Expansion and Erosion
By 1960 the Saskatchewan White Cross Centres were no longer focusing to integrate former patients into the labour force, shifting its emphasis to social programs. Activities and member attendance was growing at all the centres and CMHA board and staff were aware that the clientele of White Cross Centres had shifted to include people from the community referred by clergy and general practitioners. But a voluntary organization could not sustain the full range of services necessary to help people find housing and jobs, nor provide education and support to people running housing services. Tragically, no other organization or government body picked up the range of employment, education and housing services that the CMHA no longer offered.
Gradually, CMHA realized that if they were to continue to run the programs, they needed annual grants. The 1960 CMHA annual meeting discussed the respective roles of government and CMHA in provision and funding of rehabilitation services and the board requested and received a $10,000 rehabilitation grant from the provincial government.
This program funding moved White Cross Centres from an innovative experiment in services which CMHA believed the government would eventually provide, to direct services through a voluntary, non-profit organization. The Scientific Planning Committee developed a divisional policy regarding function, membership, evaluation, and job descriptions.
The role of the wider community sector was critical in the ongoing activities of White Cross Centres. In Regina, the Centre hosted a field program for student nurses to further the role of the nurse in social rehabilitation and benefited from financial and transportation assistance from the local Rotary Club. In Swift Current, the Kinsmen Club provided transportation to bring members to the White Cross Centre and to the Saturday Club for children with developmental disabilities. With the help of community organizations, CMHA North Battleford rented the Empress Theatre for the White Cross Centre in 1961 and hired the Supervisor at $90 per month for keeping the Centre open three days a week. As the programs expanded, the supervisors in the various cities requested pay increases.
When it became obvious that some centre clients were not ready for mainstream employment and few prospective employers ready to hire them, the White Cross Centre took on the role of “sheltered workshops”, with money from contracts to dismantle, sort or make items contributing to keeping their doors open. Into the 1970s, former patients took apart telephones, power meters and other equipment for recycling. One crew assembled plastic bags with a fork, napkin, and condiments for a fast food chain. A participant remembers turning countless strips of coloured plastic into “flowers” used to decorate parade floats and wedding cars. Members stuffed envelopes or shredded documents for CMHA and businesses that contracted for this service. Workers were paid a small honorarium, a few dollars a month, to ensure that their “earned income” was under the maximum allowed for people on Income Assistance.
CMHA was a member of the coordinating council that produced the 1960 provincial Special Report on Rehabilitation of Handicapped Persons in Saskatchewan. This report, never fully implemented, argued that a full range of employment, income, education, and social supports was needed if community mental health was to take real responsibility for people it was meant to serve. While the report recommended comprehensive planning and coordination of rehabilitation services through government departments of health, education and welfare, it also that acknowledged these might be limited in scope:
Ideally, it can be argued that for any disability, injury, or illness that occurs, restoration of every person towards optimum function is desirable. The rehabilitation process cannot, therefore, be divorced from the regular health, welfare, and education services of the community … For practical purposes, it becomes necessary to consider the rehabilitation process …more narrowly…, recognizing such realistic limits as finances, facilities, personnel supply, public demand and potential recovery of the individual in relation to the effort expended. – Special Report on Rehabilitation, 1960
In other words, the public, and organizations representing persons with disabilities, could not expect unlimited resources to meet their needs. Instead of the earlier ideal of “optimum function” or what CMHA had called “a full and satisfying life”, the new standard was more modest, “a functional goal would seem to be the restoration of handicapped persons to a level adequate for them to maintain their place in society with minimal dependence on others.”
A complete range of services is, in a sense, a minimum requirement. For instance, the benefits of existing medical and psychiatric restorative services are diminished or dissipated without the complementary support (psychological, social, educational and vocational) required by the disabled to achieve maximum independence. Successful treatment of persons suffering from psychosis, for example, is of questionable value without sufficient skilled social and vocational staff to rehabilitate the patient into the community. – Special Report on Rehabilitation, 1960
Saskatchewan’s White Cross Centres were just one of many early plans for a comprehensive system of community mental health services that were never truly implemented. Doctors, hospitals, and mental health clinics focused on the medical needs of persons with chronic and acute mental illness. Income, employment, housing, education and other supports were not integrated into a system of mental health care. Psychologists and other counselors are often not covered under Medicare.
The new population of persons who received counseling and treatment for mental disorders might never have been hospitalized, but that did not mean that their illnesses were less severe and disabling. As a voluntary agency based in the cities, CMHA could not meet the serious psychological, social, educational and vocational needs of people living with mental illness throughout the province. They and their families continued to fall between the cracks, without comprehensive and coordinated programs and supports in community mental health services.