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2013-09-23 ‘Growing Pains’: An historical analysis of population mental health in Kitimat, British Columbia, 1950-2010
Lucyk, Kelsey
Lucyk, K. (2013). ‘Growing Pains’: An historical analysis of population mental health in Kitimat, British Columbia, 1950-2010 (Unpublished master's thesis). University of Calgary, Calgary, AB. doi:10.11575/PRISM/26331 http://hdl.handle.net/11023/992 master thesis
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‘Growing Pains’: An historical analysis of population mental health
in Kitimat, British Columbia, 1950-2010
by
Kelsey Lucyk
A THESIS
SUBMITTED TO THE FACULTY OF GRADUATE STUDIES
IN PARTIAL FULFILMENT OF THE REQUIREMENTS FOR THE
DEGREE MASTER OF SCIENCE
DEPARTMENT OF COMMUNITY HEALTH SCIENCES
CALGARY, ALBERTA
SEPTEMBER, 2013
©Kelsey Lucyk 2013
! Abstract
The relationship between economic change and mental health in resource-based communities has been largely unexplored. This historical case study examines how mental health was understood alongside changing economic circumstances in the resource-based community of Kitimat, British Columbia. A content analysis of archival documents and eight qualitative interviews with long-term residents revealed that understandings of mental health shifted according to local economic circumstances.
Specifically, during times of economic growth the socially ideal family unit was seen as a way to achieve mental health. Conversely, during times of economic downturn residents were preoccupied with issues like housing or unemployment, which they identified as essential to their mental health. Overall, residents’ understandings of mental health aligned with holistic or biomedical perspectives, and sometimes both. Considering the recent state of economic development in Kitimat, and its inevitable downturn—common to other resource-based communities—this study offers important insight into the implications for mental health.
! ii Table of Contents
Abstract ...... ii Table of Contents ...... iii List of Tables ...... vi List of Figures ...... vii List of Abbreviations ...... viii Epigraph ...... ix Chapter 1: Review of the Literature ...... 1 1.1 Overview ...... 1 1.2 Perspectives of Health and Mental Health ...... 1 1.2.1 Perspectives of Health ...... 1 1.2.2 Perspectives of Mental Health ...... 3 1.2.3 Perspective of Mental Health Used in this Project ...... 5 1.3 Economic Change and Mental Health ...... 6 1.3.1 Economic Change and Suicide ...... 9 1.3.2 Economic Change and Other Mental Health Outcomes ...... 12 1.3.3 Economic Change and Mental Health Service Use ...... 15 1.4 Canadian Economic History ...... 18 1.4.1 Town Planning in Response to Economic Change ...... 19 1.4.2 Company Towns and Mental Health ...... 21 1.4.3 Case Studies of Mental Health and Resource-Based Communities ...... 22 1.5 Kitimat, British Columbia ...... 25 1.5.1 Overview of Mental Health in Kitimat ...... 28 1.6 Contribution to the Literature ...... 31 Chapter 2: Methodology ...... 33 2.1 Methodological Approach: Content Analysis ...... 33 2.1.1 Content Analysis ...... 33 2.1.2 Qualitative Content Analysis ...... 34 2.1.3 Rationale for Content Analysis ...... 37 2.2 Data Collection and Sampling ...... 38 2.2.1 Archival Materials ...... 38 2.2.1.1 Access to Archival Materials ...... 40 2.2.1.2 Selection of Archival Materials ...... 42 2.2.2 Semi-Structured Interviews ...... 43 2.2.2.1 Sampling of Interview Participants ...... 43 2.3 Analytic Approach ...... 44 2.3.1 Bracketing ...... 45 Chapter 3: Economic Opportunity and Kitimat’s Construction, 1950 to 1957 ...... 47 3.1 Background to the Kitimat Project ...... 47 3.2 The Kitimat Project ...... 50 3.3 The Master Plan ...... 51 3.3.1 Social Plan ...... 52 3.3.2 Health Plan ...... 55 3.3.3 On Language and Mental Health ...... 58
iii 3.4 Mental Health During Stage 1: Construction, 1950 to 1957 ...... 60 3.4.1 Mental Health and Social Ideals ...... 60 3.4.1.1 Work as Security ...... 61 3.4.1.2 The Socially Ideal Family Unit ...... 63 3.4.1.3 Barriers to Mental Health, as Understood Through the Ideal Family Unit ...... 67 3.4.1.4.1 Housing Shortages ...... 68 3.4.1.4.2 Substandard Housing Construction ...... 71 3.4.1.4.3 Isolation ...... 73 3.5 Summary ...... 75 Chapter 4: Economic Diversification, 1957-1979 ...... 77 4.1 Overview ...... 77 4.2 Economic Recession, 1957-1959 ...... 78 4.2.1 Child Behaviour and Mental Health ...... 80 4.2.2 Work and Mental Health ...... 82 4.3: Economic Recovery and Diversification, 1960 to 1979 ...... 84 4.4 Mental Health during Economic Recovery and Diversification, 1960 to 1979 ...... 87 4.4.1 Industrial Development and Holistic Mental Health ...... 87 4.4.2 Biomedical Mental Health and Community Services ...... 90 4.4.3 Background to Clinical Mental Health Services ...... 91 4.5 Summary ...... 93 Chapter 5: Economic Development and Community Services, 1980-2010 ...... 95 5.1 Introduction ...... 95 5.2 Economic Circumstances, 1980 to 1989 ...... 95 5.3 Mental Health from 1980 to 1989: The Pursuit of Psychiatric Services ...... 99 5.3.1 Psychiatric Services Prior to the Pursuit, (pre-1980) ...... 100 5.3.2 The Pursuit Begins, 1978 ...... 102 5.3.3 Provincial Support to the Pursuit of Psychiatric Services ...... 105 5.3.4 Tragic Events and Mental Health ...... 107 5.3.5 Mental Health and Community-Provided Services ...... 109 5.4 Economic Circumstances, 1990-2010 ...... 109 5.5 Mental Health in Kitimat, 1990 to 2010 ...... 113 5.5.1 Interagency ...... 115 5.5.2 The Eurocan Closure as a Success in Preventing Community Crisis ...... 117 5.6 Current State of Community-Provided Services ...... 121 5.6.1 Staffing Shortages ...... 122 5.6.2 Population Influx ...... 123 5.6.3 Drug and Alcohol Abuse ...... 125 5.7 Summary ...... 128 Chapter 6: Discussion ...... 130 6.1 Study Results ...... 130 6.1.1 Results in Context of Deinstitutionalization ...... 131 6.1.2 Results in Context of the Social Determinants of Health ...... 134 6.2 Strengths and Limitations ...... 136 6.2.1 Strengths and Future Research Directions ...... 136 6.2.2 Limitations ...... 138 6.3 Relation to Other Studies ...... 141 6.4 Future Research and Study Implications ...... 143 !
iv Appendix A ...... 146 Appendix B ...... 151 Appendix C ...... 152 Appendix D ...... 157 Appendix E ...... 158 Appendix F ...... 161 Appendix G ...... 162 Appendix H ...... 166 Appendix I ...... 170 Appendix J ...... 171 Appendix K ...... 172 Appendix L ...... 173 Appendix M ...... 174 Appendix N ...... 175 Appendix O ...... 176 Appendix P ...... 177 Appendix Q ...... 178 Appendix R ...... 179 Appendix S ...... 180 Appendix T ...... 181 Bibliography ...... 183
v List of Tables
Table 1.1 Comparisons of biomedical and holistic mental health perspectives ...... 4 Table 1.2 Number of articles retrieved by database search for key terms ...... 22 Table 2.1 Examples of format, type, and authors of archival resources ...... 39 Table 4.1. Health Services and their Location with the KGH, 1960 ...... 93 Table 5.1. Number of doctors reported in District of Kitimat ...... 101 Table 5.2 Timeline of the Pursuit for Psychiatric Services in Kitimat ...... 103
! Appended
Table A Summary of findings for literature regarding economic change and mental health at the population level...... 146 Table B Summary of admissions to residential facilities and outpatient programs of the Mental Health Branch, in BC, 1945-1974 ...... 151 Table C List of reviewed archival materials, by collection and institution...... 152 Table R List of current and ongoing industrial projects in Kitimat, as of 2013 ...... 179 Table S Residential Facilities of Mental Health in British Columbia post-WWII ...... 180 Table T Population Estimates and Census counts for Kitimat, 1953-2012 ...... 181
vi List of Figures
Figure 1.1 The Business Cycle...... 7 Figure 3.1 Map of Kitimat in relation to British Columbia ...... 47 Figure 3.2 Sketch of the Kitimat Project from the Kenney Dam to Kitimat ...... 50 Figure 3.3 Topography Model of Kitimat’s “Master Plan” ...... 52 Figure 3.4 The Smeltersite Hospital, ca. 1954 ...... 56 Figure 3.5 Image of the Northern Sentinel’s “Women’s Page” ...... 66 Figure 3.6 A young family and their new home ...... 67 Figure 4.1 Timeline showing conceptual stages of economic development ...... 77 Figure 4.2 A snow-blower working in front of the Kitimat General Hospital, 1964 ...... 91
! Appended Figure J A Provincial Government advertisement on the industrial and commercial opportunities in British Columbia ...... 171 Figure K Kitimat General Hospital’s Location relative to the Town Site ...... 172 Figure L An aerial view of smelter operation in Kitimat, ca. 1965 ...... 173 Figure M An aerial view of Albatross and Cormorant streets, green space, walkways and Cormorant School, ca. 1954 ...... 174 Figure N Town planner Julian Whittlesey surveys a construction site, August 1954 .... 175 Figure O An aerial view of Kitimat showing land cleared for Neighbourhood “D,” the Whitesail Neighbourhood under construction (right foreground), and the Alcan smelter and Douglas are shown in the background, 1962 ...... 176 Figure P Image of the Kitimat Master Plan Topography Model (ca. 1952) overlaid onto a current Aerial View of the townsite, showing how closely the Master Plan was followed ...... 177 Figure Q Northern Health Authority in British Columbia, Divided by Health Service Delivery Areas ...... 178
!
vii List of Abbreviations
!
