Ponoka

 

 

 

 

Name(s) of the Institution:

Alberta Hospital for the Insane (1911)

Provincial Mental Hospital in (renamed 1923)

Alberta Hospital, Ponoka (renamed 1964)

Opened:

1911

Location:

Ponoka, Alberta

Period of Deinstitutionalization:

1955-1972

Patient Demographic:

YEAR	MALE	FEMALE	TOTAL
1911*	56	108	164
1925	501	363	864
1935			1490
1945	846	604	1450
1955**			1585
1960			1052
1965			1087
1970			693
1972			641

* 16 patients were already in residence, but their sex is not recorded.
** The patient population peaked in 1955.

Deinstitutionalization:

In 1908, the Government of Alberta sought to address the needs of a perceived growing number of people deemed “mental defectives,” with the development of a mental health institution in Ponoka. The Alberta Hospital for the Insane, as it was initially known, was opened in 1911. It was built to house 150 patients, and included homes for nurses and doctors.

In 1922, the facility was brought under the administration of the Alberta Department of Health. Both the Alberta Hospital in Ponoka and the Alberta Hospital Edmonton (opened in 1923 as the Institute for the Feeble Minded) catered to adult psychiatric patients.

The patient population at Ponoka peaked in 1955, followed by a gradual decline during the 1960s and more rapid de-institutionalization in the early 1970s. Many factors influenced the provincial government’s decision to deinstitutionalize, including the advent of psychotropic drugs, provincial divisions of the Canadian Mental Health Association (CMHA), and the establishment of health insurance.

By 1958, tranquilizing drugs were being used extensively at the Provincial Mental Hospital while electroconvulsive therapies (ECT) were employed only in a minimum number of cases. By 1962, insulin shock therapy had been completely discontinued and ECT use was further minimized.

In 1967, the provincial government sponsored a study of mental health in Alberta, headed by University of Alberta psychologist W. R. N. Blair. The study, published in 1969, revealed serious problems in Alberta’s mental health services. Blair emphasized a need for increased recruitment of hospital personnel, treatment for addictions, psychiatric clinics in universities, and an end to the segregation and stigmatization of people with mental health difficulties. He nonetheless also supported the continuation of the eugenics program. By 1972, as that program was dismantled, Alberta had sterilized 2, 822 people, the majority of whom had been residents of mental hospitals or the Training School at Red Deer. Also that year, Ponoka reached its lowest in-patient numbers in decades with 641 patients in residence.

Transinstitutionalization:

In 1952, Rosehaven opened as a provincial facility for geriatric psychiatric patients in Camrose. Five years later, the Deerhome facility was opened in Red Deer to expand the neighbouring Provincial Training School for Mental Defectives. Children requiring long-term care were thus slowly removed from the main mental hospitals (Ponoka and Edmonton), which became “active treatment centres” through the 1950s and 1960s.

In 1961, the Alberta Hospital Ponoka, the Provincial Guidance Clinic, and the City of Calgary together established an outpatient clinic to provide recently discharged patients with regular access to a physician.

In 1964, the CMHA and the Provincial Hospital at Ponoka developed and launched a foster home program. In the first year, twenty-four patients were placed in eight private homes. Reportedly, by the end of the program’s first year, six of these patients had become self-supporting, three had returned to the hospital, and the remainder were “functioning adequately with welfare assistance in the community.” By 1966, the foster home program was in place in Calgary, Edmonton, and Red Deer, with fifty-seven patients placed in homes.

Also in 1966, patients were placed in Roberts’ House, a halfway house established and operated by the CMHA. In addition, the Social Services Department at Ponoka began assisting with discharge planning for patients, including finding them employment opportunities. Rehabilitation offered at Roberts’ House and the foster homes, as well as the transferring of senior patients to nursing homes, contributed to a decreasing population in Ponoka.

Work Therapy into Occupational Therapy:

The Alberta Hospital, Ponoka operated a large farm site from its inception. Patients typically worked either on the farm, in housekeeping, or in the kitchen. Farm operations continued until 1962, with only a small number of vegetables grown after that date.

A Occupational Therapy department was established in 1922 under the guidance of Miss C. C. Dingman. Two large rooms in the Main Building were set aside for this purpose and instruction was given in knitting, embroidery, and woodworking.

Both organized and informal recreation took place under the broad umbrella of occupational therapy. Evenings included shows, dances, and other social gatherings. In 1953, it was reported that over one hundred patients were in daily attendance of organized classes. In this year, painting classes were organized in response to patient interest. By 1957, over 450 patients attended classes in the main studio.

In 1963, wide use was made of occupational therapy. Craft skills were taught to short-term patients, while a large array of other activities were arranged for long-term care patients. Several of these activities involved small monetary payments to the individuals or groups working on them. These projects required the cooperation and collaboration of both people in the hospital and in the surrounding region, a bridge to community mental health.

