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 Hôpital Saint-Jean-de-Dieu
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 Provincial Hospital, New Brunswick
 Nova Scotia Hospital
 Waterford Hospital
The back of a postcard which reads, "My thanks to: the staff at Mount Saint Vincent University Library and photo acknowledgement to the Nova Scotia Archives. Author: Leslie Baker"
black and white photograph of wing of old brick institutional building, driveway and gardening in front

Information at a Glance

Institution Names

  • Nova Scotia Hospital (1901)
  • Mount Hope Asylum (1856)

Location

300 Pleasant Street, Dartmouth, Nova Scotia, B2Y 3S3

Timelines

  • Opened: 1856
  • Period of Deinstitutionalization: 1960–1980
A sepia-toned black and white photo of a many-windowed building with a vine-covered trellis covering one section. A well-manicured garden sits at the front of the building.

Main Building, Nova Scotia Hospital.

Source: Notman Studio NSARM accession no. 1983-310 number 7580.

Patient Demographic

Adults, adolescents and children, both male and female. The hospital also received the province’s forensic and warrant patients.

Patient Statistics by Year and Sex, 1951-1973
Year Patients in Hospital at Start of Year Admitted During Year Discharged** During Year
M F Total M F Total M F Total
1951* 306 228 534 382 346 728 386 349 735
1952 302 225 527 293 280 573 312 305 617
1953 285 250 535 383 386 769 334 392 726
1954 334 244 578 397 405 802 451 412 863
1955 280 287 517 457 435 892 422 430 852
1956 315 242 557 541 527 1068 514 769 1625
1957 342 291 633 660 505 1165 642 493 1135
1958 352 315 667 358 549 1207 654 544 1198
1959*** 356 320 676 646 572 1218 712 593 1305
1960 290 299 589 686 615 1301 692 589 1281
1961****
1962 409 338 747 912 683 1595 904 696 1600
1963 417 325 742 966 774 1740 1014 781 1795
1964–72****
1973 332 207 539 2445 1345 3788 2447 1351 3798

From 1974 onward, the annual reports do not consistently specify the sex of patients.

Patient Statistics by Year and Sex, 1974-1980
Year Patients in Hospital at Start of Year Admitted Discharged
1974 511 3986 3994
1975 530 3931 3945 (incl. deaths)
1976 Unavailable 2955 Unavailable
1977 Unavailable 2480 Unavailable
1978 Unavailable 2548 Unavailable
1979 Unavailable 2427 Unavailable
1980 Unavailable 2143 Unavailable

* During the business year 1950–1951, the year’s start and end dates were changed so that the year was sixteen months long. The hospital’s business year ended on March 31.
** Provincial records identify patients who died as “discharged” until the 1970s—subsequent to 1973 discharge statistics do not include deaths.
*** Starting 1960, the business year changed to January 1–December 31, so statistics for this period end December 31, 1960.
**** unavailable

Source: Nova Scotia Hospital, Annual Reports.

Deinstitutionalization

Deinstitutionalization began relatively late in Nova Scotia. As of 1970, both the total admissions and average number of daily residents continued to grow. Patient population, indicated by total number of admissions (3,986) and total number under treatment (4,997) peaked in 1974.

A black and white photo of a large 4 storey brick building. A leafless tree is in the foreground at the right.

Nova Scotia Hospital, North Unit

Source: McNulty, Nova Scotia Hospital.

A black and white photo of a very large, modernist, many-windowed institutional building.

Nova Scotia Hospital, South Unit

Source: McNulty, Nova Scotia Hospital

The hospital’s Day Care program, which provided treatment to outpatients, began slowly in the late 1960s. In 1973, this program served 101 outpatients, with the number of new admissions declining until 1981, when it rose back up to 91. That year, the medical director reported a “trend toward an increased demand for community health services.” (Nova Scotia Hospital, Annual Report,1981)

Year Admissions for Day Care Service No. of Treatment Days for Day Care Patients
1973 101 2596
1974 89 4981
1975 85 4445
1976 80 unavailable
1977 Unavailable unavailable
1978 48 4896
1979 56 6868
1980 91 7128

Source: Nova Scotia Hospital, Annual Reports, 1973–1980.