BC — British Columbia BCMA — British Columbia Medical Association CCHS — Canadian Community Health Survey CMHA —Canadian Mental Health Association CPS — community-provided services DSM — Diagnostic and Statistical Manual for Mental Disorders EI — employment insurance FNIM — First Nations, Inuit, and Metis groups GDP— gross domestic product KCP — Kemano Completion Project KCSS —Kitimat Community Services Society KGH — Kitimat General Hospital MB —Manitoba MHO — Medical Health Officer NIDC —National Industrial Design Council NIMH — National Institute of Mental Health NKK — Nippon Kōkan KK ON — Ontario PNE — Pacific National Exhibition PTA — Parent-Teacher Association RCMP — Royal Canadian Mounted Police SDOH — social determinants of health SWAT — Special Weapons and Tactics UI — unemployment insurance UNBC — University of Northern British Columbia US — United States of America UVIC — University of Victoria WHO — World Health Organization WWII — World War Two
! viii Epigraph
If any community had its choice of tribulations surely it would pick growing pains as the kind it would be happiest to live with. Kitimat will long be a community where growth is the normal experience. That means it will enjoy growing pains. It will be like the adolescent boy, always growing out of his latest suit of clothes and making new furnishings, constantly necessary. And just as Dad and Mom look at their gangling offspring with dismay at the problem of keeping him clothed and fed to the limit of his unearthly appetite, so the city fathers of Kitimat will be hard pressed to keep up with the town’s needs. Along with drive and initiative there will have to be a measure of patience. Rome wasn’t made in a day and Kitimat will take time, too.
Howard T. Mitchell and Lawrence G. Ecroyd, “Growth and Growing Pains” (appearing in the premier issue of the Northern Sentinel, April 15, 1954)
ix! Chapter 1: Review of the Literature
1.1 Overview
The relationship between mental health and economic change is complex, and the literature on this topic is spread across a number of disciplines (e.g. history, economics, epidemiology). In this section I will first define mental health and how it is used in this study. Next, I will examine the relationship between economic change and mental health by reviewing pertinent literature on the subject, for each topic most commonly studied at the population level: suicide, other mental health outcomes (e.g. stress, anxiety, depression1), and service-use. In the third portion, I provide a brief history of economic change in Canada, followed by its influence on town planning and economic development. Finally, I review literature regarding company towns, resource-based communities and mental health, and introduce this historical case study on economic change and mental health in the town of Kitimat, British Columbia.
1.2 Perspectives of Health and Mental Health
1.2.1 Perspectives of Health
While there are a number of ways to conceptualize health, the most common understandings in the medical field are: 1) the biomedical model; 2) the holistic model; and, 3) the wellness model. The biomedical model conceptualizes health as the absence
!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!! 1 Major Depressive Disorder is a mood disorder defined in the Diagnostic and Statistical Manual, Fourth Edition as two or more major depressive episodes meeting the criteria of five of the following over a two week period: 1. Depressed mood; 2. Lack of interest or pleasure in most activities; 3. Significant unintentional weight loss or gain; 4. Insomnia or sleeping too much; 5. Agitation or psychomotor retardation; 6. Fatigue; 7. Feelings of worthlessness or guilt; 8. Diminished concentration or decisiveness; 9. Recurrent thoughts of death. American Psychiatric Association, Diagnostic and Statistical Manual of Mental Disorders, 4th Text Revision ed. (Washington, DC: American Psychiatric Association, 2000), p. 356.
1 of disease and illness, and the presence of high functioning.2 Thus, the scholarly view of the biomedical model is “concerned with resolving health problems,” and measures health through disease-related outcomes (e.g. annual prevalence of depression).3
The holistic model of health significantly broadened the understanding of health as conceptualized by the biomedical model when introduced by the World Health
Organization (WHO) in 1946.4 At the International Health Conference in New York,
WHO members defined health as “a state of complete physical, mental and social well- being and not merely the absence of disease or infirmity.”5 Due to its breadth and discouragement of using health indicators that reduce health to biomedical elements (i.e. disease), it is difficult to measure health within the holistic model.6 For example, a measure of holistic health might frame questions in a survey on wellbeing (e.g. self-rated mental health ranging from poor to excellent), rather than symptoms of illness.7
The wellness model of health represents the WHO’s shift away from their understanding of health as an obtainable state, which they introduced in 1984. In a move towards health promotion, the WHO re-conceptualized health as a process or force, and defined health as “the extent to which an individual or group is able to realize aspirations and satisfy needs, and to change or cope with the environment…it is a positive concept, emphasizing social and personal resources, as well as physical capacities.”8 A measure of
!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!! 2 “Definitions of Health,” University of Ottawa, Society, the Individual, and Medicine, n.d., accessed June 6, http://www.medicine.uottawa.ca/sim/data/Health_Definitions_e.htm. 3 Ibid. 4 Ibid. 5 World Health Organization, Preamble to The Constitution of the World Health Organization as Adopted by the International Health Conference, New York, 19-22 July 1946, vol. 2 (Official Records of the World Health Organization, 1946): p. 100, accessed June 1, 2013, http://www.who.int/about/definition/en /print.html. 6 Ibid., p. 100. 7 Ibid., p. 100. 8 World Health Organization Regional Office for Europe, Health Promotion: A Discussion Document on
2 health within the wellness model might include measuring “the success with which [a] population adapts to change,” which may incorporate biomedical measures (e.g. prevalence of depression) to determine how a population adapted to some form of change
(e.g. economic change).9
1.2.2 Perspectives of Mental Health
Different models of health affect the ways in which we define and conceptualize mental health. A holistic mental health perspective focuses on understanding, improving, and promoting mental health by considering the complexities that influence the mental health of each person (e.g. state of emotional, physical, and spiritual health), as well as outside of them (e.g. social determinants, such as housing or employment).10 Holistic mental health is a broad concept that focuses on improving mental health rather than treating mental illness.
In contrast to the holistic perspective for mental health, the biomedical perspective focuses on mental illness—defined by the Canadian Mental Health
Association (2009) as an impediment to “a person’s ability to cope with daily life,” that may occur when biological, social, economic, genetic, or environmental factors influence one’s mental health.11 Mental illness is often understood according to the diagnostic criteria used by psychiatrists and psychologists, and understood commonly amongst mental health professionals as defined in the Diagnostic and Statistical Manual of Mental
!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!! ! the Concept and Principles, ICP/HSR 602 (Copenhagen: World Health Organization Regional Office for Europe, 1984). 9 University of Ottawa, “Definitions of Health.” 10 “What is Mental Health?,” World Health Organization, September 3, 2007, accessed June 9, 2013, http://www.who.int/features/qa/62/en/index.html. 11 “Types of Mental Illness,” Canadian Mental Health Association, Calgary Region, accessed January 28, 2012, http://www.cmha.calgary.ab.ca/mentalhealth/Types_of_Mental_ Illness/Index.aspx.
3 Disorders (DSM). In his article on the culture and history surrounding psychiatric diagnosis, psychiatrist and anthropologist Horacio Fabrega, defines mental illness in this way as “disturbances in personal experience, social behaviour, and bodily function” that can be major (e.g. dementia) or minor (e.g. nervous disorder).12 Thus, the biomedical perspective is narrower in scope than the holistic perspective and operates with the primary function of identifying, preventing, and treating mental illness to improve mental health.
Both the biomedical and holistic perspectives of mental health seek to improve mental health, with different foci. An example of these different perspectives appear in
Table 1.1, below, comparing the vision and mission of two national agencies that are each concerned with improving mental health, the National Institute for Mental Health
(NIMH) and the Canadian Mental Health Association (CMHA). While the CMHA aims broadly for “mentally healthy people in a healthy society,” NIMH envisions “a world in which mental illnesses are prevented and cured.”13 Likewise, the mission statements for each agency reflect a narrow biomedical and broad holistic perspectives, for both NIMH and CMHA, respectively.
Table 1.1 Comparisons of biomedical and holistic mental health perspectives14
Biomedical Holistic
Agency National Institute of Mental Health Canadian Mental Health Association A world in which mental illnesses are prevented Mentally healthy people in a healthy society. Vision and cured.
!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!! 12 Horacio Fabrega, “Culture and History in Psychiatric Diagnosis and Practice,” Psychiatric Clinics of North America 24, no. 3 (2001): 391-405, p. 391. 13 Ibid., p. 391. 14 “About NIMH,” National Mental Health Association, last modified May 22, 2013, accessed May 22, 2013, http://www.nimh.nih.gov/about/index.shtml/; “About CMHA,” Canadian Mental Health Association, last modified 2013, accessed May 22, 2013, http://www.cmha.ca/about-cmha/our-vision-mission-and- values/#.UZ0RN-DpO5g.
4 Biomedical Holistic
Mission The mission of NIMH is to transform the As the nation-wide leader and champion for understanding and treatment of mental illnesses mental health, CMHA facilitates access to the through basic and clinical research, paving the way resources people require to maintain and improve for prevention, recovery, and cure. For the Institute mental health and community integration, build to continue fulfilling this vital public health resilience, and support recovery from mental mission, it must foster innovative thinking and illness. ensure that a full array of novel scientific perspectives are used to further discovery in the evolving science of brain, behavior, and experience. In this way, breakthroughs in science can become breakthroughs for all people with mental illness.
1.2.3 Perspective of Mental Health Used in this Project
For the purpose of providing the reader with a discernible understanding of mental health, this project follows the commonly cited, holistic definition put forth by the
WHO as “a state of well-being in which every individual realizes his or her own potential, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to her or his community.”15 However, because mental health is not the only area of interest for this project (also economics, psychiatry, population health), this project will also incorporate components of the biomedical model of mental health.
Thus, throughout this thesis, mental health will be referred to as “holistic” or “biomedical” to illustrate the different perspectives of mental health at play in Kitimat’s history. As well, the use of the term “clinical” mental health is used occasionally to refer specifically to mental health within the context of medical services (i.e. psychiatry). It is important to note, as will be made apparent through this thesis, that biomedical and holistic models of mental health are not mutually exclusive, and often contain significant overlap.
My incorporation of the biomedical perspective, in addition to the holistic
!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!! 15 WHO, “What is Mental Health?”
5 perspective, aligns well with the population mental health framework. This framework holds mental health as a human right, endorses universal access to mental health services, and works to improve the mental health of the entire population so that each individual is able to enjoy life, balance its demands, and develop psychological and emotional resilience. 16 Population mental health research pursues the abovementioned goals primarily through the surveillance of mental health over time, through measure of biomedical mental health indicators (e.g. prevalence, admission). As a result, the published literature regarding mental health and economic change at the population level predominantly focuses on measured biomedical indicators. Consequently, the literature reviewed for this project pertains more to a biomedical perspective of mental health, than a holistic one.
