THE NATIONAL SCENE

How Kings County, NS, Found The Cure For Despair

One Canadian out of every six will spend some part of his life in a psychiatric institution. Too often that means confinement in dirty, dismal surroundings, a lack of personal care, an end of hope. In Waterville, NS, that pattern has been shattered

G. TORI SALTER January 1 1971
THE NATIONAL SCENE

How Kings County, NS, Found The Cure For Despair

One Canadian out of every six will spend some part of his life in a psychiatric institution. Too often that means confinement in dirty, dismal surroundings, a lack of personal care, an end of hope. In Waterville, NS, that pattern has been shattered

G. TORI SALTER January 1 1971

How Kings County, NS, Found The Cure For Despair

THE NATIONAL SCENE

One Canadian out of every six will spend some part of his life in a psychiatric institution. Too often that means confinement in dirty, dismal surroundings, a lack of personal care, an end of hope. In Waterville, NS, that pattern has been shattered

G. TORI SALTER

WATERVILLE IS a small town in Nova Scotia — perhaps it is quintessential small-town Canada.

In a brightly lit studio, a tall angular man in a brown sports shirt leans forward and speaks into the microphone: “Good morning, ladies and gentlemen,” he says, “this is Bill Duncan [not his real name], your disc jockey on the favorite request program. All set? Here we go with our first request, a real swinger — Hank Snow’s Spanish Fireball.”

The day is beginning.

Two men in blue jeans hurry downstairs. “Bill, you got the bait? Boy! are the trout running in the Cornwallis today. Don got four this morning.”

The subject of The Newspaper Club’s debate is an editorial on ecology in the Halifax Chronicle-Herald. The club director reads the editorial aloud, then adds: “You know all about the pollution problem at Boat Harbor. But the question is — what can the government do about it?” The discussion is heated.

“B-a-1-1 two." The ball is barely out of the pitcher’s fist when: “C’mon ya lughead . . .hit it!” The team is practising. There is yelling, roughhousing, gesticulating. The letters KCH ripple across the backs of players wearing blue-and-white uniforms. The team has had a very good year.

The bond between disc jockey, fishermen, debaters and ballplayers is not just that they live in this same small town. It is that they are all mentally sick — all patients in the Kings County Hospital in Waterville, NS.

More remarkable, a decade ago

many of them now on the road to mental health and a return to society would have been labeled “hopeless” or “chronic” cases and abandoned to an institutional fate. That was in the days of the old Kings County Hospital, which, as a disturbing number of mental institutions still are, was modeled and run on the lines of a 19thcentury lunatic asylum.

Before 1960 the old Kings County Hospital used to discharge about two patients a year as once more fit to live with the rest of us. In 1969 the new hospital was able to discharge an astonishing 59 men and women. In the same year it calculated it had a readmission rate of 8% — that is, four of those 59 will need further hospital treatment. Elsewhere in Canada readmission rates range alarmingly from 45% to 60%.

Mental ills and disturbances are increasing in Canada, a nation in which, statistically, one in six of the population will in future spend some part of their lives in a psychiatric institution. Yet public and social attitudes toward mental illness have been slow to change.

There is what might be called a “stigma gap” between the incidence of mental illness and the public attitude toward it, which is that the mentally sick are skeletons in society’s cupboard and should probably be kept there. This gap has been closed in Waterville, which is why Kings County Hospital has been transformed from a dead-end mental institution to one of the nation’s most progressive municipal psychiatric treatment centres.

Henry A. Hiltz, the hospital’s blunt and fiercely dedicated administrator, still remembers his first day at the old hospital. As a hospital official showed him round, Hiltz asked, “Why are the patients pressing back against the wall like that?” He was told: “They’re frightened. They’ve been taught to keep out of staff’s way, or to expect a kick or a cuff on the ear.”

Hiltz says: “It was called a hospital

— but it was a place where the sick were not expected to get better. Although the patients suffered from chronic mental illness, no psychiatric treatment was available. A medical doctor looked in on a part-time basis to attend to physical ills, and at death

— a welcome release for many — penniless patients were either buried in unmarked graves in a field back of the hospital, or their bodies were sent to the Dalhousie medical school for the use of students.

“The wards reeked of urine and vomit that had penetrated the wooden floors over the years. In the wards, 167 patients had been jammed into space intended for 90. There were no registered nurses, therapists or social workers. Professionally trained people refused to work under such deplorable conditions.”

A registered nurse, formerly on the teaching staff of the Nova Scotia Hospital in Dartmouth, Hiltz accepted the job of administrator of the Kings County Hospital in 1959 with the understanding that a new modern hospital would be built within a year. When the year passed without any sign of the new building, Hiltz asked for an explanation.

“We knew the need and sympathized with Hiltz,” says Donald Keith, High Sheriff of Kings County and chairman of the hospital board at the time. “Our problem was getting the taxpayers — the people footing the bills — behind us. The public, most of whom had never been in the hospital, weren’t convinced of the need.”