By 1973, the average stay for in-patients had dropped to 52.9 days from an average of 60 the year before. In 1975, the average stay dropped to 46.7 days but climbed to 66 in 1976 before dropping again to 48 days in 1977. Despite the apparent increase in average time spent institutionalized, in 1978 the hospital reported that there was a general growth in outpatient treatment, including for group and individual therapy, home visits, and follow-ups. One key factor in the establishment of these outpatient programs was the relationship between the hospital and provincial public health nurses during this period.

Year Total Admissions Outpatient Visits
1978 2548 4790
1979 2427 4131
1980 2143 8902

Source: Nova Scotia Hospital, Annual Reports, 1978–1980.

Transinstitutionalization

A black and white photo of a cedar-shingled building with a ramp leading up to it. Leafless trees can be seen at the right.

Marshall Treatment Centre

Source: McNulty, Nova Scotia Hospital

A black and white photo of a nicely-appointed room. Two couches, a coffee table, a fireplace, plants and wood panels can be seen.

New spaces for day patients, circa 1960s or 1970s.

Source: McNulty, Nova Scotia Hospital.

In the 1960s, there began a slow and, at times, sporadic move toward community-based care and services. In 1974, Unit N-4 was opened to serve as short-term and crisis intervention for adults. This coincided with an increase in the hospital’s Day Care outpatient group therapy, as well as in-home assessments and therapy and increased professional co-operation with the province’s public health nurses.

A surprising trend indicated in the annual reports is the transfer of patients to county institutions.

Year Transferred to County Institution Transferred from County Institution
1959 195 46
1960 198 49
1962 191 32
1973 177 9
1974 180 10

Source: Nova Scotia Hospital, Annual Reports,1959–1974.

Work Therapy into Occupational Therapy

Supervised work therapy was present from the outset at Nova Scotia Hospital, beginning first with the institution’s farm and gradually including many basic chores within the hospital itself.

A black and white photo of a large grassy field at the end of which is a large barn and a smaller farm house.

Hospital Farm

Source: McNulty, Nova Scotia Hospital

Occupational therapy was not recorded in the hospital’s annual reports until 1950, although it was established at least a decade earlier. In 1950, the department was first acknowledged under the category of “Patients’ Entertainment,” which included the weekly showing of “moving pictures.” By 1952, the department administered a growing library and provided a series of entertainment events throughout the year.

Also beginning that year, the Occupational Therapy department gave patients the option of learning crafts, including sewing, weaving, leatherwork, glove making, knitting, toy making, typing, knotting, crocheting, shell craft, sign painting, braiding, rug making, art, cork work, and simple woodwork. Male patients could also participate in work projects both inside and outside the institution. In 1959, female patients began to be placed in work positions throughout the institution, and the 1960 annual report noted that additional efforts were being made to find more positions for female patients.

In 1962, the Occupational Therapy department began a shift toward “industrial therapy.” Under this new program, the hospital claimed to have “utilized over one hundred placements for patients, using the hospital as an industry,” and anticipated the institution of a “token salary scale for working patients.” Although patients carried out much of the labour within the hospital, there was no discussion of paying them until 1962, when it was suggested as a future possibility but not actualized (Department of Public Health, Nova Scotia Hospital  Report, 1962).

In 1974, the Occupational Therapy department merged with Volunteer Services and was renamed the Department of Motivational Therapy. Under the newly created department, 192 patients worked a total of 5,684 days over the course of the year in “work situations within the hospital.” In November of that year, an “experimental pay plan” rewarded patients financially for their work according to “time worked and functional level achieved” (Department of Public Health, Nova Scotia Hospital Report,1974). The department reported that the provision of rewards allowed patients to “[appreciate] their improvement” as well as to recognize their areas of “unsatisfactory” performance. Administration stated that they “hoped that such a program may become part of our work rehabilitation service.” In 1974, $4,257.95 was “returned to the department from the sale of articles produced during treatment periods” (Nova Scotia Hospital, Annual Report, 1974).