1.3 Economic Change and Mental Health
Economic change is an inevitable component of the market economic system; that is, a system where resources and services are owned and provided both publicly and privately.17 Private businesses supply the market demands of the population, and public policy regulates economic growth and the delivery of goods and services.18 Economic change occurs within market economies because they follow a pattern of growth known !!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!! 16 National Mental Health Development Unit, (2009), Commissioning Population Mental Health and Well-Being: A Leadership Briefing For Boards and Senior Managers—The Role Of Well-Being and Mental Health Promotion in Achieving Whole System Improvement [DRAFT] (Tamworth Borough Council: Government of the United Kingdom, November 2009), accessed April 25, 2012, http://www.tamworth.gov.uk/pdf/Agenda%20part3.pdf; Population Mental Health Promotion Initiative, University of Ottawa Institute of Mental Health Research, Population Mental Health Promotion: What is it? What can it Become? [Complementary article to the Canadian Institute for Health Information’s Report Improving the Health of Canadian 2009: Exploring positive mental health.], N. Joubert (Ottawa, Canada: CIHI, 2009), 1-30, accessed April 25, 2012, http://secure.cihi.ca/cihiweb/products/ Complementary_Joubert_Final_ Eng_20Feb2009.pdf. 17 Gary Rabbior, The Canadian Economy: The Big Picture, revised edition (Toronto: Canadian Foundation for Economic Education, 2001): p. 3, accessed April 23, 2012, http://cfee.org/en/pdf/bigpicture.pdf.; Christopher Ragan, “Why Monetary Policy Matters: A Canadian Perspective,” Bank of Canada, 2010, accessed April 23, 2012, http://www.bankofcanada.ca/wpcontent/uploads/2010/10/ragan_paper.pdf. 18 Rabbior, The Canadian Economy, p. 3; Ragan, “Why Monetary Policy Matters.”
6 as the business cycle (see Figure 1.1). The business cycle is an economic theory, which maintains that as economies grow, they experience periods of expansion (i.e. “boom,” recovery, growth) and decline (i.e. “bust,” recession, contraction) in goods and services that are reflected in large-scale, macroeconomic measures such as the gross domestic product (GDP) or unemployment rate. 19 Both economic growth and recession are measured by quantitative economic change, with growth identified by the percent increase in GDP in one year, and recession by a fall in GDP over two successive financial quarters. 20 The effects of economic growth and decline are felt across different populations and within different levels of the economy; individuals may lose or gain work, factories may open or close, and prices may rise or fall.
Figure 1.1 The Business Cycle21
Studies included for review of economic change and mental health were first identified using the medical subject headings (MeSH) terms “economic recession” and
!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!! 19 Andrew Abel, Ben Bernanke, and Gregor Smith, Macroeconomics, 3rd edition (Toronto, Canada: Pearson Education Canada Inc., 2003). 20 “Definition of ‘Recession’,” Investopedia, last updated 2013, accessed April 25, 2013 http://www.investopedia.com/terms/r/recession/asp. 21 Adapted from information provided in Abel et al., Macroeconomics.
7 “mental health” in PubMed. While broad, these terms were chosen to reflect a) the specific theory of the business cycle, and b) the broad understanding of mental health. As a single business cycle contains periods of both economic growth and recession (see
Figure 1.1 and footnote 21),22 studies retrieved using the term “economic recession” reported on both of these periods of economic change. A MeSH heading search for
“mental health” included a number of subheadings that covered an array of disciplines.23
“Mental health” was not reduced any further in scope, with the intent to determine a broad understanding of the literature available for this term. Studies retrieved for economic recession and mental health were reviewed by title and abstract, to determine its relevance to the objective for this thesis.24 Generally speaking, included studies were those that contained some measure of mental health/illness, and identified some component of economic change. Further articles were identified from the reference lists of included studies. This allowed for the inclusion of studies that were not retrieved through online searches (e.g. Durkheim, 1897).
There are entire bodies of literature regarding specific economic indicators and their relation to mental health (e.g. unemployment and alcohol dependence); however, while they may use macroeconomic indicators (e.g. employment status), if they did not focus specifically on changing economic circumstances, they were not included for review. It is a recognized limitation of this study that this review is not exhaustive of all possible search combinations regarding mental health and economic change. As a further !!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!! 22Note: A business cycle is measured from “peak to peak” (high point of economic expansion to low point of recession to high point of expansion) or “trough to trough” (low point of economic recession to high point of recovery to low point of recession). 23 Subheadings listed included: classification; diagnosis; drug effects; economics; education; epidemiology; ethics; ethnology; history; legislation and jurisprudence; manpower; methods; nursing; organization and administration; prevention and control; standards; statistics and numerical data; therapy; trends. 24 Research Objective: To determine how understandings of mental health have changed alongside economic changes in the population of Kitimat, British Columbia since its 1952 incorporation.
8 step in the feasibility for this project, this review focuses on studies that look at mental health and economic change at the population level (e.g. city, province; country).
Subsequently, the outcomes that have been studied regarding economic change and mental health fall broadly into one of three categories, as used most commonly in population mental health surveillance: suicide, mental health outcomes, and service use.
The findings from the literature review are summarized in Appendix A.
1.3.1 Economic Change and Suicide
Much of the literature regarding the effects of economic change on mental health at the population level has focused on suicide rates. As early as 1897, French sociologist
Emile Durkheim (1858-1917), looking at the fast-growing urban centres of late nineteenth-century France and their social modernization problems, theorized that economic upheaval could disrupt an individual’s circumstances to the point that they could not cope, driving them to commit anomic suicide.25 While Durkheim focused on the behaviour of individuals, his use of aggregate statistics marks his work as an early venture in population mental health.
The association between suicide/depression and economic change is explained by
American psychologist Roy Baumeister in his 1990 article, “Suicide as Escape from
Self.”26 Baumeister describes suicide as an action rationalized by individuals who attempt to escape their “aversive self-awareness,” when experiencing a state of depression and pain brought on by personal failures or inadequacies.27 Thus, in the context of economic change, suicide may be one’s attempt to escape a situation they view as dire—such as the severe personal and financial stresses that may be brought on by economic change. !!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!! 25 Emile Durkheim, Suicide: A Study in Sociology [1897] (New York: The Free Press, 1951). 26 Roy Baumeister, “Suicide as Escape from Self,” Psychological Review 97, no .1 (1990): 90-113. 27 Ibid.
9 Recent work has focused on correlating business cycles, as indicated by the rate of growth in GDP or the un/employment rate over time, with suicide rates. An American study conducted by the Center for Disease Control (2011), sought to determine age- specific suicide rates with business cycles. They (2011) found that suicide rates fell during periods of economic expansion (1991-2001), and rose during times of economic recession from 1929 to 2007 for each age group.28 Most significantly, the study found that during the largest economic recession in the United States—the Great Depression
(1929)—suicide rates increased by 22.8 percent, the highest for any four-year period.29
Another study by Alfonso Ceccherini-Nelli and Stefan Priebe from the London National
Health Service and School of Medicine, respectively, found a long-term correlation between suicide and unemployment rates in four European countries by analyzing data collected from national agencies.30 In their analysis, Ceccherini-Nelli and Priebe (2010) found that in the United Kingdom (1901 to 2006), United States (1900 to 1997), France
(1970 to 2004), and Italy (1970 to 2001), an increase or decrease in the unemployment rate predicted an increase or decrease in suicide rates.31 A 1985 study by psychiatric epidemiology researchers Hugues Cormier and Gerald Klerman found supporting results for the period of 1966-1981 in the province of Quebec; suicide rates rose and fell significantly alongside economic change—measured by the province’s unemployment
!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!! 28 “CDC Study Finds Suicide Rates Rise and Fall with Economy: Study Looks at Suicide Rates from 1928- 2007,” Center for Disease Control, last updated April 14, 2011, accessed April 22, 2012, http://www.cdc.gov/media/releases/2011/p0414_suiciderates.html. 29 Ibid. 30 Alfonso Ceccherini-Nelli and Stefan Priebe, “Economic Factors and Suicide Rates: Associations Over Time in Four Countries,” Social Psychiatry and Epidemiology 46(2011): 975-982. 31 Ibid.
10 rate.32 Another study, undertaken by Allison Milner and colleagues (2012) of the WHO, analyzed socio-economic factors for suicide rates within thirty-five countries.33 They found that suicides increased significantly with unemployment for both males and females, from the period of 1980-2006.34 Elias Kondilis et al. (2011) of the Aristotle
University’s Laboratory of Hygiene and Social Medicine also found an increase in suicide rates. Kondilis et al. (2011) discovered that between 2007 and 2009 in Greece, during the country’s economic debt crisis, suicide rates increased by 22.7 percent.35 In a related study, Michael Snipes et al. (2012) of New Mexico University found that in the
American population, from 1980 to 2006, a higher national unemployment rate was correlated with a higher probability of death being ruled as a suicide.36
While the majority of studies reviewed found a correlation between suicide and unemployment, the results were not consistent for all of them. For example, English researchers Ajit Shah and Ritesh Bhandarkar (2008) found no statistical significance in the relationship between unemployment and suicide rates in a cross-national study of twenty-seven countries. 37 Furthermore, psychiatrist Orestis Giotakos and colleagues
(2011) found that from 1981 to 2008, as income decreased, so too did Greek suicide
!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!! 32 Hugues Cormier and Gerald Klerman, “Unemployment and Male-Female Labor Force Participation as Determinants of Changing Suicide Rates of Males and Females in Quebec,” Journal of Social Psychiatry 20 (1985): 109-114. 33 Alison Milner, Roc McClure, and Diego De Leo, “Socio-economic Determinants of Suicide: An Ecological Analysis of 35 Countries,” Social Psychiatry and Psychiatric Epidemiology 47(2012): 19-27. 34 Ibid., p. 25. 35 Elias Kondilis, Stathis Giannakopoulos, Magda Gavana, Ioanna Ierodiakonou, Howard Waitzkin, and Alexis Benos, “Economic Crisis, Restrictive Policies, and the Population's Health and Health Care: The Greek Case,” American Journal of Public Health (2013, April 4) [Published online ahead of print], accessed April 29, 2013, http://www.ncbi.nlm.nih.gov/pubmed/23597358. 36 Michael Snipes, Timothy Cuhna, and David Hemley, “Unemployment Fluctuations and Regional Suicide: 1980 – 2000,” Journal of Applied Economics and Business Research 2, no. 2 (2012): 103-122. 37 Ajit Shah and Ritesh Bhandarkar, “Cross-National Study of the Correlation of General Population Suicide Rates with Unemployment Rates,” Psychological Reports 103, no. 3 (2008): 793-796.
