\nand the interest of the conferences. Conferences between the Superintendent and\nother departments are held frequently, and a collegiate team structure is gradually\nevolving.\nAn annual handicraft sale was held this year with both good and bad results,\nand it is proposed to try to effect some alteration of the sale philosophy within the\nnext year in order that the relatives of students and the elder and less-alert members\nof the community may have a better chance to avail themselves of products made\nby the students of this School.\n L 144 MENTAL HEALTH BRANCH REPORT, 1967/68\nThe Nursing Department is still the largest one in the School, under the directorship of Mr. A. Mcintosh, R.N. It is the one department probably in most intimate contact with the trainees, and as such has many contributions to offer and\nmany more are already being offered to the general training programme.\nIntegration between social work, medicine, and nursing is a desirable picture\nwhich is becoming more acceptable every day. The nursing staff continues to consist of registered nurses with psychiatric training, registered nurses without this latter,\nand psychiatric nurses and aides, and a happy atmosphere and association between\nall these groups is in evidence.\nDuring the year the usual School events of May Day, Carnival Day, and the\nPine Crest Barbecue were held, and many students spent holidays at Kamp\nKiwanis.\nThe community interests and resettlement programmes are continual and\nhave been the direct charge of the Social Work Department. Many students are\nemployed in this community, some returning to Tranquille at night, while others\nare living out in various situations. Integration with Venture training centre in\nVernon continues.\nFinally, during the year much work was done in the construction area. The\nrenovation of the laundry is complete, a dairy section for milk-cooling is finished,\nand a renovation of offices is proceeding.\n IN-PATIENT SERVICES\nL 145\nSTATISTICAL TABLES\nTable 1.\u00E2\u0080\u0094Movement of Population, The Tranquille School,\nApril 1, 1967, to March 31, 1968\nMale\nFemale\nTotal\nIn residence, April 1, 1967 \t\nOn extended leave, carried forward from 1966/67\u00E2\u0080\u0094\n368\n18\n4\n290\n11\n2\n658\n29\nOther _\t\n6\nTotal on books as at April 1,1967\t\n390\n303\n693\nAdmissions\u00E2\u0080\u0094\n12\n11\n3\n6\n13\n4\n18\nReadmissions to a different institution of Mental Health Services. \t\nReadmissions to the same institution \t\n24\n7\n26\n23\n49\n416\n326\n742\nSeparations\u00E2\u0080\u0094\n21\n2\n16\n3\n8\n4\n4\n1\n21\n3\n29\nDied -\t\n4\n6\n1\nOn extended leave and still out\u00E2\u0080\u0094\u00E2\u0096\u00A0\n37\nOrtipr\n6\n42\n41\n83\n+6\n374\n\u00E2\u0080\u00945\n285\n+ 1\nIn residence, March 31,1968- \u00E2\u0080\u0094 . ...\n659\ni Includes 7 male and 9 female transfers from The Woodlands School, 1 male and 1 female transfer from\nRiverview Hospital.\nTable 2.\u00E2\u0080\u0094First Admissions and Readmissions to the Tranquille School\nby Mental Diagnosis, Age-group, and Sex, April 1, 1967, to March\n31,1968.\nAge-group (Years)\nTotal\nMental Diagnosis\nUnder\n1\n1-3\n4-6\n7-9\n10-14\n15-19\n20-29\n30-39\n40 and\nOver\nGrand\nTotal\nM.\nF.\nM.\nF.\nm.|f.\nM.\nF.\nM.\nF.\nM.\nF.\nM.\nF.\nM.\nF.\nM.\nF.\nM.\nF.\nFirst Admissions\nMental deficiency\u00E2\u0080\u0094\nIdiocy\t\nImbecility\t\nMoron\t\nBorder-line intelligence\t\nOther and unspecified\n\u00E2\u0080\u0094\n\u00E2\u0080\u0094\n\t\n\u00E2\u0080\u0094\n1\n1\n2\n1\n1\n2\n1\n1\n~1\n1\n1\n1\n1\n1\n~3\n1\n2\n1\n5\n3\n~~1\n3\n1\ni\nl\n~~1\n1\n1\n\u00E2\u0080\u0094\u00E2\u0080\u0094\n3\n7\n8\n4\n1\n2\n7\n6\n3\n5\n14\n14\n7\n1\nChronic brain syndrome, N.O.S\t\n.-..\n.....\n1\n__\n1\n1\nTotals\t\n\u00E2\u0080\u0094|\u00E2\u0080\u0094\n_|_| 1| 1\n2| 2| 5| 2\n3\n6\n9| 6\n2\n2\n1\n\t\n23\n19\n42\nReadmissions\nMental deficiency\u00E2\u0080\u0094\nIdiocy..... \t\nImbecility\t\nMoron \t\nBorder-line intelli\n\t\n\u00E2\u0080\u0094\n\t\n\u00E2\u0080\u0094\n\t\n\t\n\t\n\t\n1\n1\n\t\n\"l\n1\n1\n1\n\t\n\t\n\t\n\t\n1\n1\n1\n2\n1\n1\n3\n2\ngence\t\n\u00E2\u0080\u0094\n\u00E2\u0080\u0094\n_\u00E2\u0080\u0094\n\u00E2\u0080\u0094\n\t\n\t\n\t\n\u00E2\u0080\u0094\n\u00E2\u0080\u0094\n\t\n\t\n\t\n1\n\t\n\t\n\t\n\t\n1\n1\nTotals\t\n\u00E2\u0080\u0094\n\u00E2\u0080\u0094\n\t\n\u00E2\u0080\u0094\n\t\n\t\n\t\n\u00E2\u0080\u0094\n1\n1\n\t\n1\n2\n2\n\t\n\t\n\t\n\t\n3\n4\n7\n L 146\nMENTAL HEALTH BRANCH REPORT, 1967/68\n\u00E2\u0080\u00A2rt \u00E2\u0080\u0094\nth ri (MCOvOvfiWIflm\no\nr- m oo \nB\nOs\nm\nft\n; ; cn cn oo so t> th th\n00\ns\n(S^HHH\nOs\nu\nO\nCD\nI ; fN\ntN\nQ\n\u00E2\u0080\u00A2<*\nft'\nII Ifi't^ !H j |\nTf\nC3\n;*\nca\n_j\no\no o\nX vo\nOX)\n<\n2\nU\ns\n. ! Nt> ; | j i ;\n0\\nOs\nft\nj 1 ; 1 j i i j j\n\u00E2\u0096\u00A0rt\nso\nX}\ns\n: i ' '\"\"'.: 1 1 j\nw\na\nO Ov\nRANQUILLE S\nEMBER 31, 1\nSO\n4\nft\nc\no\n\"I-\nII !!!!!!!\nj\nCfl\n1\nft\n| j ( | I | | | j\na\ng\ns\n1 1 |||Mii\nj\ntN\n\u00E2\u0080\u00A2rt\ntH\n^\nI : ; : j ; ; i :\n\u00C2\u00AB\n\"O-H\na\"\ns\nI\n\u00C2\u00A3\nW Q\nD\n*rt\nE\nH\nin\n\u00E2\u0080\u00A2O\nn.\ns\no\nra\n1-1\nu\ntn\n\u00C2\u00A3\nM\no\nO\ncm\nO\npq\n*o\nz\n\u00C2\u00AB\no\no\nXi\nz\nc\no\nd>\nt-H\n\nts_\no\n*rt\ns\n<0\nOh\ns\n.2\noo\n>_]\no\ntJ\n<\ns\ns\nrt\ntn\n6\nrt\no\n1\nCfl\ni-\n<__\ncn\na\n0\nS\na\nu\nc\na.\nIE\n55\nS\n(U\n*rt\ns\nt-i \u00C2\u00AB\no o\na\ni-i\nca\nlie dison\nf other d\n:iency\u00E2\u0080\u0094\n>\n2\n.5\nSi\nind unsp\niin syndr\ntals\t\n\"rt\nO\ntfl\nEh\ni\nu\nxi\nP\no\nN\n1\no\nV\nC\n>\ncfl\nCh\ntfi >.\no u\n\u00E2\u0080\u00A2a c\n-h 2\na\nu\ns\nCD\nc\n1\n1\nm\nc\ni\nc\ns\nU\n1\ni\no\n0\nP\no\nxj\nO\nc\nrC\nO\nlH\n IN-PATIENT SERVICES\nL 147\nGERIATRIC DIVISION\nJ. Walsh, M.B., B.Ch., D.P.M., Superintendent\nReport for April 1, 1967, to March 31, 1968\nThe Geriatric Division consists of three hospitals\u00E2\u0080\u0094Valleyview Hospital, Essondale, 779 beds; Dellview Hospital, Vernon, 239 beds; and Skeenaview Hosiptal,\nTerrace, 300 male beds.\nDuring the year a total of 1,868 patients received care and treatment in the\nthree hospitals of this Division. Applications for admission totalled 776\u00E2\u0080\u0094590 for\nValleyview Hospital, 105 for Dellview Hospital, and 21 for Skeenaview Hosiptal\nActual admissions totalled 551, of whom 533 were admitted directly from the community and 18 were received on transfer from other mental health facilities One\nhundred and eighty-four patients were returned to the community, and 427 patients\ndied during the year. The resident population of the three hospitals as of March 31\n1968, numbered 1,238. To this number may be added 254 patients who, though\nresident in the community, are still on the hospital register, making a total of 1,492.\nVALLEYVIEW HOSPITAL, ESSONDALE\nThis is the largest of the three hospitals of the Geriatric Division Eighty per\ncent of admissions are from the Lower Mainland up to, but not including Langley\n10 per cent are from the Mainland beyond the Lower Mainland, and 10 per cent are\nfrom Vancouver Island and the Gulf Islands.