Year Patient Referrals Patients Accepted Days Worked Revenue Made
1974 1220 192 5684 $4257.95
1975
1976 1063 236 5622
1977 1081 201 5737
1978 1126 229 5138 $2820.45
1979 1057 3812 $3968.03

In 1981, the Department of Motivational Therapy expanded beyond its entertainment and work-based programs to offer group meetings such as the “Adult and Adolescent Vocational Interest Group,” the “Sexual Awareness Group” for adolescents, “Formalized Community Living Skills Assessments,” and an outpatient “Pre-Vocational Training” program.

Source: Department of Public Health, Annual Reports,1974–1979.

Patient Into Person

A black and white photo of a horse and buggy with two women in it. Trees and a road are in the background.

Buggy Ride - Early 1900s

Source: McNulty, Nova Scotia Hospital

Occupational therapy played an important role in the transition of patients into people at the Nova Scotia Hospital. Patient privileges were gendered: male patients were permitted to attend the theatre, seasonal shows, and bus tours for many years before female patients were allowed to participate. In the 1950s, male patients attended the Mayfair theatre, the Ice Cycles (an annual ice show at the Halifax Forum), and other extracurricular trips throughout the province. Within the larger male population, there were also hierarchies of freedom and responsibility, with one group of male patients being given the opportunity to work unsupervised in areas such as the hospital store or kitchen.

The province’s New Hospitals Act of 1979 represented the first institutionalization of patients’ rights by introducing mandatory reviews and increased access to the appeals process.

A black and white photo of a large group of people posed in front of a stage wearing Halloween costumes

Patients’ Halloween Party - Early 1940s

Source: McNulty, Nova Scotia Hospital

A black and white photo of a large indoor swimming pool.

Swimming Pool Facility

Source: McNulty, Nova Scotia Hospital

Source: Nova Scotia Hospital, Annual Reports.

Staffing in the Deinstitutionalization Era

Staff at the Nova Scotia Hospital were structured hierarchically, with the superintendent having authority over the assistant superintendent as well as physicians, nurses, attendants and occupational therapists. As the hospital became increasingly populated over the first two-thirds of the twentieth century, the number of physicians, nurses, and attendants increased correspondingly. Of constant concern was a shortage of occupational therapists. In 1958, the department reported that programs were being cut because of staff shortages. Counter to trends seen in residential mental health facilities in other parts of Canada in the late 1950s and early 1960s, the Occupational Therapy department at the Nova Scotia Hospital appeared to have been in the process of being phased out as both its programs and employees were increasingly sent to positions in other departments. Throughout the 1960s, the department reported staff shortages and, for a significant portion of 1977, the position of Supervisor remained unfilled.

A black and white photo of six people gathered around a large table. A man in a shirt and tie is looking at a file while holding a pen.

Assessment team

Source: McNulty, Nova Scotia Hospital

The adoption of the New Hospitals Act on April 1, 1979, affected referral and custody patterns, leading to increased demands on psychiatrists and physicians which, in turn, according to the annual report, threatened the amount of time spent directly treating patients. During this period, community mental health initiatives expanded and in-patients’ average length of stay at the hospital continued to decline.

Source: Nova Scotia Hospital, Annual Reports.

Bibliography

Department of Public Health. Nova Scotia Hospital Report. Murray MacKay Superintendent. Dartmouth: Department of Public Health. 1962, 1974–1979.

McNulty, Susan. Nova Scotia Hospital 125 Anniversary: Special Edition, 1858–1983. Dartmouth: Nova Scotia Hospital, 1983.

Nova Scotia Hospital. Annual Reports of the Nova Scotia Hospital. Halifax: Queen’s Printer. 1960, 1963, 1973–1981.