11 rates.38 These findings show that while most studies have shown economic downturn may influence mental health, this relationship is not consistent across all populations.
1.3.2 Economic Change and Other Mental Health Outcomes
Some researchers have examined economic change and mental health by focusing on an array of mental health outcomes, such as depression and anxiety. A positive relationship between unemployment or job insecurity and mental health outcomes is supported within a number of different geographic and economic contexts. In response to the 2008 Greek recession, Aristotle University’s Marina Economou et al.’s (2013) repeated cross-sectional study found that the one-month prevalence of major depression increased significantly (by 4.9 percent) from 2008 to 2011. 39 These findings are consistent with the qualitative work of Julia Anaf et al. (2013) in Australia, who interviewed 22 workers who had been laid-off from a Mitsubishi automobile plant between 2004 and 2005.40 Anaf et al. (2013) found that feelings of loss, status, control, and self-esteem were common among workers, as well an increase in their grief, financial strain, and stress.41 Another Australian study by epidemiologist Lyndall Strazdins and colleagues (2011) found that depression and anxiety increased amongst employees aged
40 to 48 as they became more job-insecure.42
!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!! 38 Orestis Giotakos, D. Karabelas, and Alexandros Kafkas, “Financial Crisis and Mental Health in Greece [Article in Greek, Modern],” Psychiatrike 22, no. 2 (2011): 109-119. 39 Marina Economou, Michael Madianos, Lily Peppou, Athanasios Patelakis, and Costas Stefanis, “Major Depression in the Era of Economic Crisis: A Replication of a Cross-Sectional Study Across Greece,” Journal of Affective Disorders 145, no. 3 (2013): 308-314. 40 Julia Anaf, Frances Baum, Lareen Newman, Anna Ziersch, and Gwenyth Jolley, “The Interplay Between Structure and Agency in Shaping the Mental Health Consequences of Job Loss,” BMC Public Health 13, no. 1 (2013): 1-12. 41 Ibid. 42 Lyndall Strazdins, Rennie D’Souza, Mark Clements, Dorothy Broom, Bryan Rodgers, and Helen Berry, “Could Better Jobs Improve Mental Health? A Prospective Cohort Study of Change in Work Conditions and Mental Health in Mid-Aged Adults,” Journal of Epidemiology and Community Health 65, no. 6 (2011): 529-534.
12 University of Balearic Islands psychologist, Margalida Gili et al. (2013), found that the proportion of mood, anxiety, and alcohol-related disorders increased following the 2006 economic crisis in Spain, having increased from their baseline measures in 2006 to 2010. 43 As well in Great Britain, survey respondents for Howard Meltzer and colleagues’ (2010) study reported that those who were job insecure or in debt were more likely to experience depression.44 Similarly in Canada, psychiatric epidemiologist JianLi
Wang et al. (2010) found that within the population of Alberta, the twelve-month prevalence of major depressive disorder increased after the 2008 economic crisis.45 In
Iceland, public health scholars Arna Hauksdottir et al. (2013) found that unemployed women experienced higher stress than women who were employed, following economic collapse.46 An American study conducted by Catalano and Dooley (1977) in Kansas City found that not only did unemployment affect stress, but stress also affected one’s employment.47 Other studies support the relationship between mental health outcomes and unemployment among general Finnish,48 British,49 Japanese,50 and East European51 populations.
!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!! 43 Margalida Gili, Miquel Roca, Sanjay Basu, Martin McKee, and David Stuckley, “The Mental Health Risks of Economic Crisis in Spain: Evidence from Primary Care Centres, 2006 and 2010,” European Journal of Public Health 23, no. 1 (2013): 103-108. 44 H. Meltzer, P. Bebbington, T. Brugha, R. Jenkins, S. McMAnus, and S. Stansfeld, “Job Insecurity, Socio-economic Circumstances and Depression,” Psychological Medicine 40, no. 8 (2010): 1401-1407. 45 JianLi Wang, Elizabeth Smailes, Jitender Sareen, Gordon Fick, Norbert Schmitz, and Scott Patten, “The Prevalence of Mental Disorder in the Working Population Over the Period of Global Economic Crisis,” Canadian Psychiatric Association 55, no. 9 (2010): 598-605. 46 Arna Hauksdottir, Christopher McClure, Stefan Jonsson, Orn Olafsson, and Unnur Valdimarsdottir, “Increased Stress Among Women Following an Economic Collapse—A Prospective Cohort Study,” American Journal of Epidemiology (advanced online publication February 13, 2013), accessed May 22, 2013, http://aje.oxfordjournals.org/content/early/2013/02/12/aje.kws347.full.pdf. 47 Ralph Catalano and David Dooley, “Economic Predictors of Depressed Mood and Stressful Life Events in a Metropolitan Community,” Journal of Health and Social Behaviour 18, no. 3 (1977): 292-307. 48 Heimo Viinamaki, Jukka Hintikka, Osmo Kontula, Leo Niskanen, and Kaj Koskela, “Mental Health at Population Level During an Economic Recession in Finland,” Nordic Journal of Psychiatry 54, no. 3 (2000): 177-182.
13 According to the Desjardins Financial Security & Canadian Mental Health
Association National Health Survey (2009), following the 2008 economic recession, over
46 percent reported higher stress levels in Canada.52 In April 2009, the College of Family
Physicians of Canada asked family doctors how the current economic recession was affecting their practices. While results are no longer open for public viewing, Louise
Bradley (2009) of the Mental Health Commission of Canada reported that nearly 88 percent of physicians responded ‘yes’ to the question: “Since the recession began, have any of your patients presented with stress-related problems that you and/or they attribute to the economy?”53 Further, Robin Collier (2009) of the Canadian Medical Association
Journal reports that, “Nearly 40% of those who responded said that they now treat many patients for stress-related problems caused by economic worry.”54 The Institute of Work and Health’s (2009) research on mental health and unemployment found that this
!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!! !
49 Claudia Thomas, Michoela Benzeval, and Stephen Stansfeld, “Employment Transitions and Mental Health: An Analysis from the British Household Panel Survey,” Journal of Epidemiology and Community Health 59, no. 3 (2005): 243-249. 50 S. Nagata, “Stress Management in the Workplace in the Era of Industrial and Economic Change [Japanese],” Sangyo Eiseigaku Zasshi 42, no. 6 (2000): 215-220. 51 Amanda Nicholson, Hynek Pikhart, Andrzej Pajak, Sofia Malyutina, Ruzena Kubinova, Anne Peasey, Roman Topor-Madry, Yuri Nikitin, Nada Capkova, Michael Marmot, and Martin Bobak, “Socio-economic Status Over the Life-Course and Depressive Symptoms in Men and Women in Eastern Europe,” Journal of Affective Disorders 105, no. 1-3 (2008): 125-136; Istvan Bitter, “Mental Disorders and Economic Change—The Example of Hungary,” Bulletin of the World Health Organization 78, no. 4 (2000): 505-506. 52 “Health is cool! Employee summary survey — regional results,” Desjardins Financial Security and Canadian Mental Health Association, last update 2009, accessed April 22, 2012, http://www.desjardinslifeinsurance.com/en/lifeevents/Documents/Health%20survey%202009%20Highlight s%20employees.pdf. 53 Louise Bradley, The Recession’s Impact On The Mental Health Of Workers And Their Families: A Global Perspective [Speaking Notes], Speech presented at Queen’s International Institute on Social Policy 2009 Conference: Social Policy and the Recession, Kingston, Ontario, August 18, accessed April 22, 2012, http://www.mentalhealthcommission.ca/SiteCollectionDocuments/Key_Documents/en/2009/LB_QIISP_Ki ngston_18Aug09_FINAL_for%20web%20_2_.pdf. 54 Roger Collier, “Recession Stresses Mental Health System,” Canadian Medical Association Journal 181, no. 3/4 (2009), accessed April 22, 2012, http://www.cmaj.ca/content/181/3-4/E48.short; College of Family Physicians of Canada, E-News 6, no. 5 (2009), last updated May 2009, accessed April 22, 2012, http://www.cfpc.ca/uploadedFiles/Publications/_PDFs/e-news_vol6-5_may2009.pdf.
14 relationship is bidirectional: unemployment negatively impacts mental health and poor mental health negatively impacts unemployment, as individuals with poor mental health were shown more likely to become unemployed.55 Psychiatric epidemiologists Patten and colleagues (2009) found that Canadian individuals experiencing major depressive episodes were more likely to transition from employed to unemployed status, compared to working individuals who did not experience major depressive episodes.56 Thus, the above findings suggest that indicators of economic change (e.g. unemployment) are associated with a number of mental health outcomes (e.g. anxiety, mood disorders).
1.3.3 Economic Change and Mental Health Service Use
Aside from changes in the rates or prevalence of mental health outcomes, research regarding mental health and economic change also looks at patterns of mental health service use. Economist and sociologist M. Harvey Brenner (1967) identified an inverse correlation between employment and mental health hospitalization in state of New York from 1910 to 1960.57 While Brenner (1967) notes that service-use varied amongst population subgroups, at the population level mental health hospitalization increased as employment decreased. As was the case with Durkheim’s theory on anomic suicide,
Brenner hypothesized that the added stress caused by deteriorating financial
!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!! 55 Ralph Catalano, “The Health Effects of Economic Insecurity,” American Journal of Public Health 81 (1991); “Unemployment and mental health,” Institute of Work and Health, last updated August 2009, accessed January 30, 2012, http://www.iwh.on.ca/briefings/unemployment-and-mental-health. 56 Scott Patten, JianLi Wang, Jeanne Williams, Dina Lavorato, and Andrew Bulloch, “Prospective Evaluation of the Effect of Major Depression on Working Status in a Population Sample,” Canadian Journal of Psychiatry 54, no. 12 (2009): 841-845. 57 M. Harvey Brenner, "Economic change and mental hospitalization: New York State, 1910--1960." Journal of Social Psychiatry 2, no. 4 (1967): 180-188.
