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 pioneer study of A. B. Hollingshead and F. C. Redlich, recorded in their book, Social Class and Mental Illness, indicates that social class is related to a number of factors pertaining to mental illness. Subsequent studies prompted by this work have examined some of these factors. All of these investigations were carried out in the United States in various mental health settings. It became our purpose to examine the relevance of these factors in a Canadian mental hospital setting. Three hypotheses were postulated. First, that social class would be related to the type of treatment received in the hospital. Second, that the duration of stay in the hospital would be related to social class. And, third, that the patient's level of improvement upon discharge from the hospital would be related to social class. Routinely collected data from Riverview Provincial Mental Hospital were used to test these hypotheses. No statistically significant relationships were found between social class and of the three dependent variables. However, it was noted that the higher social class levels of psychotics, as measured by the educational index, seemed to receive more electro-convulsive therapy and group therapy than was the case with any other diagnostic category. Possibly this trend could be persued in subsequent studies. Also, duration of stay was not considered to be an important variable because of the relatively short stay of the majority of all persons admitted to the hospital. It was concluded that the definition of treatment was too narrow. Electroconvulsive therapy and group therapy were the most amenable to statistical examination. However, it is widely recognized that milieu therapy is a major form of treatment in Riverview Hospital and therefore, should be included in any consideration of treatment in subsequent studies. / Arts, Faculty of / Social Work, School of / [Other authors, Allan Lloyd Failing Mary Louise Ferguson Pamela Dawn Gaudette Roberta Miriam Jauck Gordon Edward McLeod] / Graduate

The topic of disability within counselling is one that has received relatively little attention, despite counselling’s focus on multicultural competencies. Some scholars argue that mental illness can be conceptualized as a disability, and that viewing it as such can provide important insight and empowerment to individuals dealing with these issues. In particular, exploring mental illness as psychological disability can provide a framework for understanding the impacts of both internal and external experiences of disability on the individual. This research draws on critical disability studies theory to frame psychological disability within a social-relational model, examining the potential impact of ableism and sanism on counselling clients with psychological disabilities. Three participants were interviewed using a semi-structured protocol to explore their experiences with counselling and psychological disability. Using interpretive phenomenological analysis, six main themes emerged: Embodied Difference, Meaning and Disability, Intersections of Identity, Emotional Labour, Language, and The Therapeutic Alliance. Implications for research, training, and practice include further exploration of intersectional identities such as gender and physical disability, and incorporating an understanding of the psycho-emotional dimensions of disability, including emotional labour, into counsellor education and practice.

Concern about mental health is on the increase in North America. Increased concern necessitated the provision of more treatment facilities for mental illness. For this reason, research is being conducted in the mental health field. This study is the first undertaken in Canada, in an attempt to investigate a possible relationship between social class and mental illness. The study focussed on social class and treatment in a mental health setting at the Mental Health Centre, Burnaby, and comparisons were made with studies done in the United States. Data were made available through the B. C. Department of Vital Statistics. These data were collected at the Mental Health Centre, Adult Clinic, Burnaby from April 1, 1959 to March 31, 1964. As the data were not collected by the researchers, there are limitations which are discussed in the study. Of the total number of persons seen at the Adult Clinic, 1231 were given treatment and terminated during this five year period. These were the subjects of this study. The findings reveal no significant relationship between social class and the kind of treatment, or, between social class and the length of treatment. However, the findings do indicate that diagnosis is related to both social class and assignment of a therapist. / Arts, Faculty of / Social Work, School of / Graduate

This research project was undertaken to determine if there are social class differences in the pre-hospitalization and post-hospitalization experiences of individuals defined as mentally ill. Social class was defined through the application of educational level and occupational status. The data obtained from the Riverview Hospital covered a two year period from April 1, 1965 through March 31, 1967. Three main hypotheses were formulated to deal with the following topics: (1) The relationship between social class and employment. (2) The relationship between social class and duration of illness prior to admission to hospital. (3) The relationship between social class and contact with family or relatives. Significant trends were found to exist. Representative of these were: (1) Relating social class and employment before admission to hospital and following discharge from hospital, more higher class subjects than lower class subjects were employed before admission to and following discharge from hospital. (2) Relating social class and the period of mental illness prior to hospitalization, the results show more higher class subjects than lower class hospitalized within a one year period for psychotic mental illness. The findings of this research project support the stated hypotheses, confirm the results shown by other studies, opened new areas for further research, and indicated possible application of findings for social work practice. / Arts, Faculty of / Social Work, School of / Graduate