\nOccupational therapy for the older folks at Valleyview Hospital provides not only a sense\nof personal achievement, but also a wonderful opportunity to socialize.\n L 148\nMENTAL HEALTH BRANCH REPORT, 1967/68\nDuring the year 442 patients were admitted\u00E2\u0080\u0094424 direct from the community\nand 18 received on transfer from Riverview Hospital.\nOne hundred and thirty-five patients were returned to the community. Of this\nnumber, 18 were discharged in full and 117 were placed on leave. Forty-nine patients already on leave were discharged in full from leave. Of these patients on leave\nduring the year, 45 were returned to hospital, representing 12.5 per cent. Of those\npatients returned to hospital during the year, 14 were again placed on leave. Factors\nother than mental breakdown may contribute to return to hospital in some cases.\nForty-five patients died while on leave.\nAs of March 31, 1968, the number of patients on leave totalled 214.\nDeaths in hospital totalled 279. Twenty-three patients were transferred to\nSkeenaview Hospital and 23 to Dellview Hospital.\nIn June, 1967, a medical consultation service was made available to physicians\nin the community on a limited geographical basis. By January 1, 1968, this service\nwas made available to the whole of the Lower Mainland area. The primary objective of this service is an assessment of the need or urgency for admission to hospital.\nBy the end of the year 127 patients were seen and early admission for the more\nurgent cases was arranged.\nIn the hospital an active-treatment and rehabilitation programme has been\nmaintained. At the time of admission both the patient and the relatives are made\naware that hospitalization may be only temporary and that the patient will be returned to the community as soon as he is well enough to do so.\nOwing to the high incidence of physical illness in the aged, its investigation and\ntreatment form a large part of the total medical treatment programme.\nThe services of consultants are available from Riverview Hospital, and all\nsurgical procedures are performed there.\nNo problem with the \" generation gap \" here as youngsters of the Rainbow Band entertain\nolder patients during recreational-therapy sessions on the wards at Valleyview Hospital.\n IN-PATIENT SERVICES L 149\nThe hospital's Dental Department provides a satisfactory dental service for the\npatients. The Pathological Department, under the supervision of the pathologist\nfrom Riverview Hospital, provides adequate diagnostic services.\nA high standard of nursing care is provided for patients, and the work involved\nrequires a high degree of dedication on the part of the staff. An organized system\nof ward visiting by volunteers was initiated toward the end of the year. It is expected\nthat this service will be of great value to patients.\nThe Department of Occupational Health provides useful help in dealing with\ncases of long-term illness among staff.\nThe Social Service Department, with an establishment of five positions, has\noperated with an average of 3 Vz workers throughout the year. Post-admission services, including discharge, form the most important area of activity. Despite\nincreases in the rates payable to nursing homes and boarding homes by the Department of Social Welfare, it is becoming almost impossible to place such patients in\nthe community.\nThe physiotherapy programme has been maintained, and a part-time podiatry\nservice is a useful adjunct.\nThe Occupational Therapy Department was without a director for part of the\nyear. A useful programme, however, was arranged by the two handicraft instructors.\nThe average monthly attendance at the occupational therapy centre was 1,252, with\nabout 200 patients involved in programmes on the wards.\nThree first-year and one second-year student from the School of Rehabilitation\nMedicine spent part of their internship in the Department during the summer.\nThree volunteers from the Canadian Mental Health Association provide valuable assistance to the programme.\nDELLVIEW HOSPITAL, VERNON\nThis hospital has a complement of 150 female and 89 male beds. Ninety-one\npatients were admitted from the community, and 27 were received on transfer from\nValleyview Hospital. Forty patients were returned to the community on leave\nstatus, and six were discharged in full. A promising feature of the rehabilitation\nprogramme is the increasing number of patients placed singly in homes in the community. As of March 31st there were 13 patients placed in this way.\nAs of March 31, 1968, the resident population was 202. To this may be added\n40 patients on leave, making a total of 242 on the hospital register.\nMedical services to patients is provided by a local physician on a part-time basis.\nThe psychiatrist in charge of the North Okanagan Mental Health Centre attends\non a regular weekly basis and provides a valuable psychiatric service to patients.\nDental and ophthalmic services are provided by the community dentists and\nophthalmologists as needed.\nA good standard of nursing care has been provided for patients. Improvement\nin the ratio of graduate nurses to aides has been continued. The establishment of\na housekeeping staff has facilitated the work of nursing staff. Reorganization of\nstaff through reclassification has strengthened the supervisory area.\nThe Occupational Therapy Department has provided handicraft programmes\nfor a number of patients.\nAn extensive programme of recreation and entertainment was made possible\nthrough the combined efforts of staff and volunteer agencies such as Canadian Mental\nHealth Association, Independent Order of Foresters, and various other service\norganizations in the Vernon area.\n L 150 MENTAL HEALTH BRANCH REPORT, 1967/68\nEducational opportunities were made use of where possible. One assistant\ncharge nurse attended an eight-month course at Vancouver College, and the Director\nof Nursing attended a four-day nursing institute in Vancouver.\nClasses of instruction for nurses' aides were conducted in the hospital by an\ninstructor from the Department of Nursing Education at Essondale, and two psychiatric nurses attended a two-day nursing institute in Vancouver.\nSKEENAVIEW HOSPITAL, TERRACE\nThis hospital has 300 male beds and provided care and treatment for 334\npatients during the year.\nEighteen patients were admitted direct from the community, an increase of\nseven over the previous year. Twenty-three patients were received on transfer from\nValleyview Hospital. Three patients were discharged in full to the community, and\n53 patients died. The resident population at March 31st was 278.\nSatisfactory medical service has been provided by a local physician on a part-\ntime basis. The services of the Mills Memorial Hospital are available for diagnostic\nand surgical procedures.\nThe nurse to aide ratio improved during the year, and a satisfactory standard\nof care was provided.\nThe Occupational Therapy Department has given good service to patients, and\nmany worth-while projects have been completed in the woodworking shop. A\nsuitable entertainment programme has developed through the efforts of the staff with\nthe aid of local volunteer groups.