15 circumstances may result in individuals’ inability to cope with the conditions of their daily lives, and may intensify to the degree where it becomes mental illness.58
Brenner’s findings may be in part explained by the theoretical work of economist, urban planner, and public health scholar Elliott Sclar (1980), who found that families and social networks adjust to economic change, may experience increased stress and strain that could lead to an increase the incidence or prevalence of mental health outcomes.59
Sclar’s (1980) explanation is supported by the findings of public health scholar Ralph
Catalano and colleagues (1983), who found that previously untreated persons with mental illness sought treatment during periods of economic downturns due to increased stress brought on by altered economic circumstances.60
Many studies of mental health at the population level have attempted to replicate
Brenner’s (1967) findings in different geographical contexts, finding a positive relationship between economic decline and mental health admissions. University of
California scholar Jeanine Frank (1981) found that in the state of Hawaii, first admissions increased for middle-income groups alongside unemployment/economic decline between
1972 and 1975. 61 In another study, Ralph Catalano et al. (1981) found that in a nonmetropolitan community in Washington County, worsened economic conditions and increased unemployment predicted an increase of inpatient admissions for mental health
!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!! 58 Ibid. 59 Elliott Sclar, “Community Economic Structure and Individual Well-Being: A Look Behind the Statistics,” International Journal of Health Services 10, no. 4 (1980): 563-579. 60 Ralph Catalano, David Dooley, and Robert Jackson, “Economic Predictors of Admissions to Mental- Health Facilities in a Nonmetropolitan Community,” Journal of Health and Social Behaviour 22, no. 3 (1983): 284-297. 61 Jeanine Frank, “Economic Change and Mental Health in an Uncontaminated Setting,” American Journal of Psychology 9, no. 4 (1981): 395-410.
16 between 1971 and 1974.62 The work of psychologist Michael Kiernan et al. (1989) also supports Brenner’s (1967) hypothesis, for they found that in three American states, employment was inversely related to first admissions of mental health in state hospitals and community outpatient facilities and service use appeared to increase following an economic stressor.63
Other researchers have attempted to replicate Brenner’s (1967) findings with contrasting results. In Canada, mental health worker John Trainor, and colleagues (1987) found that in metropolitan Toronto at the Queen Street Mental Health Centre, as unemployment increased, admissions and discharges decreased.64 In 1990, sociologist
George Dowdall et al. conducted a time series analysis on historic admissions data for three American psychiatric institutions—Eerie County Poorhouse, Providence Retreat, and Buffalo State Asylum—from 1881 to 1891. 65 Dowdall et al. (1990) found no support for their hypothesis that economic change would provoke first admissions.66 Relating to more specific mental illness, Tor Eriksson (2000) found that manic-depressive illness was not linked to unemployment in the population of Denmark from 1970-1983.67 Concerning major depressive disorder, epidemiologist and biostatistician Zhehui Luo et al.’s (2010) analysis of the American National Epidemiological Survey on Alcohol and Related !!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!! 62 Catalano et al., “Economic Predictors of Admissions to Mental-Health Facilities in a Nonmetropolitan Community.” 63 Michael Kiernan, P.A. Toro, J. Rappaport, and E. Seidman, “Economic Predictors of Mental Health Service Utilization: A Time-Series Analysis,” American Journal of Community Psychology 17, no. 6 (1989): 801-820. 64 John Trainor, Katherine Boydell, and Robert Tibshirani, “Short-term Economic Change and the Utilization of Mental Health Facilities in a Metropolitan Area,” Canadian Journal of Psychiatry 32, no. 5 (1987): 379-383. 65 George Dowdall, James Marshall, and Wayne Morra, “Economic Antecedents of Mental Hospitalization: A Nineteenth-Century Time-Series Test,” Journal of Health and Social Behaviour 31, no. 2 (1990): 141- 147. 66 Ibid. 67 Tor Eriksson, “Labour Market Changes and Mental Illness in Denmark during the 1980s,” in The Mortality Crisis in Transitional Economies, eds. Giovanni Cornia and Renato Paniccia (Oxford: Oxford University Press, 2000), 370-391.
17 Conditions found that men and women who were admitted to hospital for major depressive disorder, were more likely to be employed and working fulltime compared to those who were not admitted.68
1.4 Canadian Economic History
Historically, Canadian business cycles have occurred in relation to natural resources or staples industries, such as fish, fur, timber, wheat, oil, gas, or power.69 In his 1930 publication The Fur Trade in Canada, 70 political economist Harold Innis termed
Canada’s reliance on natural resources for economic growth as staples theory. 71
Economic geographers Roger Hayter and Trevor Barnes (2001) have determined that the
Canadian economy has operated in accordance with the staples theory since
Confederation in 1867, when Canada’s exportation of staples resources to European nations first began.72 Simon Fraser University geographer, Roger Alex Clapp, further expands on Innis’ theory in his categorization of Canadian business cycles as “resource cycles.”73 Clapp (1998) explains that the development of Canadian communities based on the extraction of natural resources, such as twentieth-century fishing or forestry towns, have almost always failed because resource stocks eventually deplete while production and extraction costs rise, which cause industries to reduce their costs and restructure their labour.74
!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!! 68 Zhehui Luo, Alexander Cowell, Yulta Musuda, Scott Novak, and Eric Johnson, “Course of Major Depressive Disorder and Labour Market Outcome Disruption,” Journal of Metnal Health Policy and Economics 13, no. 3 (2010): 135-149. 69 Abel et al., Macroeconomics; Roger Hayter, and Trevor Barnes, “Canada’s resource economy,” Canadian Geographer 45, no. 1 (2001): 36-41. 70 Harold Innis, The Fur Trade in Canada (Toronto: University of Toronto Press, 1930). 71 Ibid. 72 Hayter and Barnes, “Canada’s Resource Economy,” p. 39. 73 Roger Alex Clapp, “The Resource Cycle in Forestry and Fishing,” The Canadian Geographer 42 (1998): 129-144. 74 Ibid.
18 1.4.1 Town Planning in Response to Economic Change
Town planning in Canada has developed alongside staples industries and in response to their resource cycles. Since the 1920s, corporations—often internationally owned—established resource-extraction based work settlements in undeveloped parts of
Canada, and would abandon the area once resources were depleted.75 These settlements differed based on the permanency that corporations wished to establish. The most temporary form of a resource-based settlement is a “camp town,” where transient workers temporarily (and often, seasonally) live in camp-style settlements owned and operated by their employer, for whom they work extracting natural resources. Historic examples of camp towns include those set up during British Columbia’s gold rush era in the 1860s, such as Barkerville (1860s) and Emory Creek (1858).76 Contemporary examples of camp towns also exist, such as the settlements established and managed by oil companies around the Alberta tar sands, and fracking-related industries in Saskatchewan.77 This shows that despite the potential shortcomings of camp towns (i.e. disorganization, crowdedness), this planning model has continued throughout Canadian history due its timely and profitable benefit to companies. While camp towns are an interesting component of Canadian economic history, their lack of permanent residents make this population difficult to study, especially when considering issues as complex as mental health.
!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!! 75 Hayter and Barnes, “Canada’s Resource Economy,” p. 38. 76 “Concise History of Barkerville,” Barkerville Historic Town, last modified 2013, accessed April 25, 2013, http://www.barkerville.ca/history.htm; “About This Park,” Emory Creek Provincial Park, accessed April 25, 2013, http://www.env.gov.bc.ca/bcparks/explore/parkpgs/emory_crk. 77 For example, areas around Fort McMurray, Alberta and Melfort, Saskatchewan.
19 Another type of resource-based settlement common to pre-1970s Canadian resource development is the “company town.”78 Company towns were established with the same purpose as camp towns, although they were meant for the longer term.
Companies built infrastructure around an area where they extracted natural resources, often by building factories or mills, and closed operations when they were no longer economically profitable.79 One example of a company town is Anyox, BC, a copper mining town where the Granby Company owned and operated all aspects of the semi- permanent settlement, including the houses, school, water, sewage, and the grocery store.80 When the mine shut down in 1935, the town was abandoned by the Granby
Company and its residents were forced to move out.81 Countless examples of company towns exist across Canada, and have similar histories of economic growth and decline as the result of resource depletion and market fluctuations. The main problems of company towns emerged from the economic power over the community held by the corporations who managed them, and their unaccountability for the welfare of their workers.82 More information regarding company towns and their effects within communities can be found in Rex Lucas’ (1991) work, Minetown, Milltown, Railtown: Life in Canadian
Communities of Single Industry.83
A final example of a town plan connected to economic change is the “Instant
Town”—a comprehensively designed town constructed quickly, with permanence in !!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!! 78 Hayter and Barnes, “Canada’s Resource Economy,” p. 39. 79 Greg Halseth and Lana Sullivan, “From Kitimat to Tumbler Ridge: A Crucial Lesson Not Learned in Resource-Town Planning,” Western Geography 13/14 (2003/2004): 132-160. 80 Pete Loudon, “Gone But Not Forgotten,” Canadian Geographic Jan/Feb (1992): 61-64, p. 61, as referenced in Halseth and Sullivan, “From Kitimat to Tumbler Ridge.” 81 Ibid. 82 Allen Seager, “Company Towns,” The Canadian Encyclopedia, 2012, accessed June 2, 2013 from www.thecanadianencyclopedia.com/articles/company-towns. 83 Rex Lucas, Minetown, Milltown, Railtown: Life in Canadian Communities of Single Industry (Don Mills: Oxford University Press, 2008).
20 mind, that was intended to avoid the pitfalls of previous unplanned boom towns (e.g. labour turnover; housing shortages; violence). Following a discussion of the existing literature on company towns and mental health, this study will introduce the Instant Town of Kitimat, British Columbia, and how mental health was examined in this community.
1.4.2 Company Towns and Mental Health
Literature regarding company towns and mental health is scarce. As shown in
Table 1.2, the search for terms “company town” and “mental health” in title, abstract, keyword, and full-text returned zero results for the following databases: Academic Search
Complete, EconLit, PsychNet and PubMed. This represents a substantial literature gap across the disciplines of social sciences, economics, psychology, and medicine. Even when the search strategy was expanded to include “company town” OR “resource-based community” (which captured alternate wordings for “community”) AND “mental health.”
Again, as shown in Table 1.2, the results were scarce. So not to miss potential articles, the title and abstracts for each of the articles retrieved for “company town” or “resource- based community” were reviewed in each database for their relevance to this project; however, the vast majority of articles focused on paternalism, urban design, and social policy. Subsequent literature regarding mental health and company towns was gathered through searches of the reference lists of key papers, 84 grey literature, and recommendations from colleagues.
!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!! 84 For example, those identified in Zivin et al.’s (2011) review on population mental health.
21 Table 1.2 Number of articles retrieved by database search for key terms
Database Search Terms mental health mental health mental company resource-based AND AND resource- health town community company town based community Academic Search 210, 984 210 3 0 1 Complete EconLit 1, 239 19 0 0 0 PsychINFO 36, 830 11 1 0 0 PubMed 180, 809 75 44 0 2 Search conducted May 22, 2013 through University of Calgary library.
