Today much emphasis is placed on the rehabilitation of the mentally ill. This study undertakes a survey of the values of foster home care as a therapeutic resource in the rehabilitation of such patients. The programs presently in operation in Maryland, U.S.A. and Ontario have been examined to determine their effectiveness in meeting needs evinced by recidivist patients at the Provincial Mental Hospital, Essondale, B.C. A sample group of twenty-one patients was obtained by taking all recidivist patients returning to the hospital from probation between July 1, 1959 and December 31, 1959, who had been active with the social service department during the previous admission. Patients who met these criteria were assessed primarily through the use of rating scales based on information contained in the files. An examination of the needs and resources of these patients indicated that the average patient was unmarried, returning for his fourth admission, without family resources, and limited in social, vocational and educational skills. Previous to this readmission one out of every two had become the client of public welfare agencies, drawing social assistance. The study suggests that patients' needs may be adequately met through a foster care program which provides emotional support, thus helping to stabilize and aid the patient in his adjustment to the community. The use of this system is also indicated for the care of chronic patients whose symptoms of illness are controlled, yet who are unable to accept full responsibility for their own care. The program could also be adapted to provide care for the geriatric patients who today swell the population of mental hospitals. Considering the program under three headings: general policy, required facilities and type of patients, methods of implementing foster home care in the community are indicated. Research would be of value in developing methods of selecting patients who would derive optimum benefit from the program, and in assessing the progress made in the new setting. Foster home care, which has as its goal the placing, of patient's in family settings in the community, is in line with the current emphasis on decentralization of large mental institutions, and, as such, provides a suitable therapeutic resource in the rehabilitation of the mentally ill. / Arts, Faculty of / Social Work, School of / Graduate

This thesis is a study of the care of the mentally ill in British Columbia from the early days of the pioneers to the present time. It is hoped that this study will be of value to those charged with the care of the unfortunate persons among us who suffer from some form of mental illness. It is also hoped that this work will help to clear up some of the misconceptions surrounding the whole topic of mental hygiene. The study begins in the early years of the nineteenth century. The so-called insane were at first sent to an asylum in California but later were placed in the gaol in Victoria. Later the Royal Hospital in that city was used to house them up until the first asylum was built in New Westminster. After the turn of the century many new ideas regarding the care of the mentally ill began to spread throughout the civilized world, and had a profound affect on the administration of the mental hospitals in British Columbia. After World War I psychiatry developed very rapidly and scientific treatment began to replace simple custodial care in the mental hospitals. The findings of a survey made by the Canadian National committee for Mental Hygiene in 1919 and the recommendations of a Royal Commission in 1927 greatly influenced the government in providing better facilities throughout the province. The first social worker came to hospital at Essondale in 1932, and later that year the Child Guidance Clinic was opened. It has done excellent work but it has been successful in helping only the children who need urgent attention. Shock therapy is used extensively at Essondale and the results have been very encouraging. Other modern forms of therapy are used including organized recreation, handicrafts, and cosmetherapy. Neither psychoanalysis nor group psychotherapy is practised at the hospital. There has been a gradual development in British Columbia from simple custodial care to modern treatment procedures. In spite of present day knowledge, however, the mentally ill in this province are not getting the full benefit of all the techniques for curing them. Overcrowding has always been, and still is, a major problem. Lack of trained personnel, of adequate methods of after-care, of satisfactory preventive services are all problems which need more attention. / Arts, Faculty of / Social Work, School of / Graduate

The complexities of man's current social universe permit little opportunity for him to function in a social environment that is undergoing constant change, without experiencing stress. Those who are unable to adapt or adjust to the stresses of modern living fall prey to the ravages of mental illness. Changing professional perspectives and the research of social scientists are re-awakening professional eyes to the significance of the patient in relation to his social environment. The experience of mental illness and all its ramifications are also the experience of those who shared in a reciprocal role relationship to the patient. Isolation - the remedy of old - today is a lost cause. For social work, current theories of social dynamics promise to add a new dimension, by which to understand the social structure of the mentally ill person and those who interact with him. The new theory requires inspection and testing. This thesis is an attempt to examine some of the clinical applications of a theory that might well have great consequences for social casework. Social role theory is reviewed as background, and the concepts of role and stress are explored in relation to the family, when one of its members becomes mentally ill and requires hospitalisation. To examine clinically the effects of hospitalization on family and patient, using role concepts, a small group of families was selected and studied. Structured interviews were used to elicit both descriptive details and feelings about the family, as well as the meaning and effect of hospitalisation. The sample group was drawn from both female and male sections of the Crease clinic of Psychological Medicine; and, where possible, both the patient and a reciprocal (close relative) were interviewed. The questions were directed particularly to roles and relationships before and after admission. The study reveals that patients and their reciprocals experienced stress in two phases: (a) when the patient is mentally ill, but living at home and (b) when the patient has been hospitalised. In the former, stress centres around changes in perception and performance in an effort to continue functioning, in spite of the maladaptive roles of the mentally ill family member. In the latter, stress centres around the absence of the family member, whose absence displaces role and relationships upon which the social structure of the family network is highly dependent. The study also reveals that hospitalisation is relieving for both patient and reciprocals, and in some cases leads to the resumption of certain roles discarded during the presence of the mentally ill member at home. / Arts, Faculty of / Social Work, School of / Graduate