\nReport for April 1 to December 31, 1968\nVALLEYVIEW HOSPITAL, ESSONDALE\nDue to the installation of a ventilating system on six wards, there was a loss\nof 12 beds, so that the present establishment of beds is 779. Bed occupancy\nhas been maintained at a consistently high level. The need to use beds to the\nmaximum frequently presents a threat to elementary classification of patients and\nto free movement of patients, requiring special acute treatment in wards allotted\nfor this purpose.\nApplications for Admission\nThese are received from all areas of the Province, with the exception of\nthe Okanagan-Kootenays region and the Terrace-Prince Rupert area.\nSince April 1, 1968, the number of applications for admission averaged 56\nper month, an increase of six over the monthly average for the previous year.\nThis reverses the trend toward a reduction which appeared in the previous year\nand indicates a resumption of the upward trend which has been evident over the\npast five years.\nOwing to the increased length of stay of female patients as compared with male\npatients, the allotment of beds is two-thirds female and one-third male. The higher\nproportion of females in the population is also now a more important factor.\nThe rapid increase in the number of applications demanded that some action\nbe taken to ensure that the more urgent cases be dealt with and, where necessary,\nadmitted without undue delay. For this reason, a community consultation service\nwas instituted in June, 1967, and became fully operative at the beginning of 1968.\nThis service is available to physicians in the Lower Mainland area. Approximately\n80 per cent of admissions come from this geographic area. During the period April\n IN-PATIENT SERVICES L 151\n1st to December 31st an average of 48 patients per month has been seen. Of this\nnumber, almost one-third were not considered in need of committal to a mental\nhealth facility. The demand, however, continued to exceed the number of beds\navailable for admission, and a lengthy waiting list developed, especially over the\nsummer months.\nThe rate of admission is about the same as last year. Because of increasing\ndemand for beds, the lower age limit of 70 years has been applied. This has contributed to a consistent increase in the average age on admission. A lower limit of\n65 years should be the objective to be kept in mind when planning for the future\nneeds of the mentally ill aged.\nDischarges\nPatients returning to the community from hospital may be discharged in full\nor on a stated period of leave before final discharge. This latter arrangement\nenables the patient to be returned to hospital without formality in the event of\nfurther breakdown.\nThe number of patients discharged in the period from April 1 to December\n31, 1968, shows a slight improvement on the figures for the same period of the\nprevious year. A breakdown of these figures is of some interest. Of 29 patients\ndischarged to self-care, relatives, or friends, all had adequate finances to meet care\ncosts. Of 56 patients discharged to boarding homes, rest homes, etc., 46 had\nadequate funds to meet care costs. Of 22 patients discharged to private hospitals\nor nursing homes, 19 had sufficient funds to meet care costs. Three patients were\ndischarged to extended-care facilities.\nA limited programme of after-care is provided for patients who have returned\nto the community. Of those patients who have left the hospital, about 15 per cent\nwill be readmitted in any one year. In some cases, however, factors other than\nmental breakdown will dictate return to hospital, and some are soon discharged\nagain to a more suitable placement.\nIn the same period, 38 patients were transferred to Dellview Hospital,\nVernon.\nDELLVIEW HOSPITAL, VERNON\nFrom April 1 to December 31, 1968, the admission rate remains the same\nas the previous year, at 10 per month. It is projected that 25 patients will be\nreturned to the community in nine months to December 31, 1968.\nMore than 40 patients are on leave in the community at any one time.\nAn improved ratio of trained nursing staff to aides has been maintained.\nSKEENAVIEW HOSPITAL, TERRACE\nIn April a decision was made to seek alternative accommodation and eventually close this hospital. Following on this decision it was decided that patients\nwould not be transferred there from other units.\nFive patients were transferred to Dellview Hospital, Vernon.\nThere are no facilities in the Terrace area to which patients may be discharged, and few patients return to that community.\nFive patients were transferred to Valleyview Hospital for discharge to facilities in the Lower Mainland area.\n L 152 MENTAL HEALTH BRANCH REPORT, 1967/68\nSTATISTICAL TABLES\u00E2\u0080\u0094VALLEYVIEW HOSPITAL\nTable 1.\u00E2\u0080\u0094Movement of Population, Valleyview Hospital, Essondale,\nApril 1, 1967, to March 31, 1968\nMale\nFemale\nTotal\n254\n96\n494\n147\n748\nOn extended leave, carried forward from 1966/67\u00E2\u0080\u0094\n243\nOther - -\t\nTotal on books as at April 1, 1967\t\n350\n641\n991\nAdmissions\u00E2\u0080\u0094\n158\n31\n5\n210\n29\n10\n368\n60\n15\nTotal admissions1 \t\n194\n249\n443\n544\n890\n1,434\nSeparations\u00E2\u0080\u0094\u00E2\u0096\u00A0\n35\n131\n29\n15\n83\n32\n193\n20\n7\n131\n67\nDied .\n324\n49\n22\nOn extended leave and still out\u00E2\u0080\u0094\n214\nOther _\t\n293\n383\n676\n\u00E2\u0080\u00943\n251\n+ 13\n507\n+ 10\n758\nIn residence, March 31, 1968 \t\ni Includes 12 male transfers and 7 female transfers from Riverview Hospital.\nTable 2.\u00E2\u0080\u0094First Admissions to Valleyview Hospital, Essondale, by Health\nUnit and School District of Residence and Sex, April 1, 1967, to\nMarch 31, 1968.\nHealth Unit and School District\nMale\nFemale\nTotal\nHealth Unit and School District\nMale\nFemale\nTotal\nEast Kootenay, Cranbrook\u00E2\u0080\u0094\nSchool District No. 18\t\n1\n1\n1\n1\n1\n4\n4\n5\n1\n7\n9\n5\n8\n4\n1\n1\n2\n10\n3\n16\n4\n4\n4\n4\n1\n1\n1\n1\n1\n1\n1\n6\n4\n15\n4\n23\n13\n9\n12\n8\nMetropolitan Board of Health of\nGreater Vancouver\u00E2\u0080\u0094\nSchool District No. 38\t\n4\n77\n9\n9\n4\n1\n20\n1\n1\n1\n4\n3\n1\n1\n1\n4\n123\n13\n16\n9\n4\n3\n1\n6\n1\n2\n5\n1\n1\n1\n8\nSchool District No. 7 -\n\u00E2\u0080\u009E 39\t\n200\nSouth Okanagan, Kelowna\u00E2\u0080\u0094\nSchool District No. 23\t\n\u00E2\u0080\u009E 41\t\n\u00E2\u0080\u009E 44\n22\n25\nNorth Okanagan, Vernon\u00E2\u0080\u0094\nSchool District No. 19 \t\n , 22\t\n, 45\t\nCoast-Garibaldi, Powell River\u00E2\u0080\u0094\nSchool District No. 46\t\n\u00E2\u0080\u009E \u00E2\u0080\u009E 47\t\n9\n8\n3\nGeorge\u00E2\u0080\u0094\u00E2\u0096\u00A0\nSchool District No. 57\t\nSkeena, Prince Rupert\u00E2\u0080\u0094\nSchool District No. 54\t\n1\nUpper Fraser Valley, Chilliwack\u00E2\u0080\u0094\nSchool District No. 32 \t\nPeace River, Dawson Creek\u00E2\u0080\u0094\nSchool District No. 59\t\nGreater Victoria Metropolitan\nBoard of Health-\nSchool District No. 61...