1.4.3 Case Studies of Mental Health and Resource-Based Communities
There is a lack of in-depth case studies in the literature that examine the effects of
economic change on mental health over time, and much research is required to address
the literature gap for economic change, resource-based communities, company towns,
and mental health. This section highlights two studies that best address both aspects of
mental health and economic change in the context of resource-based communities. The
first example is a qualitative case study that examines masculinity and depression among
workers in the lumbering resource-based community of Prince George, British
Columbia.85 The second example is a synopsis of the decades of work produced by
Alexander Leighton and colleagues from the Stirling County study, which looks at a
resource-based community in Atlantic Canada from the perspective of psychiatric
epidemiology.86
Stephanie Coen et al. (2013) of the University of British Columbia’s School of
Nursing conducted a study with nine heterosexual couples living in Prince George,
!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!! 85 Stephanie Coen, John Oliffe, Joy Johnson, and Mary Kelly, “Looking for Mr. PG: Masculinities and Men’s Depression in a Northern Resource-Based Canadian Community,” Health and Place 21 (2013): 94- 101. 86 Alexander Leighton, My Name Is Legion: The Stirling County Study of Psychiatric Disorder and Sociocultural Environment, vol. I (New York: Basic Books Inc., 1959).
22 British Columbia, where the male partner self-identified as living with depression.87
Through thematic analysis, Coen et al. (2013) found that the qualities that couples liked about Prince George, a city in the BC interior dependent on the lumber industry (e.g. snow, quiet, close-knit community), also contributed to their experience of depression
(e.g. poor weather, isolate, gossip).88 In describing the mentality of depressed men, the authors found that because of the attributes of strength and stoicism related to dominant masculinity in this community, men with depression were unlikely to go to the doctor or seek treatment for their illness.89 Coen et al. define the idealized Prince George man as
“strong, indefatigable, impenetrable; he commanded nature, extracting natural resources and turning them into consumer products.”90 In Prince George, the ideal masculinity was that of a heterosexual, blue-collar, resource-based workingman who “personified physical and mental endurance” as well as “an indomitable work ethic.”91 Coen et al.’s study speaks to the masculine ideals that currently dominate in this resource-based community, and how they affect the way that individuals experienced mental health. As well, Coen et al.’s study lends well to this project due to the interpretive way that mental health is explored.
The second study to majorly inform this project is the Stirling County Study. The
Stirling County Study is a longitudinal psychiatric epidemiologic study that has been ongoing since 1952.92 The study collects information from a representative sample of a resource-based community (population approximately 20,000) in Atlantic Canada
!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!! 87 Coen et al., “Looking for Mr. PG,” p. 94-101. 88 Ibid., p. 97. 89 Ibid., p. 97-98 90 Ibid., p. 98. 91 Ibid., p. 98. 92 Jane Murphy and Alexander Leighton, “Chapter 5: Repeated Investigations of Prevalence: The Stirling County Study,” Acta Psychiatrica Sandinavica 79, S348 (1989): 45-59.
23 (pseudonym “Stirling County”) whose livelihood is predominantly fishing, lumbering, and farming.93 Through the collection of psychiatric treatment records, general physician reports, face-to-face interviews, and computer analysis, Leighton et al. determined in
1952 that the baseline of all psychiatric disorders94 was about 20%.95 Murphy (1980)96 found that for this community the lifetime prevalence of those suffering from “a disabling episode of depression and/or anxiety” remained constant at about 12% for samples drawn in 1952, 1962, 1970.97 Considering depression only, the study reported overall lifetime prevalence to remain constant at about 5 percent for sample drawn from 1952 to 1992.98
In their discussion for this trend, Murphy et al. (2000) report their understanding that depression is a complex disorder that combines both genetic and social circumstances.99
What is important to note, is that the Stirling County study’s lifetime prevalence of depression and anxiety remained constant despite the social and economic changes that occurred throughout the community: 1) increased transportation, 2) decline of population working in primary industries, 3) increase of service industries, 4) increased standard of living; 5) increased women into the labour force; among others.100 The two studies mentioned provide good context for the examination of the relationship between
!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!! 93 Ibid., p. 45-59. 94 This included “organic brain syndromes, mental retardation, psychoses, psychoneuroses, and well as disorders in the psychophysiologic and personality categories.” As cited in Murphy et al. “Chapter 5,” p. 45. 95 Alexander Leighton, My Name Is Legion: The Stirling County Study of Psychiatric Disorder and Sociocultural Environment, vol. I (New York: Basic Books Inc., 1959). 96 Jane Murphy, “Continuities in Community-Based Psychiatric Epidemiology,” Archives of General Psychiatry 37(1980): 1215-1223. 97 Murphy et al. “Chapter 5,” p. 45-59. 98 Jane Murphy, Nan Laird, Richard Monson, Arthur Sobol, Alexander Leighton, “A 40-Year Perspective on the Prevalence of Depression: The Stirling County Study,” Archives of General Psychiatry 57, no. 3 (2000): 209-215, accessed May 23, 2013, http://archpsyc.jamanetwork.com.ezproxy.lib. ucalgary.ca/article.aspx?articleid=481578 99 Murphy et al., “A 40-Year Perspective on the Prevalence of Depression,” n.p. (HTML format). 100 Jane Murphy , “The Stirling County Study: Then and Now,” International Review of Psychiatry 6 (1994): 329-348.
24 economic change in a resource-based community and mental health in depth, which is the focus of this thesis.
1.5 Kitimat, British Columbia
Following the Second World War (1950s), Canada experienced a resurgence of resource expansion throughout the country, which resulted in a number of new communities.101 In response to the problems associated with company towns, namely their vulnerability to economic change, a new type of town model was adopted in an attempt to maintain a stable workforce after the “boom” of resource extraction had passed. 102 This new model, the “Instant Town” was meant to “create a livable environment for the workers and their families, while at the same time, keeping all non- production costs for the company as low as possible.”103 In contrast to company towns, instant towns were incorporated as municipalities prior to industrial development, and never owned by a single company. Additionally, instant towns were more comprehensively planned, and considered the social needs of their workforce. For example, houses were built in residential areas located away from the noise and pollution of industry.104 One of the earliest examples of a comprehensively planned instant town is
Kitimat, British Columbia, after which later towns such as Mackenzie, BC (incorporated
1966) and Tumbler Ridge, BC (incorporated 1981) have been modeled.105
!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!! 101 J.H. Bradbury, “Class Structures and Class Conflicts in 'Instant' Resource Towns in British Columbia— 1965 to 1972,” BC Studies: The British Columbian Quarterly 37(1978): 3-18. 102 Greg Halseth and Lana Sullivan, “From Kitimat to Tumbler Ridge: A Crucial Lesson Not Learned in Resource-Town Planning,” Western Geography 13/14 (2003/2004): 132-160. 103 Ibid. 104 Ibid. 105 Ibid.
25 Kitimat, British Columbia is located on the Northwest Coast of British Columbia, at the head of the Kitimat Arm of the Douglas Channel.106 Due to its deep-sea harbor sheltered by coastal mountains, and its relatively close proximity to Vancouver (650km north coast), Kitimat was seen as an ideal development for the Province. While human occupation in the area prior to this period will not be explored for this project, it is important to note that Kitimat has a rich First Nations history extending thousands of years.107
For nearly 9000 years, the Haisla First Nation has occupied a portion of the
Kitimat Arm (located 3 km upriver of the Kitimat town site), for use as an oolichan and salmon fishing village.108 Today, the Haisla settlement—the Kitamaat Village (11 km from the townsite)—consists of approximately 1500 residents who form eight matrilineal clans, governed by a hereditary chief.109 Like a number of First Nations, Inuit, and Metis
(FNIM) groups across Canada, the Haisla adopt a holistic model of health consistent with traditional Aboriginal culture.
The mental health of FNIM groups, such as the Haisla, has been influenced historically by culturally specific events, such as colonization, assimilation, and the
!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!! 106 District of Kitimat, Kitimat, British Columbia: Community Profile [DRAFT], 2009, http://www.kitimat.ca/assets/Residents/PDFs/community-profile.pdf, Accessed September 2011. 107 For more information on the history of the Haisla, see Charles Hamori-Torak, “The Haisla,” in Handbook on North American Indians, ed. Wayne Suttles (Washington, DC: Smitchsonian, 1991); Ivan Lopatin, Social Life and Religion of the Indians in Kitimat, British Columbia (Los Angeles: USC Press, 1945); Ronald Olson, The Social Organization of the Haisla of BC (Anthropological Records) (New York: Kraus Reprint Co., 1976 [1940]), p. 200; Gordon Robinson, Tales of Kitamaat, 6th ed., (Kitimat: Northern Sentinel Press, 1975); Nancy Turner, Food Plants of Coastal First Peoples (Vancouver: UBC Press, 1995); Janice Beck, Three Towns: A History of Kitimat, 4th ed. (Victoria, BC: Trafford Publishing, 2009); Haisla Nation Council, Historical and Documentary Corroboration Regarding the Haisla Nation’s Occupation of its Traditional Territory [Expert Report], Eric Wolfhard, A37859 (December 19, 2011), 46 pgs., accessed May 22, 2013, http://www.ceaa-acee.gc.ca/050/documents_staticpost/cearref_21799/56568/A37859_- _Eric_Wolfhard_Report.pdf. 108 “History,” Haisla First Nation, http://haisla.ca, accessed April 11, 2013. 109 Ibid.