Hiltz was convinced that at least half his patients could be helped to the point of being able to leave hospital, perhaps even to return to work, if decent accommodation and modern psychiatric care could be provided. To convince taxpayers, he spoke in public halls, service clubs, churches, at Home-and-School meetings, whenever he had the opportunity.

As a result, the new mental hospital achieved the status of a worthy cause in Kings County. In 1962 the new 250-bed institution — described by some architects as “the prototype of the mental hospital of the future” — was opened. The long, splitlevel building, constructed of buff brick with banks of picture windows paneled in rose and sky-blue glass, is

reminiscent of a Holiday Inn. It cost two million dollars. Of this, $800,000 was underwritten by the now sympathetic municipality; the balance came from provincial and federal governments.

With new and progressive facilities Hiltz was able to obtain the topflight, highly motivated professional staff he sees as the hospital’s greatest strength.

Dr. P. P. (Joe) George, one of the hospital’s two full-time psychiatrists, says: “About one third of our patients are adult mental defectives (at present incurable) and geriatric cases suffering from arteriosclerosis and senile brain disease. Little can be done for these patients, but we can make them comfortable by treating their physical ailments and add some happiness and a sense of usefulness through occupational therapy.

“About half the rest of our patients suffer from schizophrenia. Basically we have adopted the ‘therapeutic community’ concept in treatment. We make use of modern psychiatric treatment involving chemotherapy, electroconvulsive therapy (ECT), as well as group, occupational and spiritual therapy.”

Administrator Hiltz has in large measure achieved his aim. He has proved that with proper treatment and care many of the degraded, hopeless patients of the old Kings County Hospital could return to the community. “We’ve discharged about 85 of those patients,” he says. “They were the easy ones. Now we’re getting down to the tough cases — and we’re still discharging them. We send them back to their homes, to nursing homes and foster boarding homes. Many have returned to work. In the past eight years the hospital has discharged about 400 patients.”

A former patient, now employed as a housekeeper, speaks for many in the old hospital: “Living there was like being caught up in some terrible never-ending nightmare,” she says. “There was no privacy at all. In our bathroom, there were two old-fashioned toilets for 40 to 50 women, and one open tub behind a meagre partition. It was dreadful. The only thing that kept me going was my faith in God. All day I’d work as an unpaid maid, cleaning and scrubbing, but no matter how hard you worked you couldn’t get the stench out of the place.

“There was no treatment other than pills, and no therapy. Sometimes all we had to eat after a hard day’s work was bread, pudding and tea.

“When we moved into the new hospital I felt like a human being again. There was occupational therapy instead of scrubbing, a doctor to treat you and the kind of food that didn’t

CURE continued

leave you feeling hungry. The new hospital cured me.”

An Annapolis Valley farmer who regained his mental health adds: “In the new hospital men weren’t separated from the women. Guys who hadn’t used a razor in weeks — and then only when they were forced to — began to shave every day. The ladies sure perked us up.”

In the new hospital a variety of therapeutic programs were set up to stimulate the patient, stir him out of his apathy, and encourage independent action. In the creative hobby room, I found one man finishing a copy of a Model T Ford, cleverly contrived from squares of black cardboard and discarded X-ray film. Built around a wheelchair, it later won prizes as a float at two local fairs.

Every member of the hospital staff, including the kitchen help, gets involved. About 18 months ago, a staff meeting discussed the problem of crippled patients, who, because they can’t get out of the hospital much, live in an institutional shroud. Nurse Mrs. Pat Fraser suggested, “Why don’t we build our own swimming pool right here on the grounds? And let’s get a new bus — one that can be fitted with wheelchairs. We can raise the money ourselves.” The meeting unanimously approved the scheme, which meant raising $100,000.

First they staged a walkathon in which 85% of the staff participated. It netted $8,000, and is to be a yearly event. A lottery with 10,000 nickels as first prize added $2,000.

The top ticket seller was plump, affable Mrs. Dora Parrish, the hospital pastrycook. She sold $511.14 worth of tickets. Then broadcaster Loran Fevens, from nearby Kentville, and organist Mrs. Dot Taylor, of Middleton, cut a record called Merry Christmas From Us and donated more than $1,000 to the fund.

Today, with $13,000 in the kitty and plans to raise the remaining $87,000, the hospital staff has purchased the bus.

Despite these signs of progress, administrator Hiltz notes there are hurdles still to be faced. “We need psychologists,” he says. “There’s also a great need for halfway houses and for a sheltered workshop.”

But money and facilities are only part of the answer. As Hiltz showed me the hospital, a troubled girl with close-cropped blond hair ran up and pressed her forehead against his chest. “Please,” she said in a small, thin voice, “help me. I’m lost . . .” Hiltz held her gently for a moment, then took her arm and directed her to her ward. “You’re not lost,” he corrected her. “You’re among friends.” □