\n1\n\u00E2\u0080\u009E \u00E2\u0080\u009E \u00E2\u0080\u009E 33 \t\n\u00E2\u0080\u009E 34\t\n26\nBoundary, Cloverdale\u00E2\u0080\u0094\nSchool District No. 36\n\u00E2\u0080\u009E 62 \t\n1\n\u00E2\u0080\u009E 63\t\n1\n\u00E2\u0080\u009E 37\t\n\u00E2\u0080\u009E 64\t\n3\nSimon Fraser, New Westminster\u00E2\u0080\u0094\nSchool District No. 40.\t\n 43 \t\nCentral Fraser, Mission\u00E2\u0080\u0094\nSchool District No. 35\t\n\u00E2\u0080\u009E 42 -\n\u00E2\u0080\u009E 75\t\nCentral Vancouver Island, Nanaimo\u00E2\u0080\u0094\u00E2\u0096\u00A0\nSchool District No. 66\t\n 68\t\n\u00E2\u0080\u009E 69\n1\n5\n5\n\u00E2\u0080\u009E 70\nUpper Island, Courtenay\u00E2\u0080\u0094\nSchool District No. 71\t\n,. \u00C2\u00BB 72.\n3\n2\n2\nTotals\t\n189\n239\n428\n IN-PATIENT services\nL 153\nTable 3.\u00E2\u0080\u0094First Admissions and Readmissions to Valleyview Hospital,\nEssondale, by Method of Admission, Age-group, and Sex, April 1,\n1967, to March 31,1968.\nMethod of Admission\nAge-group (Years)\n60-69\n70-79\n80-89\n90 and\nOver\nGrand\nTotal\nM.\nF.\nM.\nF.\nM.\n1\nF.\nM.\nF.\nM.\nF.\nFirst admissions\n8\n\u00E2\u0080\u0094\n6\n68\n11\n104\n8\n92\n5\n101\n7\n18\n14\n175\n16\n223\n30\n398\nTotals. .\nSI 1 74\n115\n100|106\n71 181189\n?M>\n428\nReadmissions\n1\n\t\n2\n1\n2\n4\n1\n2\n1\n1\n~~1\n2\n3\n~~;5\n3\n7\n10\n5\n10\nTotals....\n1\n\t\n3\n6\n\t\n3\n1\n15\nTable 4.\u00E2\u0080\u0094First Admissions to Valleyview Hospital, Essondale, by Mental\nDiagnosis, Age-group, and Sex, April 1, 1967, to March 31, 1968\nMental Diagnosis\nAge-group (Years)\n60-69\nM. F.\n70-79\nM.1F.\n'I i\n80-89\nM. F.\n90 and\nOver\nM. F.\nTotal\nGrand\nTotal\nM. F.\nSchizophrenic disorders-\nManic-depressive reaction..\nParanoia and paranoid states-\nSenile psychosis-\nPsychosis with cerebral arteriosclerosis-\nAlcoholic psychosis-\nPsychosis of other demonstrable etiology..\nOther and unspecified psychoses \u00E2\u0080\u0094\nHysterical reaction..\nNeurotic-depressive reaction..\nPsychoneurosis with somatic symptoms affecting other symptoms.\nPathological personality. \t\nAlcoholism ..\nOther and unspecified character, behaviour, and intelligence disorders\t\nChronic brain syndrome with behavioural reaction\t\nChronic brain syndrome, N.O.S.\t\nSenility, N.O.S-\nObservation without need for further care-\nTotals..\n74\n115\n18\n189\n239\n9\n10\n10\n9\n28\n1\n3\n4\n2\n17\n1\n12\n8\n7\n146\n5\n152\n4\n428\nTable 5.\u00E2\u0080\u0094First Admissions to Valleyview Hospital, Essondale, by Mental\nDiagnosis, Marital Status, and Sex, April 1, 1967, to March 31, 1968\nTable 6.\u00E2\u0080\u0094First Admissions to Valleyview Hospital, Essondale, by\nReligion and Sex, April 1, 1967, to March 31, 1968\nDetailed information for the above tables may be obtained on request.\n L 154\nMENTAL HEALTH BRANCH REPORT, 1967/68\nc 3\nSo\nOH\nN\u00C2\u00BBtJ\nV\nvC\nvo ov tt o -* r-\n\u00C2\u00BBr\nTT\n\u00C2\u00A9\nX\nw\nCS CN\nr-\n\nw\no\noo\na!)\nCD\n<1\n2\n><\n7\nBh'\n1 1th 1 1 1 1 1 1 ! i 1 1 1 1 1 1 1 1 i t 1 1\nrt\nCQ\no\nso\n%\nj M | 1 j\n1 '\u00E2\u0096\u00A0\"' J j j j 1 j { j j j [ 1 j j j\nm\nw\n_J\n<\nOs\nBh\n[ 1 1 i i\nj j 1 jw 1 j 1 j 1 1 *\"4 1 j 1 j 1\nQ\n\"i\no\nZ\no t>\nS\nH> j | j\n! ! Ith ! i 1 1 ! ! !N Ith i i !\ntN\nco so\nb2\nBh\n1 *\"* 1\n| |H | : j | | | Hc,) i i i \u00E2\u0096\u00A0 i\n\u00C2\u00ABn\n3\no\nTr\n\u00E2\u0096\u00A0< CO\nS\nIf- t | 1\n1 I II ! II 1 II ! i 1 II 1 1\nt>\nC-. w\nBh'\nTt\nCO CO\ncn\no\nCN\nHH 2\n3h w\nS\n! i i i ! ! 1 1 ! ! !M ! ! ! ! !\nVD\na o\n>\n>H\nw\nhJ\nI-I\nu\n<\n>\nM\nc\nH\n'\u00E2\u0096\u00A03\n<\ntU\nw\nfl\no\n00\nZ\nF\nc\nH\nQ\n09\ntj\n\u00E2\u0096\u00A0Ur\nCO\n\u00C2\u00AB\n0\n>\ntu\n>\n1, C\nn t3\nrt\nDO\n_o _(_)\n_r p\nZ\nZ\nO\nl-H\nQ\n*rt\nC\nu\nC\nc\n>\no\no\nS\no \u00E2\u0080\u0094\n-ft o\n9 \u00E2\u0080\u0094\n11\nH\n\u00C2\u00ABi\n__\u00E2\u0096\u00A0 u.\n2 B\nSJ_\u00C2\u00AB\n<:\n0\nX\nU\n8S\u00C2\u00A7\nc\nD\n_0\ncr\n\u00E2\u0096\u00A0Js 3\nS S o\nc\nS'^z\nOh\no\ng\ny\nR\n\u00E2\u0096\u00A0a\nrt\n\"rt\np!\nOg1\"\nit\nSii\nW\nca\na\np\na\no\n-0\n\u00E2\u0096\u00A0C\nc\na\nc\nir.\nX\nc\nX\n_u\n\"c\na\nc\nc\ns\n|c\nt\nir.\ncd\n>\nO\nc\no\n\u00E2\u0080\u00A2o\n1\n5\n4=\nO\nc\nB\n\"flj\n\u00C2\u00A3\nR\nc\nc\n=\nc\n>\nc\no\ni\nu\nrt\nP\n\u00E2\u0096\u00A00\nc\nrt\nrt\nO\nC\nrt\nrt\nft\ncy\nO\nxi\no\n?-\na\no\no\n.0\nc\nxi\no\n>\nir\nP\nc\ne_\nc\nX\no\nc.\nu\n\u00E2\u0096\u00A05\ntf\no\nu\n>\nc\n>\na\no\n0\nxi\no\ne\n<\nu\nu.\nCJ\nX\n0\no\nX\nu\neft\na\ns\n*t\nCJ\nD\nc\n3\n\u00E2\u0096\u00A0a\nc\n0\nll\nQJ\n\u00E2\u0096\u00A0c\n0\n'I\nc\nc\nu\nrt\nV\nu\n>\n4\n'x\nc\n<\nc\nc\nX\nu\nrt\nQ\nt\nc_\n>\n>\nc7\nc\no\nCJ\n>\n\u00C2\u00BB\na\nc\n4,\n>\nc7\nw\na\nB\nu\nc\nl-\n:\nCJ\na\nc\nc\nc\ns\nc\nrt\nCJ\n'5\nC\n1\nrt\na.\nE\n\=.\nc\ns\n<\n>\nt,\ne\nc\nI\n\u00C2\u00AB\ne\n!\ns\ncc\n'I\n_\n\u00E2\u0080\u00A2C\nc\ncc\n1\nc\np\n>\n._\n0\n|\n0\nS\nc\n\"5\nJ=\nc\nc\nc\n0\n>\nc\nc\noj\na\nCJ\n4]\n\u00E2\u0080\u00A2a\n'cy_\nO\nc\nCD\nrt\n5\nif\nC\nc\nh\n IN-PATIENT SERVICES L 155\ncC\n2o\nOvClOcXiTtcncNcNtN'-'cnXTj'r-i'rj-tNCNW-.\n00\n5\ntN *-i cN fN tn Tt\nCN\ntN\no\ntt\nc5h\no\nMrt iri N \u00E2\u0096\u00A0* h fl -i h m t m ;cN ! ivo\n\u00E2\u0096\u00A0*t\n1\nPh\nrH rH rH rH j m 1 tn\n\u00E2\u0096\u00A0*\nw\no\nrt\nS\ncNcnmcNOvr-( |th :cs-*rHr-(SMfNOi\nTt\n<\nCO*\nrH ! rH j Ol\n00\n\"2 M\nBh'\nC^CNTtOvvO ; :^t ! |th ! [rt ! !\u00C2\u00A9\noo\ntn\nO\nZ\no\naa>\n\u00C2\u00A9o\nOO W\nt>\nS\ncn rH tn r-l t\u00E2\u0080\u0094 tH IVO ! ! jr-OOrH\nOv\ncn\n<\no\nQ\n<\nOv\nr-\nl\nin\nBh\n: : ; : i : : i\ncn\nVOrH irHfN | ;\u00E2\u0096\u00A0>* :tN !rH \ <\ni i i -j ,,,,__,,,,\nCN\nov\nBh\u00C2\u00B0\nCO\na\n7\nin\nvo\nS\n- i i i i i i i i i i n i i i i\n-\no\nW\no\nz\no\n00\nCU\n00\nTt\n2\nvO\nBh'\n-<\ns\n\u00C2\u00A7!>\n< vo\nOv\nBh'\n1-1 |\nrH\nm-1\n7\nO\ntn\ns\n^ i r i i i i i i i i i i i i i i\n-\nz -T\n1-1 co\na w\nOv\n2\nBh'\ncn\na \u00C2\u00A7\n\u00C2\u00ABt\ns\nw w\nf-_ c_\nBh\n i i i r\t\ncN\nOs\n?\nt-TQ\n\u00C2\u00A9\ntN\nS\n5 x\nQ BJ\nZ cn\ns e\ncn Z\nc\nw <\n\u00E2\u0096\u00BAJ\ns\nOJ\nCU\n<\ncn\nu\nH\n>>\n.5\ns\nCO\nU\n-o\nO\ncn\n\u00C2\u00AB\nX\n4>\n.2?\ni-\"\nf5\n\u00E2\u0080\u00A2a\ntU\n3\n>\nrt c\nW_\nxi c\n\u00C2\u00A3\no\n\u00E2\u0096\u00A1\n00\nc\nXI CJ\n- rt\nw\n_C3\nCU\nU. CD\nCU Ih\n\u00E2\u0096\u00BAJ\ntc\nJ\n13\n>\nrt\n\u00C2\u00ABl\n<\n>\n\"rt\nC\na\nC\nc\ni\no\n\u00C2\u00BB 5\n* .2\ny 3\ni\nBh\no\nCO\nH\nZ\nC\na\nX\nc\nC\n_y\nrt\nOJ\nCJ\nX\nrt\nV-\nC\nc\nc\nft\nS\n>.\nrt\nt*H rt\n0 J3\nW\nH\n<\ntt\nCJ\nX\nC\nX\n$\nt\nrt\nCJ\nu\nCJ\n>\n\u00E2\u0080\u00A2a\no\ne\nR\nK\nQ\nrt\nVh\n*\u00C2\u00B0 \u00C2\u00AB\nW .-\n8j\nC\nI\nX\nu\nQJ\ny & >\nrt o h_j\n* - 5\nsis\nCfl r* 4-1\n\nCJ\nS 4J 4J\n\u00C2\u00AB \u00C2\u00A3 \u00C2\u00A3\ntc \u00C2\u00AB3 *o\n'OOP\nCU R >>\no, \u00C2\u00AB \u00C2\u00AB\n1.\no\ncn TJ\nc\nOg-g ft\n-ii\n1.S.S\n*?.\n00\n\"5\n\u00C2\u00A3 S\nft rt\nJ3\nO\n>\nO U Ih n C\n'u\ntc\ncu\n3 rt rt\nTJ 5 \u00C2\u00A3\n1\nW\n\u00E2\u0096\u00BAJ\nca\nX\nc\nc\ntv\n31\nc rt\n4\n\u00C2\u00B01\no o\n\u00E2\u0080\u00A2H ti \" \"00-H\nO * o -2 0\nO -1 (. fi 0\n\u00E2\u0080\u00A26\ni .2 .a \u00C2\u00A3\ncu o o _2\n>.\n\u00C2\u00A3\n1\non\nrt\n3\nrt\nft\nC\nCJ\nin\n>\nca\nft\n<\n>\nft\nCD\nz\n>* ^H\n\u00C2\u00AB_ rt\nft ft\n<\na\n5^\nOU\nX\n0\n2\nw\n0\nCJ\n L 156\nMENTAL HEALTH BRANCH REPORT, 1967/68\nTable 9.