26 legacy of residential schools.110 This is shown through disproportionate representations of
FNIM individuals regarding adverse mental health outcomes for suicide, self-injury, substance abuse, and depression.111 While it is important to note that this rich, complex, and compelling history of mental health exists for FNIM groups, due to the limited geographical scope (Municipality of Kitimat) and time frame for this project (1950-2010) it will not be examined at length. More information on FNIM mental health can be found through the National Aboriginal Health Organization, 112 Health Canada, 113 and the
Mental Health Commission of Canada.114 Further readings regarding the history of the
Haisla Nation, and its relation to the Kitimat Project can be found in Janice Beck’s (2009) short history in Three Towns: A History of Kitimat,115 and Elizabeth Varley Anderson’s
(1981) recollection life at the Kitamaat Village in her biographical history, Kitimat, My
Valley.116
Like much of Northern British Columbia, Kitimat is the product of post-World
War II provincial policy that sought to develop “the province’s hinterland regions as a resource bank from which to ‘withdraw’ wealth for the benefit of the provincial economy.”117 Kitimat has experienced several distinct stages of economic growth in its short history (incorporated as a Municipality in 1952), and has remained a community
!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!! 110 “Mental Health and Wellness,” Health Canada, First Nations and Inuit Health, last modified February 4, 2013, accessed June 1, 2013, http://www.hc-sc.gc.ca/fniah-spnia/promotion/mental/index-eng.php. 111 Ibid. 112 National Aboriginal Health Organization, 2013, accessed May 31, 2013, www.naho.ca. 113 Health Canada, “First Nations & Inuit Health,” last modified December 17, 2012, accessed June 1, 2013, http://www.hc-sc.gc.ca/fniah-spnia/index-eng.php. 114 Mental Health Commission of Canada, “Issue: First Nations, Inuit and Metis,” 2013, accessed June 1, 2013, http://www.mentalhealthcommission.ca/English/issues/first-nations-inuit-andmétis?routetoken=7696 59f960c8a476cc9da91e66f55ec7&terminitial=59. 115 Beck, Three Towns. 116 Elizabeth Varley Anderson, Kitimat, My Valley (Terrace, BC: Northern Times Press, 1981). 117 Sean Markey, Greg Halseth, and Don Manson, “Challenging the Inevitability of Rural Decline: Advancing the Policy of Place in Northern British Columbia,” Journal of Rural Studies 24, no. 4 (2008): 409-421.
27 despite industrial layoffs and closures. These factors make Kitimat the ideal case through which to study the effects of economic change on mental health, and contribute to the aforementioned literature gap. This thesis examines the relationship between mental health, holistically conceptualized for the resource-based community of Kitimat from its
1952 incorporation to 2010. An economic history and interpretive analysis of mental health is provided for each of Kitimat’s three periods of economic development: Stage 1:
Construction, 1950-1959; Stage 2: Diversification, 1960-1979; and, Stage 3:
Development, 1980-2010.
1.5.1 Overview of Mental Health in Kitimat
It is difficult to assess the state of mental health in Kitimat epidemiologically or historically, as limited information exists. This section will attempt to provide an overview of mental health in Kitimat based on existing evidence and grey literature available, and place it in the context of mental health for Northern British Columbia, and the province of BC as a whole. In their 2011 report, Healthy Northern Communities
2011: District Municipality of Kitimat, Northern Health (Kitimat’s regional health authority) reported an estimated 3,010 existing cases of depression in Kitimat.118 While this is the only mental health measure that Northern Health provided, it is significant.
Based on Kitimat’s population provided by Northern Health in the same report—9,178— this translates to a crude estimate for the point prevalence of depression at 32.78 percent.
To place this in perspective, the crude annual prevalence reported for British Columbia in
!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!! 118 “Healthy Northern Communities 2011: District Municipality of Kitimat,” Northern Health Authority, last modified August 6, 2011, accessed June 8, 2013, http://chip.northernhealth.ca/Portals/2/Document% 20Repository/2011%20Updates/Community%20Profiles%202011/LHA%20080%20- %20Kitimat%20DM.pdf.
28 2008 was over ten percent lower, at 21.8 percent.119 The annual report published for 1999 by the Provincial Health Officer, Penny Priddy (b. 1944), reported that 5 percent of
British Columbians were depressed in 1996-7.120 Unfortunately, no comparable data exists for Kitimat prior to the 2011 report mentioned above, for they do not report the same measures (e.g. estimated cases of depression) across time.
In the province as whole, statistical information for mental health varies greatly by time frame, outcome, and area. Some information from Statistics Canada is available on various mental health issues in the Province, but are only available to the public beginning in 1994: life stress (point prevalence of self-report “high life stress” 1994
[24.7%]; 2003 [21.7%]; 2005 [22/7%]), probably risk of depression (1994 [5.8%]; 1996
[5.1%]; 1998 [4.8%]; 2000 [8.3%]).121 Other forms, like administrative data, provide information for British Columbia as a whole, but not for Kitimat or the Northwest region.
For example, Statistics Canada reports data on residential care facilities in British
Columbia for mental disorders from 1948 to 2010 regarding bed capacity, length of stay, occupancy, separations, patient-days, and number operating.122 The limitation of mental hospital data is that they show admission and occupancy numbers (summarized in
Appendix B), but do not further contextualize these outside of the institution.123
!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!! 119 Ibid. 120 Province of British Columbia, Provincial Health Officer, A Report on the Health of British Columbians, 1999: Provincial Health Officer’s Annual Report (Victoria: Ministry of Health and Ministry Responsible for Seniors, 1999), accessed June 8, 2013, http://www.health.gov.bc.ca/pho/pdf/phoannual1999.pdf 121 These findings can be generated through Statistics Canada’s CANISM function at http://www5.statcan.gc.ca/subject-sujet/resultresultat.action?pid=2966&id=2443&lang=eng&type= ARRAY&pageNum=1&more=0, accessed June 8, 2013. 122 These findings are retrievable through Statistics Canada, Historical Statistics of Canada, Section B: Vital Statistics and Health (Series B1-81), last modified October 22, 2008, accessed June 8, 2013, http://www.statcan.gc.ca/pub/11-516-x/sectionb/4147437-eng.htm#2. 123 Personal email communication with Dr. Geertje Boschma, June 8, 2013. Dr. Boschma is an associate professor and historian of mental health nursing at the University of British Columbia. Dr. Boschma has worked and published on the history of asylums in BC. See Geertje Boschma, “Deinstitutionalization
29 Academic publications that address mental health in British Columbia prior to
1994 include a history of Provincial Mental Health Services before 1961, 124 a commentary on trends in BC admission procedures to mental hospitals,125 and a survey of groups across Canada treating alcoholism in 1960, that includes BC.126 Other papers focus on the mental retardation of children in BC in the general population (1952-
1960),127 or those with phenylketonuria—a metabolic genetic disorder (1950-1971).128
Some information from Statistics Canada, informed by the Canadian Community Health
Survey (CCHS), shows information for the Northwest Service Delivery Area, which
Kitimat belongs to, from 2003 to 2011 regarding perceived mental health, life satisfaction, alcohol consumption and mood disorder. However, the majority of these conditions were consistently marked by Statistics Canada as too unreliable to be published, or to be used with caution, based on the limited number of residents sampled in the Northwest.129
Therefore, the major contribution of this study is the insight it provides for mental health
!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!! !
Reconsidered: Geographic and Demographic Changes in Mental Health Care in British Columbia and Alberta, 1950-1980,” Social History 44, no. 88 (2011): 223-256. 124 Richard G. Foulkes, “British Columbia Mental Health Services: Historical Perspective to 1961,” Canadian Medical Association Journal 85 (1961): 649-655. Mental health services that existed before 1961 included jails (until 1871), asylums (until 1901), moral treatment (until 1919), custodial care (until 1950), and rehabilitation clinics and hospitals (until 1961). 125 R.R. Maclean, “Present Day Trends in Regulations Governing Admission to Psychiatric Hospitals,” Canadian Medical Association Journal 68 (1953): 199-121. This work by R.R. Maclean found that individuals were admitted to institutions either voluntarily, involuntarily, or by warrant/court order. 126 Morgan Martin, E.W.R. Best, Gordon Josie, and R. LeBlanc, “Survey of Organizations in the Field in Alcoholism in Canada, 1960,” Canadian Medical Association Journal 88 (1963): 982-989. Organizations treating alcoholism in the field in British Columbia included general hospitals (5), a psychiatric unit, mental hospitals (3), a charitable foundation, industrial organizations (3), Salvation Armies (2), a medical clinic, and prisons (2). 127 D.H.G. Renwick, “Estimating Prevalence of Certain Chronic Childhood Conditions by Use of a Central Registry,” Public Health Reports 82, no. 3 (1967): 261-269. 128 R.B. Lowry, B. Tischler, W.H. Cockcroft, and C.H.G. Renwick, “Incidence of Phenylketonuria in British Columbia, 1950-1971,” Canadian Medical Association Journal 106 (1972): 1299-1302. 129 Statistics Canada, “Table 105-0501—Health indicator profile, annual estimates, by age group and sex, Canada, provinces, territories, health regions (2011 boundaries) and peer groups, occasional,” CANSIM (database), accessed June 8, 2013 from http://www5.statcan.gc.ca/cansim/a47.
30 in Kitimat using qualitative and historical methodology, where statistical or longitudinal information is not available.
The use of Kitimat for this case study suggests a methodological model through which other Canadian towns can be studied for similar mental health-related research questions, despite the limitations of statistical data that may be present. The qualitative and historical methods used in this project, outlined in detail in Chapter 2, provide a way through which to examine mental health problems, understandings, and experiences over time in a population even where quantitative data does not exist. This project presents an in-depth look behind statistical findings, by analyzing an extremely rich source of data collected and examined for this project, using historical methods.
1.6 Contribution to the Literature
While a reasonable body of literature exists for mental health and economic change, it is limited in a few ways. First, existing literature overwhelmingly consists of studies that aim to quantify measures of suicides, prevalence of mental illness, and service utilization. While these are effective methods for study, they fail to capture the complexities of mental health within local economies, or community reactions to economic change. Additionally, while useful for an array of purposes, the instruments used to collect information regarding mental health are designed within the context of a biomedical perspective of mental health, i.e. using symptomatic or diagnostic criteria to determine prevalence or incidence of disorder. The qualitative methods used in this study offer a new, in-depth approach to the studying mental health and economic change at the population level. Interviews with long-term Kitimat residents and analysis of archival
31 documents (see Chapter 2) allow for the in-depth study of mental health and economic change from a holistic mental health perspective.
32 ! !
Chapter 2: Methodology
2.1 Methodological Approach: Content Analysis
To understand how residents of Kitimat, BC have experienced and defined mental health (see Section 1.2.3) since 1950, I conducted a content analysis of historic and recent materials produced by this population. In this section I will first describe my methodological approach, followed by details of the specific methods I used for sampling, data collection, and analysis to answer the research question: how have discourses of mental health changed alongside economic change throughout the history of Kitimat,
British Columbia?