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Childhood chronic illness is replete with stressors that affect children's functioning across physical, social, emotional, and psychological domains. In this project, efforts were directed toward the identification and assessment of spirituality as a potential addition to the approach-avoidance paradigm of coping response. Twenty-two children diagnosed with either cancer or sickle cell disease were interviewed, along with their mothers, regarding psychosocial adjustment and typical approaches to coping with stressors. Children completed depression, anxiety, and quality of life questionnaires. Child participants were also asked to rate how often they utilized specific spiritual and general coping strategies in the month prior to the assessment. Mothers completed measures of depression and spiritual well-being, as well as parent proxy reports on their children's quality of life and use of spiritual coping. A factor analysis of the spiritual coping measure designed for use in the study (the Spiritual Coping Module) indicated strong support for the theoretically driven factors of religious and existential coping. Children's use of coping did not significantly account for heightened quality of life, nor for the presence of depressive and anxious symptomatology. However, maternal spiritual well-being accounted for 52.5% of the variance in self-reported maternal depression. Results are discussed in the context of improving children's adjustment to chronic illness through increased understanding of the child's and family's pattern of coping responses. / Master of Science

Cigarette smoking in adults with serious mental illness (SMI) has increased even when accounting for a decrease of smoking among the general population. Most of the research has focused on the prevalence, rates, and effects of smoking in adults with SMI. Little research has examined the motivations for smoking and experiences with smoking cessation among adults with SMI. Such an understanding may facilitate a reduction in smoking in this population. To address this gap in the literature, 12 adults with SMI who live in the southern Nevada area and smoke were selected through invitations distributed at a treatment facility and the use of the snowball technique. Interviews were designed to elicit these adults' views and experiences of smoking and smoking cessation. The health belief model provided the conceptual framework for this phenomenological study. Interview data were recorded, transcribed, coded, and analyzed with emergent codes and themes. Three major themes emerged from participant stories: perceived benefits to cigarette smoking, problems related to smoking cessation, and risks related to cigarette smoking. Results indicated that participants found a sense of relaxation and means of socialization while smoking. Despite attempts to quit smoking, participants struggled with the withdrawals of nicotine which led to continuous smoking despite the negative consequences of smoking on their quality of life. This study contributes to positive social change by revealing the voices of adults with SMI, which helps illuminate a more holistic approach to treatment. Study findings may contribute in the development and implementation of smoking cessation programs for this specific population.

Indiana University-Purdue University Indianapolis (IUPUI) / Objectives: The Attribution Model of mental illness stigma posits that attributions about the causes and controllability of mental illness contribute to prejudicial emotional reactions, which in turn may lead to discriminatory behaviors towards people with mental illnesses. Given that people make different assumptions about different mental illnesses, if this model is correct, it suggests that specific diagnoses would elicit different types of stigma. Another important, but unexamined, predictor is extrinsic religious orientation, which correlates positively with other types of prejudice and may predict higher levels of mental illness stigma. The purpose of this study was to test the Attribution Model of stigma and examine the relationships between diagnosis, religious orientation, and stigma. Methods: Participants (n = 334) were recruited via Amazon Mechanical Turk, randomized to read one of three vignettes about a person with a mental illness (i.e., schizophrenia, anorexia nervosa, depression), and completed measures of mental illness stigma, religious orientation and affiliation, familiarity with mental illness, and authoritarianism. Using latent variable path analysis, analysis of covariance, and multiple regression analyses, relationships in the Attribution Model of mental illness stigma were assessed, as well as the impact of diagnosis and extrinsic religiosity on specific aspects of stigma as measured by the Attribution Questionnare-27 subscales (i.e., blame, anger, pity, danger/fear, avoidance, segregation, and coercion). Results: Assessment of the Attribution Model indicated moderate overall model fit after respecification. Path coefficients indicated strong relationships between variables that were generally consistent with paths predicted by the model. One notable exception was that feelings of pity were not associated with greater helping behaviors. Analysis of covariance suggested that diagnosis was a key predictor of stigma, and that schizophrenia was the most stigmatized. Multiple regression analyses revealed that extrinsic religiosity was also an important predictor of stigma; extrinsic religiosity appeared to increase certain types of stigma, and moderate the relationship between diagnosis and stigma overall. Discussion: Although the respecified Attribution Model fit the data fairly well, the findings suggest that either the scale or the model would benefit from further refinement. Results support prior evidence that severe mental illnesses like schizophrenia are more stigmatized than other diagnoses. Extrinsic religiosity was also predictive of increased stigma, both directly and indirectly. As a moderator, extrinsic religiosity may decrease the impact of diagnosis on stigma, raising stigma for diagnoses perceived as more “controllable” (i.e., anorexia nervosa, depression) such that levels were similar to schizophrenia. Limitations and suggestions for future research are discussed.