\u00E2\u0080\u0094Live Discharges from and Deaths Occurring in Valleyview\nHospital, Essondale, by Mental Diagnosis, Age-group, and Sex, April\n1, 1967, to March 31, 1968.\nAge-group (Years)\nMental Diagnosis\nUnder\n60\n60-69\n70-79\n80-89\n90 and\nOver\nGrand\nTotal\nM.\nF.\nM.\nF.\nM.\nF.\nM.\nF.\nM.\nF.\nM.\nF.\nLive Discharges\n9\n1\n4\n2\n3\n1\n\t\n2\n3\n1\n3\n~ 1\n3\n1\n1\n1\n2\n1\n1\n6\n2\n2\n5\n2\n1\n3\n2\n4\n1\n3\n1\n7\n4\n1\n4\n3\n6\n1\n1\n2\n1\n3\n3\n\t\n1\n1\n16\n4\n4\n2\n~7\n1\n2\n9\n3\n4\n8\n1\n1\n2\n2\n1\n8\n3\n3\n2\n3\n1\n8\n25\n7\nParanoia and paranoid state _\t\n8\n10\nPresenile psychosis -\t\n1\n8\nAlcoholic psychosis \t\n1\n4\n2\n1\n1\n1\n3\n3\n2\n2\n6\n2\n2\n2\n1\n6\n1\n4\n2\n1\n3\n15\n3\n6\n1\n1\n1\n14\n1\n7\nAlcoholism , _.\t\n2\n4\nOther and unspecified character, behaviour, and intelligence disorders \t\n5\n18\n\u00E2\u0080\u0094\n1\n1\n\t\n4\nSenility \t\n14\n1\nObservation without need for further psychiatric care \u00E2\u0080\u0094\n1\nTotals \t\n9[ 4| 8| I] 30| 25\n291 241 2| 3[ 791 59\n138\nDeaths\n1\n4\n21\n~~1\n1\n10\n1\n1\n4\n2\n1\n24\n1\n19\n1\n6\n6\n4\n1\n1\n41\n3\n2\n1\n12\n11\n1\n2\n1\n45\n42\n2\n1\n4\n3\n1\n1\n6\n12\n3\n3\n2\n17\n18\n1\n4\n1\n2\n74\n1\n67\n4\n.....\n\t\n1\n\t\n3\n1\nParanoia and paranoid states.. \u00E2\u0080\u009E \t\n2\n23\n30\n1\n\" 1\n1\n9\n1\n1\n5\n6\n4\n1\n2\n1\n72\n1\n1\n29\n8\nPsychoneurosis with somatic symptoms affecting diges-\n1\n3\n2\nOther and unspecified character, behaviour, and intelli-\n1\n146\n1\nEpilepsy \t\n1\n1\n96\nTotal'\n1\n\t\n38\n53\n78\n120\n14\n20\n131\n193\n324\n IN-PATIENT SERVICES\nL 157\nTable 10.\u00E2\u0080\u0094Live Discharges from and Deaths Occuring in Valleyview\nHospital, Essondale, by Mental Diagnosis, Length of Stay, and Sex,\nApril 1, 1967, to March 31, 1968.\nDetailed information for the above table may be obtained on request.\nTable 11.\u00E2\u0080\u0094Deaths Occurring in Valleyview Hospital, Essondale, by\nCause of Death, Age-group, and Sex, April 1, 1967, to March 31, 1968\nAge-group (Years)\nCause of Death\n60-69\n70-79\n80-89\n90 and\nOver\nJrand\nTotal\nM.\nF.\nM.\nF.\nM.\nF.\nM.\nF.\nM.\nF.\n1\n1\n1\n3\n11\n29\n2\n7\n57\n4\n18\n83\n2\n8\n1\n1\n1\n1\n~2\n15\n1\n1\n1\n4\n18\n90\n1\n\t\n8\n2\n5\n3\n5\n3\n31\n127\n1\n1\n14\n~1\n9\n1\n9\n3\n\t\n9\n25\n49\n\t\n217\n1\n1\n\t\n\t\n1\n5\n1\n3\n~~6\n1\n3\n2\n1\n8\n6\n1\n22\n2\n1\n1\n14\nAccidents\t\n4\nTotfll*\n1\n38\n53\n78\n120\n14\n20\n131\n193\n324\nTable 12.\u00E2\u0080\u0094Deaths Occurring in Valleyview Hospital, Essondale, by Cause\nof Death, Length of Stay, and Sex, April 1, 1967, to March 31, 1968\nDetailed information for the above table may be obtained on request.\n L 158\nMENTAL HEALTH BRANCH REPORT, 1967/68\nSTATISTICAL TABLES\u00E2\u0080\u0094DELLVIEW HOSPITAL\nTable 1.\u00E2\u0080\u0094Movement of Population, Dellview Hospital, Vernon,\nApril 1, 1967, to March 31, 1968\nMale\nFemale\nTotal\n89\n5\n126\n14\n215\nOn extended leave, carried forward from 1966/67\u00E2\u0080\u0094\n19\nOther \t\nTotal on books as at April 1, 1967\t\n94\n140\n234\nAdmissions\u00E2\u0080\u0094\n40\n8\n1\n44\n22\n3\n84\n30\nReadmissions to the same institution \u00E2\u0080\u0094 \u00E2\u0080\u0094\n4\nTotal admissionsi- \t\n49\n69\n118\nTotal under care ...\t\n143\n209\n352\nSeparations\u00E2\u0080\u0094\n7\n53\n13\n6\n44\n27\n13\nDied \t\n97\nOn extended leave and still out\u00E2\u0080\u0094\n40\nOther .. \t\n73\n77\n150\n\u00E2\u0080\u0094 19\n70\n+6\n132\n\u00E2\u0080\u0094 13\nIn residence, March 31, 1968 \t\n202\n1 Includes 6 male transfers and 20 female transfers from other geriatric facilities, 1 female transfer from\nRiverview Hospital.\nTable 2.\u00E2\u0080\u0094First Admissions to Dellview Hospital, Vernon, by Health\nUnit and School District of Residence and Sex, April 1, 1967, to\nMarch 31, 1968.\nHealth Unit and School District\nMale\nFemale\nTotal\nHealth Unit and School District\nMale\nFemale\nTotal\nEast Kootenay, Cranbrook\u00E2\u0080\u0094\nSchool District No. 1 \t\n\u00E2\u0080\u009E 2 \t\n2\n3\n2\n1\n1\n4\n3\n4\n5\n1\n1\n1\n7\n4\n1\n1\n1\n2\n2\n2\n1\n4\n3\n4\n1\n8\n5\n3\n3\n4\n4\n2\n1\n1\n4\n5\n1\n8\n8\n1\n5\n1\n1\n15\n9\n3\n1\nCariboo, Williams Lake\u00E2\u0080\u0094\nSchool District No. 27\t\nBoundary, Cloverdale\u00E2\u0080\u0094\nSchool District No. 36\t\n1\n1\n4\n1\n1\n2\n3\n1\n1\n13\n1\n1\n1\n2\n1\n2\n1\n3\n4\n3\n\u00E2\u0080\u009E 86\t\nSelkirk, Nelson\u00E2\u0080\u0094\nSchool District No. 7\t\nCentral Fraser, Mission\u00E2\u0080\u0094\nSchool District No. 35 -\t\nMetropolitan Board of Health of\nGreater Vancouver\u00E2\u0080\u0094\nSchool District No. 38.\t\n, 39\u00E2\u0080\u0094.\t\n\u00E2\u0080\u009E 41...\t\nCoast-Garibaldi, Powell River\u00E2\u0080\u0094\nSchool District No. 46 _\t\nSkeena, Prince Rupert\u00E2\u0080\u0094\nSchool District No. 52\n2\nWest Kootenay, Trail\u00E2\u0080\u0094\nSchool District No. 9\t\n1\n 11\u00E2\u0080\u0094\t\n\u00E2\u0080\u009E 12......\t\n\u00E2\u0080\u009E 13\u00E2\u0080\u0094\t\nSouth Okanagan, Kelowna\u00E2\u0080\u0094\nSchool District No. 14\n17\n1\n1\n\u00E2\u0080\u009E \u00E2\u0080\u009E \u00E2\u0080\u009E 15\n1\n\u00E2\u0080\u009E 16\t\n\u00E2\u0080\u009E 54\u00E2\u0080\u0094\t\n1\n\u00E2\u0080\u009E 23\t\nNorth Okanagan, Vernon\u00E2\u0080\u0094\nPeace River, Dawson Creek\u00E2\u0080\u0094\nSchool District No. 59\n3\n\u00E2\u0080\u009E 60\u00E2\u0080\u0094\n1\n\u00E2\u0080\u009E 21\t\n\u00E2\u0080\u009E 22...\t\n\u00E2\u0080\u009E \u00E2\u0080\u009E \u00E2\u0080\u009E 89\nGreater Victoria Metropolitan\nBoard of Health-\nSchool District No. 61 \t\n*>\nSouth Central, Kamloops\u00E2\u0080\u0094\nSchool District No. 24\t\n\u00E2\u0080\u009E 31\t\n1\nTotals\t\n48\n66\n114\n IN-PATIENT SERVICES\nL 159\nTable 3. \u00E2\u0080\u0094 First Admissions and Readmissions to Dellview Hospital,\nVernon, by Method of Admission, Age-group, and Sex, April 1, 1967,\nto March 31, 1968.\nMethod of Admission\nAge-group (Years)\nTotal\n60-69\n70-79\n80-89\n90 and\nOver\nGrand\nTotal\nM.\nF.\nM.\nF.\nM.\nF.\nM.\nF.\nM.\nF.\nFirst Admissions\n3\n1\n3\nli\n18\n25\n36\n2\n8\n48\n1\n65\n1\nInvoluntary\t\nReadmissions\n113\nTotals.\n3 | 4\n18 | 18 | 25\n36\n2 | 8\n48\n66\n114\nInvoluntary\t\n....\n1\n1\n2\n1\n3\n4\nTable 4. \u00E2\u0080\u0094 First Admissions and Readmissions to Dellview Hospital,\nVernon, by Mental Diagnosis, Age-group, and Sex, April 1, 1967, to\nMarch 31, 1968.\nMental Diagnosis\nAge-group (Years)\n60-69\nM. F.\n70-79\nM. F.\n80-89\nM. F.\n90 and\nOver\nM. F,\nTotal\nM. F.\nGrand\nTotal\nFirst Admissions\nSchizophrenic disorders\t\nParanoia and paranoid states..\nSenile psychosis..\nPre-senile psychosis _\t\nPsychosis with cerebral arteriosclerosis..\nPathological personality-\nOther and unspecified character, behaviour, and intelligence disorders.\nChronic brain syndrome with behavioural reaction..\nChronic brain syndrome, N.O.S\t\nSenility-\nDiagnosis deferred\t\nTotals\t\nReadmissions\nChronic brain syndrome with behavioural reaction..\n4 | 18\n25\n36\n5\n1\n6\n1\n2\n1\n1\n74\n17\n5\n1\n2 I 8\n48 | 66 | 114\nTable 5.\u00E2\u0080\u0094First Admissions to Dellview Hospital, Vernon, by Mental\nDiagnosis, Marital Status, and Sex, April 1, 1967, to March 31, 1968\nTable 6.