Patient into Person:

Policies and programs encouraging patient freedom, connections with the local community, and a move away from institutional practices were gradually implemented at the hospital from the mid-1950s onwards. In 1958, an “open door” policy was pursued in which patients were given greater access to hospital grounds, resulting in a significant increase in patient recreation. Patient initiatives unheard of in an earlier era took shape; for example, in 1959, a group of female patients catered formal dinners for guests, making their own business arrangements.

The expansion of recreational options at Ponoka reflects a similar shift from patient to person. In 1960, a patient band formed alongside musicians from around town. The same year, the Ponoka Art Club held all of their classes at the hospital, and a number of patients enrolled in the classes and participated in shows. A movie theatre was installed the same year, and new classroom facilities were developed. In 1963, a campsite was developed off-site for recreational purposes, and in the years that followed, regular trips were arranged to this site and other popular destinations such as Banff and Jasper National Parks. A 1969 collection of personal photographs taken by a patient at the facility reflected patient sociability and greater patient freedoms in the deinstitutionalization era.

A new Mental Health Act came into law on January 1, 1965, with provisions to facilitate voluntary admission and remove judicial action involving involuntary admissions. The act was a response to growing public concern over the rights and well-being of individuals placed in institutional care. On February 24, 1968, a lead article in Canadian Magazine told how journalist Tori Salter had feigned schizophrenia in order to be admitted to the Alberta Hospital in Edmonton. Salter divulged that most patients “passed their time in idleness” in confined, uncomfortable dormitories. Seen as controversial, Salter’s article nevertheless raised public interest among Albertans regarding mental health issues. The release of the Blair Report in 1969, which advised decentralizing mental hospitals, was a partial response to these concerns.

Alberta’s Mental Health Act of 1972 included important new avenues for patients to exercise their rights. Specifically, Part 3 of the Act gave patients the right to language interpreters, the right to have certificates of incapacity reviewed and revoked, and the right to personal privacy (including unedited mail delivery and unsupervised visitation).

In 1980, the provincial Mental Health Act was again amended to include confidentiality rights, and in 1990 it was further amended to include a Mental Health Patient Advocate to act on behalf of patients in Albertan institutions. The role of the Advocate is multifaceted and includes investigating patient complaints, acting as an independent information source for patients, and promoting public, professional, and consumer awareness of mental health rights.

Staffing in the Deinstitutionalization Era:

Ponoka is historically significant for its role in the emergence of psychiatric nursing as a specialty. In 1930, it became home to the first formal mental health nurse training program in Canada. In 1949, all general nurses trained in psychiatry in Alberta did so at the Ponoka institution.

On April 1, 1949, Neil C. Crawford was appointed to a full-time position as a Social Worker at Ponoka. The annual report stated that “the need for such has long been realized. A skilled social worker can do much in effecting the patients’ rehabilitation in the home community.” Described as providing a valuable service, Crawford made regular trips into the community to visit former patients.

However, through the 1940s and 1950s, recruiting and maintaining adequate staffing at Ponoka was a problem. The professionalization of psychiatric/mental-health nursing was believed to be part of the solution. In 1952, a transfer of senior patients to Rosehaven provided some relief to the staffing issue, but it continued to be a problem for mental health institutions across the province.

The outpatient services developed in the 1960s required additional staffing, resulting in the development of community mental health nursing in the province. In January 1966, Margaret Mandryk began working as Calgary’s first community health nurse with a specialization in mental health: she describes herself as a pioneer in the field of community nursing.

Among the 189 recommendations in the 1969 Blair Report, many related to personnel. Specifically, Blair called for services to be expanded at the community level, noting the need for highly trained staff in all initiatives provided by institutions.

Sources:

Alberta Department of Public Health. Annual Reports of the Department of Public Health. Edmonton: Department of Public Health, 1950–1966.

Alberta Mental Health Patient Advocate Office. https://www.mhpa.ab.ca.

Ambercrombie, Sheila. Alberta Hospital Edmonton, 1923 to 1983. Edmonton: Alberta Hospital Edmonton, 1983.

Boschma, Geertje. “Community Mental Health Nursing in Alberta, Canada: An Oral History.” Nursing History Review 20 (2012): 103–35.

Boschma, Geertje. “Deinstitutionalization Reconsidered: Geographic and Demographic Changes in Mental Health Care in British Columbia and Alberta, 1950–1980.” Histoire Sociale/Social History 44, no. 2 (2011): 223–256.

Kerr, Janet C. Prepared to Care: Nurses and Nursing in Alberta, 1859 to 1996. Edmonton: University of Alberta Press, 1998.

LaJeunesse, Ronald A. Political Asylums. Edmonton: The Muttart Foundation, 2002.