\u00E2\u0080\u0094First Admissions to Dellview Hospital, Vernon, by Religion\nand Sex, April 1, 1967, to March 31, 1968\nDetailed information for the above tables may be obtained on request.\n L 160\nMENTAL HEALTH BRANCH REPORT, 1967/68\nTable 7.\u00E2\u0080\u0094Total Number of Patients on Books1 of Dellview Hospital,\nVernon, by Mental Diagnosis, Age-group, and Sex, December 31, 1967\nAge-group (Years)\nMental Diagnosis\nUnder\n60\n60-64\n65-69\n70-74\nn. 79 80 and\n75 7y Over\nGrand\nTotal\nM.1\nF.\nM.\nF.\nM.\nF.\nM.I\nF.\nM.\n1\nF. M. F.\n1\nM.\nF.\n1\n8\n1\n1\n6\n3\n1\n5\n1\n1\n2\n1\n14\n1\n18\n1\n3\n1\n19\n1\n1\n1\n3\n1\n1\n1\n59\n6\n19\n1\n1\n18\n1\n6\n1\n2\n1\n106\n12\n38\n2\n|\n2\n1\n19\n1\n1\n 1 2\n 1-\t\n1\n9\n1\n1\n1\n1\n1\n\t\n1\n2\n1\n1\nOther and unspecified character, behaviour, and\n1\n17\n1\n33\n4\n70\n10\n1\nChronic brain syndrome with behavioural re-\n1\n3\n1\n3\n3\n5\n3\n10\n1\n17\n1\n165\nChronic brain syndrome, N.O.S\t\n18\nTotals \t\n1\n4\n3\n3\n7\n13\n12\n26\n26\n47\n119\n93\n168\n261\n1 Of this total, 13 males and 24 females were in boarding homes at December 31, 1967.\nTable 8. \u00E2\u0080\u0094 Live Discharges from and Deaths Occurring in Dellview\nHospital, Vernon, by Mental Diagnosis, Age-group, and Sex, April 1,\n1967, to March 31, 1968.\nAge-group (Years)\nTotal\nMental Diagnosis\n60-69\n70-79\n80-89\n90 and\nOver\nGrand\nTotal\nM. F.\nM.\nF.\nM.\nF.\nM.\nF.\nM.\nF.\nLive Discharges\n\u00E2\u0080\u0094\n1\n3\n1\n2\n1\n3\n2\n.._\n6\n1\n5\n1\n11\n1\n1\nTotals.... \t\n-1 1\n4\n3\n3\n2 I .... 1 ....\n7\n6\n13\nDeaths\n2\n1\n2\n1\n7\n5\n3\n3\n1\n18\n13\n17\n11\n5\n1\n7\n2\n32\n19\n28\n16\n2\n60\nChronic brain syndrome, N.O.S \t\n35\n2\n3\n13\n6\n32\n28\n6\n7\n53\n44\n97\nTable 9. \u00E2\u0080\u0094 Live Discharges from and Deaths Occurring in Dellview\nHospital, Vernon, by Mental Diagnosis, Length of Stay, and Sex,\nApril 1, 1967, to March 31, 1968.\nDetailed information for the above table may be obtained on request.\n IN-PATIENT SERVICES\nL 161\nTable 10.\u00E2\u0080\u0094Deaths Occurring in Dellview Hospital, Vernon, by Cause of\nDeath, Age-group, and Sex, April 1, 1967, to March 31, 1968\nAge-group (Years)\n1\nCause of Death\n60-459\n70-79\n80-89\n90 and\nOver\nGrand\nTotal\nM.\nF.\nM.\nF.\nM.\nF.\nM.\nF.\nM.\nF.\n2\n3\n11\n1\n1\n5\n1\n29\n1\n1\n1\n27\n1\n5\n1\n6\n1\n47\n2\n2\n1\n1\n41\n2\n1\n88\n2\n4\nInfluenza _\t\n1\n1\n.... | ....\n1\nTotals \u00E2\u0080\u0094 \t\n2\n3\n13\n6\n32\n28\n6\n7\n53\n44\n97\nTable 11.\u00E2\u0080\u0094Deaths Occurring in Dellview Hospital, Vernon, by Cause of\nDeath, Length of Stay, and Sex, April 1, 1967, to March 31, 1968\nDetailed information for the above table may be obtained on request.\n L 162 MENTAL HEALTH BRANCH REPORT, 1967/68\nSTATISTICAL TABLES\u00E2\u0080\u0094SKEENAVIEW HOSPITAL\nTable 1.\u00E2\u0080\u0094Movement of Population, Skeenaview Hospital,1 Terrace,\nApril 1, 1967, to March 31, 1968\nIn residence, April 1, 1967 293\nTotal on books as at April 1, 1967 293\nAdmissions\u00E2\u0080\u0094\nFirst admissions to Mental Health Services 17\nReadmissions to a different institution of Mental Health Services 23\nReadmissions to the same institution 1\nTotal admissions 2 41\nTotal under care 334\nSeparations\u00E2\u0080\u0094\nDischarged in full 3\nDied 53\nTransferred to other geriatric facilities \t\nTransferred to psychiatric facility.\t\nTotal separations 5 6\nNet decrease \u00E2\u0080\u009415\nIn residence, March 31, 1968 278\ni This institution cares for male patients only.\n2 Includes 23 transfers from other geriatric facilities.\nTable 2.\u00E2\u0080\u0094First Admissions to Skeenaview Hospital, Terrace, by Health\nUnit and School District of Residence, April 1, 1967, to March 31, 1968\nHealth Unit and School District No. Health Unit and School District No.\nNorth Okanagan, Vernon\u00E2\u0080\u0094 Skeena, Prince Rupert\u00E2\u0080\u0094\nSchool District No. 89 _ 1 School District No. 50 1\nNorthern Interior, Prince George\u00E2\u0080\u0094 \u00E2\u0080\u009E ,, ,, 52 3\nSchool District No. 57 5 \u00E2\u0080\u009E \u00E2\u0080\u009E \u00E2\u0080\u009E 54 1\nBoundary, Cloverdale\u00E2\u0080\u0094 ,, \u00E2\u0080\u009E ,, 88 6\nSchool District No. 36 2 Peace River, Dawson Creek\u00E2\u0080\u0094\u00E2\u0096\u00A0\nSimon Fraser, New Westminster\u00E2\u0080\u0094 School District No. 59 1\nSchool District No. 40 _ 3 \u00E2\u0080\u009E \u00E2\u0080\u009E \u00E2\u0080\u009E 60- \u00E2\u0080\u0094 1\nCentral Fraser, Mission\u00E2\u0080\u0094 Greater Victoria Metropolitan Board of Health\u00E2\u0080\u0094\nSchool District No. 42 _ 1 School District No. 61 2\nMetropolitan Board of Health of Greater Van- \u00E2\u0080\u0094\ncouver\u00E2\u0080\u0094 Total- - \u00E2\u0080\u0094- 40\nSchool District No. 39 _. 11\n\u00E2\u0080\u009E 41\u00E2\u0080\u0094 1\n\u00E2\u0080\u009E 44 1\n IN-PATIENT SERVICES\nL 163\nTable 3. \u00E2\u0080\u0094 First Admissions and Readmissions to Skeenaview Hospital,\nTerrace, by Method of Admission and Age-group, April 1, 1967, to\nMarch 31, 1968.\nAge-group (Years)\nTotal\nMethod of Admission\n60-69\n70-79\n80-89\n90 and\nOver\nFirst Admissions\n1\n4\n14\n20\n1\n1\nInvoluntary\n39\nTotals \t\n5 14 20 1 40\nReadmissions\nInvoluntary.\t\n\u00E2\u0080\u0094\n1\n....\n1\nTable 4.\u00E2\u0080\u0094First Admissions to Skeenaview Hospital, Terrace, by Mental\nDiagnosis and Age-group, April 1, 1967, to March 31, 1968\nAge-group (Years)\nTotal\nMental Diagnosis\n60-69\n70-79\n80-89\n90 and\nOver\nSchizophrenic disorders\t\n1\n2\n1\n1\n1\n1\n1\n2\n2\n4\n1\n1\n1\n2\n2\n1\n2\n4\n1\n7\n1\n1\n2\n2\n2\n2\n1\n2\n1\nOther and unspecified character, behaviour, and intelligence dis-\n3\n6\n3\nSenility \t\n13\n3\nTotals\t\n5\n14\n20\n1\n40\nTable 5.\u00E2\u0080\u0094First Admissions to Skeenaview Hospital, Terrace, by Mental\nDiagnosis and Marital Status, April 1, 1967, to March 31, 1968\nTable 6.\u00E2\u0080\u0094First Admissions to Skeenaview Hospital, Terrace, by Religion,\nApril 1, 1967, to March 31, 1968\nDetailed information for the above tables may be obtained on request.\n L 164\nMENTAL HEALTH BRANCH REPORT, 1967/68\nTable 7.\u00E2\u0080\u0094Total Number of Patients on Books of Skeenaview Hospital,\nTerrace, by Mental Diagnosis and Age-group, December 31, 1967\nMental Diagnosis\nAge-group (Years)\nTotal\nUnder\n60\n60-64\n65-69\n70-74\n75-79\n80 and\nOver\n8\n2\n1\n13\n1\n2\n7\n31\n1\n2\n2\n1\n1\n1\n1\n3\n1\n2\n25\n1\n3\n1\n1\n2\n1\n2\n5\n2\n36\n1\n10\n3\n1\n1\n2\n2\n3\n2\n7\n8\n1\n1\n33\n4\n1\n16\n8\n1\n1\n12\n10\n3\n12\nSchizophrenic disorders.\u00E2\u0080\u0094 _\t\n146\n7\n1\n26\n16\nAlcoholic psychosis\t\nPsychosis of other demonstrable etiology \u00E2\u0080\u0094\n4\n2\n2\n3\n8\nMental deficiency\t\nOther and unspecified character, behaviour, and\n6\n4\nChronic brain syndrome with behavioural re-\n21\n27\n5\nTotals \t\n11\n16\n51\n43\n79\n90\n290\nTable 8. \u00E2\u0080\u0094 Live Discharges from and Deaths Occurring in Skeenaview\nHospital, Terrace, by Mental Diagnosis and Age-group, April 1, 1967,\nto March 31, 1968.\nMental Diagnosis\nAge-group (Years)\nTotal\nUnder\n60\n60-69\n70-79\n80-89\n90 and\nOver\nLive Discharges\n1\n1\n1\n\u00E2\u0080\u0094\n::::\n1\n1\nObservation without need for further psychiatric care\t\n1\n.... | 2\n1\n\u00E2\u0080\u0094\n-\n3\nDeaths\nSchizophrenic disorders \u00E2\u0080\u0094\t\n1\n1\n1\n1\n1\n5\n3\n1\n1\n3\n7\n1\n3\n1\n1\n9\n10\ni\ni\ni\n14\n1\n2\n4\n1\nAlcoholism \t\n4\n12\n1\nSenility _\t\n14\nTotals \t\n1\n4\n13\n32\n3\n53\nTable 9. \u00E2\u0080\u0094 Live Discharges from and Deaths Occurring in Skeenaview\nHospital, Terrace, by Mental Diagnosis and Length of Stay, April 1,\n1967, to March 31, 1968.\nDetailed information for the above table may be obtained on request.\n IN-PATIENT SERVICES\nL 165\nTable 10.\u00E2\u0080\u0094Deaths Occurring in Skeenaview Hospital, Terrace, by Cause\nof Death and Age-group, April 1, 1967, to March 31, 1968\nCause of Death\nAge-\ngroup (Years)\nTotal\nUnder\n60\n60-69\n70-79\n80-89\n90 and\nOver\n1\n3\n1\n2\n2\n4\n1\n2\n2\n3\n6\n14\n1\n1\n6\n1\n1\n1\n1\n5\n10\n22\n2\n1\nPneumonia _\t\n9\n1\n1\n2\nTotals\t\n1\n4\n13\n32\n3\n53\nTable 11.\u00E2\u0080\u0094Deaths Occurring in Skeenaview Hospital, Terrace, by Cause\nof Death and Length of Stay, April 1, 1967, to March 31, 1968\nDetailed information for the above table may be obtained on request.\n L 166 MENTAL HEALTH BRANCH REPORT, 1967/68\nBRITISH COLUMBIA YOUTH DEVELOPMENT CENTRE,\nTHE MAPLES\nA. D. Sleigh, B.A., M.D., C.R.C.P., Executive Director\nReport for April 1 to December 31, 1968\nThe British Columbia Youth Development Centre began functioning in June,\n1968, and during that month I was appointed Executive Director. During this\ntime major organizational changes were made within the Youth Development\nCentre to prepare the way for the expansion into a comprehensive treatment complex for children and adolescents of the Province. With the reorganization, the\ncomplex was divided into three functional units\u00E2\u0080\u0094namely, the Children's and\nAdolescents' Clinic (primarily doing out-patient work), the Psycho-education Unit,\nand the Residential Unit. At the time of this writing the Children's and Adolescents' Unit (which had been up until now the Children's Clinic) and the Psycho-\neducation Unit are functioning, and preparations are being made to bring the Residential Treatment Unit into operation sometime in the spring of 1969.\nI must stress that this is a major expansion, and the aim is to provide efficient\nfirst-class treatment to emotionally disturbed children and adolescents from throughout the Province of British Columbia. This treatment unit should also be in a\nposition to give effective consultative services to therapists throughout the Province\nand contribute to training and research in mental health work with children and\nadolescents.\nDIRECT SERVICES\nChildren's and Adolescents' Clinic\nIn the complete reorganization of this clinic there has been, as yet, little change\nin the actual service given by the out-patient part of the British Columbia Youth\nDevelopment Centre. Over 300 children and adolescents are receiving active,\nintensive therapy, and this involves many times that number of family members\nas there is so often the need to involve the total family when one member of that\nfamily is emotionally disturbed. The principal treatment method is the therapeutic\ninterview, but, of course, in working with children this is not always a verbal exchange but may involve play therapy, activity group therapy, special education and\nlearning techniques, family group therapy, and many other special techniques needed\nto reach youth. Because our patients are in their formative years, all social influences on them are extremely important. Our clinic therapists are always actively\nengaged in attempting to make the social environment of the patient more conducive\nto him, or her, getting over the emotional or social difficulties, and spend many hours\nin working with such people as teachers, Probation Officers, school counsellors, and\nhealth nurses.\nMedications and somatic treatment approaches do not play any great part in\nour treatment approach. Of course, the latest medications and somatic therapies\nare utilized, if indicated, and we have at our disposal special diagnostic equipment\nsuch as the electroencephalogram and can utilize various psychological measuring\ntests and devices.\nUnder the Children's and Adolescents' Clinic Director, Dr. Alan Cashmore,\nwe have a small day centre in operation. At the present time two therapists are\nworking full time in the day centre, and they have been dealing with two small groups\nof young children. In the near future, however, we hope to expand this day centre\nand bring in additional staff.\n IN-PATIENT SERVICES L 167\nThere is a small class for emotionally maladjusted children that come from\nBurnaby area, and we have a co-operative enterprise going in which we are providing\nthe special professional staff needed to help with the treatment of these children.\nThe Burnaby School Board is providing a teacher. This is still in its beginning\nphase, having commenced operation in September, but we would hope to see these\nchildren materially aided by this special class.\nOur centre has worked very hard with a large number of very disturbed\nchildren. This seems to come about because many of these children were first in\ntreatment with other agencies or private psychiatrists, then, for practical or economic\nreasons, they could no longer be handled by these people and were then referred to\nus. The results are naturally variable although basically encouraging.\nPsycho-education Unit\nThis unit was formed in the fall of 1968 and is under the direction of Dr. D.\nShalman. Basically it consists of three psychologists and two teachers, who provide\na special treatment service to our unit and to therapists in mental health centres\nthroughout the Province. This treatment group concentrates on the school under-\nachiever and the youngster with learning plus emotional problems, and are utilizing\nspecial educational and psychological techniques to help such a patient.\nIn the months to come the Psycho-education Unit will extend its work into\nassisting our residential and day-clinic teachers in their classroom activities and\nwill also be setting up special teaching groups of their own.\nResidential Treatment Unit\nThis treatment unit is very much in the formative stage, and, at the time of\nwriting, the construction is still being completed, and the buildings will probably be\nturned over to us in January, 1969. Recruitment of therapists for this area is just\nbeginning, and the main job is to recruit child-care counsellors. Dr. Lavelle,\nResidential Treatment Unit Director, has been assisting in planning for the unit\nsince July, 1968, and he intends to have a modern active-treatment resource for 45\nyoungster who will need residential care and treatment and for 20 or more\nyoungsters who will need day-clinic treatment. Besides this comprehensive programme, he and his staff will be involved in the out-patient follow-up of these\nyoungsters and also in the functioning of other facilities, such as group-living homes,\nspecial boarding homes, and the like. These latter facilities will probably not come\ndirectly under our auspices, but there will have to be co-ordination with them in\nsome manner.\nChildren and adolescents with all manner of psychiatric and emotional disturbance will be admitted to this unit, and the principal people doing the therapy will\nbe the child-care counsellors directed and assisted by other professional staff such\nas psychiatrists, psychologists, and social workers. The plan is to have an intensive-\ncare unit giving these youngsters the very latest in treatment modalities and avoiding\nat all costs any tendency toward institutionalization. Work with the families of the\npatients will again be stressed, and a close co-ordination and integration of our\nservice with that carried out by other agencies and therapists will have to be maintained.\nA final remark should be made to the effect that the British Columbia Youth\nDevelopment Centre will be a co-ordinated treatment unit with the Children's and\nAdolescents' Clinic, the Psycho-education Unit, and the Residential Unit (and day\ncare), working in close harmony for the welfare of the patient and his family.\n L 168 MENTAL HEALTH BRANCH REPORT, 1967/68\nINDIRECT SERVICES\nTherapists are involved in offering indirect service to helping groups, treatment\nagencies, and mental health centres. Consultations are regularly given to a large\nnumber of community agencies and therapists, which is all a part of our ongoing\neveryday work. The area of indirect services always overlaps with training and\neducation functions and with our preventive services. Whenever staff are involved\nin treating a patient, they are also involved in educating the community people they\ncome in contact with, such as school-teachers, counsellors, Probation Officers, social\nworkers, public health nurses, etc.\nMany of our staff give lectures, seminars, and workshops to interested groups\nand agencies in the community, and this needs to be considered part of our indirect\nservice.\nTRAINING AND EDUCATION\nThe Youth Development Centre has been involved in the past year in many\ntraining and educational activities. We welcomed outside groups that have any\nhelping function in relation to mental health to utilize our special facilities, such as\nour auditorium, conference rooms, and group therapy rooms. We collaborated with\nthe Shalal Institute and the Y.M.C.A. in organizing a workshop by Dr. Yablonsky\non psychodrama, and also worked with them in putting on several group marathon\nexperiences for group psychotherapists from the general community.\nSeveral of our staff have been instrumental in helping to establish a family\ntherapy institute in the Greater Vancouver area.\nThe psychologists from our unit established a twice-a-month lecture series for\nall clinical phychologists from the Lower Mainland and presented a variety of topics\nof vital clinical import. Our senior psychologists, too, were directly involved in a\nsummer internship programme for clinical psychologists and gave much-needed field\nexperience to training psychologists. This programme was worked out in collaboration with others from the Mental Health Services.\nSeveral of our staff psychiatrists gave assistance to the Department of Psychiatry\nat the University of British Columbia in regard to helping with examinations of\nmedical students, training of residents and medical students.\nOur social-work staff, and indirectly all of our clinicians in the centre, continued\nto play a vital part in assisting the School of Social Work, University of British Columbia, in its field placement programme for training social workers. These social\nworkers obtained direct experience in working with patients at our centre and are\nclosely supervised by our staff and university faculty. This collaborative effort seems\nto work out very well both from our viewpoint and from the School of Social Work's\nviewpoint.\nThe senior clinicians at the centre were often involved in giving orientation\nlectures and tours of the British Columbia Youth Development Centre to public\nhealth nurses, Probation Officers, school counsellors, and other professionals.\nIn summary, the staff are offering a great deal in the way of practical training\nto professional groups and agencies working in the mental health field and are making a contribution that would be hard to duplicate.\nRESEARCH\nWith the planning and development of the total British Columbia Youth Development Centre, there is a recognized need to increase the energies and time put into\nresearch, but there is a realization that this research should be of a practical and\nclinical nature. Plans are being made at this time to do an ongoing evaluation of\n IN-PATIENT SERVICES L 169\nall of our treatment programmes. We shall evaluate the various treatment methods\nused and look very closely at our outcome studies. There is a general willingness\nto have this ongoing evaluation of our work, and we see it as vital to keep searching\nfor better and more economical treatment methods.\nAnother area of study that is being planned is to compare our pattern of practice at this centre with psychiatric practice elsewhere in this community.\nMany specific research tasks were completed during the year under review.\nThere was the study completed by several of our psychologists on the auditory discrimination test as used in the schools. The results they have obtained will be of\ngreat practical value to the users of this test. There were also studies done on\nmodelling techniques and how they can be utilized to change behaviour, an examination of an adolescent group receiving treatment at the clinic with the therapist, and\nthe researcher looking for factors that bring about desired behavioural changes.\nThis work is still going on at the time of reporting. A final research project that\nshould be mentioned is the work being done by one of our sessional psychologists.\nThis person is utilizing a great deal of marathon group therapy and is conducting\na follow-up study on these groups to find out what kind of changes are effected in\nindividuals by a marathon experience, and whether or not these changes remain\npermanent.\nThe intention of this Director is to see that further vital clinical research is\ncarried out as the new unit takes shape.\nPrinted by A. Sutton, Printer to the Queen's Most Excellent Majesty\nin right of the Province of British Columbia.\n1969\n580-1268-81\n"@en . "Legislative proceedings"@en . "J110.L5 S7"@en . "1969_V01_21_L1_L169"@en . "10.14288/1.0365685"@en . "English"@en . "Vancouver : University of British Columbia Library"@en . "Victoria, BC : Government Printer"@en . "Images provided for research and reference use only. For permission to publish, copy or otherwise distribute these images please contact the Legislative Library of British Columbia"@en . "Original Format: Legislative Assembly of British Columbia. Library. Sessional Papers of the Province of British Columbia"@en . "Mental Health Branch PROVINCE OF BRITISH COLUMBIA ANNUAL REPORT 1968"@en . "Text"@en . ""@en .