2.1.1 Content Analysis
Political scientist and professor emeritus, Ole Holsti, broadly defines content analysis as “any technique for making inferences by objectively and systematically identifying specified characteristics of messages” in his (1969) work Content Analysis for the Social Sciences and Humanities. 1 Behavioural scientist Bernard Berelson and sociologist Paul Lazarsfeld first coined the term “content analysis” in their 1948 publication The Analysis of Communication Content.2 Initially, Berelson and Lazarsfeld used content analysis as a way to quantify content from texts, images, or symbolic materials by reading them systematically. 3 However, following Berelson’s (1952)
!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!! 1 Ole R. Holsti, Content Analysis for the Social Sciences and Humanities (Reading, MA: Addison-Wesley, 1969), p. 14. 2 Klaus Krippendorff, Content Analysis: An Introduction to Its Methodology, 2nd ed. (Thousand Oaks: Sage Publications, 2004), p. 11. 3 Bernard Berelson and Paul Lazarsfeld, The Analysis of Communication Content (Chicago: University of Chicago Press, 1948); Krippendorff, Content Analysis, p. 3 33 ! ! ! ! publication Content Analysis in Communications Research, 4 content analysis was adapted for use in a number of disciplines that increased the ways it was used for analysis and interpretation, providing rich understandings of the social processes that underlie findings from the quantification and summarization of text.
Over time, specialized forms of content analysis emerged to meet the needs of different research questions for different fields, particularly in the social sciences.5 While
I will not discuss the history of content analysis at length, I will highlight some discipline-specific forms that emphasize the different ways of systematically reading and interpreting texts. One example is ethnographic content analysis, which is used by anthropologists to address the context within which social actors interact.6 Another example is directed content analysis, where the codes are predetermined by the researcher prior to data analysis and are used to support or disprove a theory.7 Yet another form of content analysis is summative content analysis, where the researcher defines keywords before, after, and during analysis and codes their data according to their use or non-use.8 For this study, I followed the style of general qualitative content analysis to explore my data.
2.1.2 Qualitative Content Analysis
Because I focused on extracting content to inform a historical narrative that addresses the components specific to my research question, this study follows the general method of qualitative content analysis, as described by renowned content analyst and
!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!! 4 Bernard Berelson, Content Analysis in Communications Research (New York: Free Press, 1952). 5 For further reading see Krippendorff, Content Analysis. 6 David Altheide, “Ethnographic Content Analysis,” Qualitative Sociology 10, no. 1 (1987): 65-77. 7 Hsui-Fang Hsieh and Sarah E. Shannon, “Three Approaches to Qualitative Content Analysis,” Qualitative Health Research 15, no. 9 (2005): 1277-1288. 8 Ibid., 1286. 34 ! ! ! ! Professor Emeritus of Communication, Klaus Krippendorff, in his 2004 work Content
Analysis: An Introduction to Its Methodology. Krippendorff acknowledges some characteristics shared amongst all disciplines that use content analysis as a qualitative methodology: 1) content analysis involves a close reading and rereading of texts; 2) read material is organized into the narrative form through the researcher’s interpretation; and,
3) content analysis as a methodology assumes that social and cultural context affects the writing, reading, and interpretation of texts.9
A fundamental knowledge assumption to content analysis is the recognition that texts do not have a single interpretation.10 To maximize the rigour of understandings of mental health in Kitimat, I triangulated my findings by analyzing texts produced by an array of authors, such as community organizations, long-term residents, and the
Municipal Council. In this way, I hoped to identify content that held true for the community as a whole, throughout the various stages of Kitimat’s economic development. Krippendorff acknowledges this necessity in the context of historical study, wherein “historians are keenly aware of the need to place the documents they analyze within the context of other relevant documents.”11
While this study follows the content analytic tradition, it is important to note that
I also use the term “discourse” borrowed from discourse analysis, an alternate methodology used to analyze text, with different underlying knowledge assumptions about language and its use. In this study I use “discourse” generally to refer generally to a collective and shared understanding within my population, based on written and spoken content. For example, I might refer to the “discourse of the family ideal” to represent the !!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!! 9 Krippendorff, Content Analysis, p. 17. 10 Ibid., p. 17. 11 Ibid., p. 26-7. 35 ! ! ! ! shared understanding of ideal family life that existed in Kitimat for the time (e.g. heterosexual parents and corresponding gender roles).
The discourses represented in this study focus on what has been communicated by permanent residents of Kitimat to each other, political leaders, and the community at large. While there are a plurality of discourses at play within the community of Kitimat, for any given time period, the discourses presented (e.g. family ideal; medical services) have been chosen to represent community understandings of mental health, due to their emergence as dominant discourses during analysis. It is important to acknowledge that a plurality of discourses do exist, and that the findings of this study could have differed, had an alternate discourse been represented. For example, the discourse of the local trade unions (e.g. United Steelworkers Union or American Federation of Labor) may have provided a less favourable picture of the economy or the mental health of its workers, due to their public conveyance of fear regarding job loss, the deskilling of workers, new technology, wage and labour disputes, or dissatisfaction with management. In Kitimat, the National Automobile, Aerospace Transportation and General Workers Union of
Canada (CAW-Canada) Local 2301—which represents Alcan hourly workers—has been an especially strong advocate for the health of their employees, through the bargaining for collective agreements with the Company that cover an extensive range of health concerns. Regarding mental health, as of 2011 the Union had negotiated a reimbursement for a maximum $800 for visits with a clinical psychologist, in addition to providing their
36 ! ! ! ! own counseling team for workers, as well as covering the full cost of recovery treatment for those suffering from drug and alcohol abuse.12
While unions do represent the voice of workers, this discourse was not examined specifically, to allow for the incorporation of children and the families of workers in addition to union members. Therefore, the main actors who are represented in the discourses for this thesis are Kitimat’s permanent residents; workers and families from a number of occupations and cultural background who collectively engage in a shared understanding of mental health.
2.1.3 Rationale for Content Analysis
My rationale for conducting historical study using content analysis lies in my desire to address a multi-faceted research question. The various components of this research question—economic change, mental health, local history—resulted in a large volume of materials identified as relevant and informative to this project. I chose content analysis as my methodology, primarily because it is an ideal method for qualitative research that deals with large amounts of data. As “a systematic, replicable technique for compressing many words of text into fewer content categories based on explicit rules of coding,” it allowed for the revision of a vast amount of collected archival materials, in an organized way that informed my research question.13
Another reason for choosing content analysis is because of my project’s interdisciplinary nature in both history and population health. Content analysis is used by
!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!! 12 Collective Labour Agreement between Rio Tinto Alcan Primary Metal North America and National Automobile, aerospace Transportation and General Workers Union of Canada (CAW – Canada) Local 2301, accessed September 9, 2013, http://www.caw2301.ca/files/2007CAW2301CLA_0.pdf. 13 Steve Stemler, “An Overview of Content Analysis,” Practical Assessment, Research & Evaluation 7, no.17 (2001): HTML format, accessed May 26, 2013 from http://PAREonline.net/getvn.asp?v=7&n=17. 37 ! ! ! ! a number of disciplines,14 which lends its use in examining the different components of my research question. As I am interested in a deep and holistic understanding of mental health throughout the history of Kitimat, informed by periods of economic change, it was necessary to choose a methodological approach that allowed for the exploration of the historical, social, medical, and economic components of this study.
2.2 Data Collection and Sampling
I extracted content from a number of different sources to construct my historical narrative regarding mental health and economic change in Kitimat. I use the term texts to refer collectively to the sources collected, which appeared in written form originally
(printed archival materials) or after transcription (participant interviews). This section is divided into two parts to describe the data collection and selection/sampling techniques used for each archival materials and participant interviews.
2.2.1 Archival Materials
The archival materials used in this study included: newspapers, regional health policy, oral histories, narratives, diaries, economic development strategies, meeting minutes, museum exhibition notes, spending reports, etc. These materials were selected based on consultation with Kitimat archivists, and the specific criteria laid out in Section
2.2.1.1. Below, Table 2.1 provides an overview of the types of archives used, the format in which they appeared, and the authors they included. For a more complete listing, see
!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!! 14 Such as Gordon Allport, Alfred Baldwin, Ralph White, or Charles Osgood et al.’s use in psychology, or Ward Goodenough’s use in anthropology. See Gordon Allport, The Use of Personal Documents in Psychological Science (New York: Social Science Research Council, 1942); Alfred Baldwin, “Personal Structure Analysis: A Statistical Method for Investigating the Single Personality,” Journal of Abnormal and Social Psychology 37 (1942): 168-183; Ralph White, “Black Boy: A Value Analysis,” Journal of Abnormal and Social Psychology 42(1947): 440-461; Charles Osgood, George Suci and Percy Tannenbaum, The Measurement of Meaning (Urbana: University of Illinois Press, 1957); Ward Goodenough, “Componential Analysis,” in James P. Spradley (ed.) Culture and Cognition, pp. 327-343 (San Francisco: Chandler, 1972); Krippendorff, Content Analysis, p. 11. 38 ! ! ! ! Appendix C. All archival resources analyzed for this project were publicly accessible through the Kitimat Centennial Museum and Archives, Kitimat Public Library, or the
District of Kitimat.
Table 2.1 Examples of format, type, and authors of archival resources
Type Format Authors
Books Ethnography • Community Organizations History • Industries Non-fiction • Local Individuals Story collection • Municipal Council
Minute books Meeting minutes • Business Organizations • Community Organizations • Municipal Council Periodicals Newsletters • Business Organizations Newspapers • Community Organizations • Editors • Individual Contributors • Union Organizations Plans Community safety • Community Groups Economic development • Consultant Groups Social transformation • Individuals Urban development • Municipal Council
Proposals Industrial project proposal • Consultant Groups Urban development proposal • Community Organization • Industries • Municipal Council Reports Annual review • Businesses Census profile • Community Organizations Child care needs • Industries Community events • Hospital Community needs assessment • Municipal Council Financial/Spending • Social and economic transformations Studies Community resource usage • Academics Environmental/biological assessment • Business Organizations Industrial impact assessment • Consultant Groups Land usage • Community Organizations Neighbourhood development • Industries Retail market • Municipal Council Shopping and commuting patterns • Union Organizations !
!
39 ! ! ! !
!
Type Format Authors Other Brochures • Business Organizations Contracts • Community Organizations Letters • Individuals Museum exhibition notes Industries Pamphlets Personal communications Speeches Yearbooks
2.2.1.1 Access to Archival Materials
Documents that were accessed in their physical form were done so with the assistance of those responsible for managing archival resources during field research conducted in the summer of 2012. Archives at the Kitimat Public Library were available free of charge for public use, provided that individuals reviewed them on the premises and provided government identification (see Appendix D). Permission to research within archives maintained by the Kitimat Centennial Museum was granted by the curator and archivists, who generously waived the retrieval fee for use of their services (see
Appendix E). Archives housed at the District of Kitimat were available free of charge for public use, provided that individuals review materials on the premises, through consultation with the Municipal Clerk’s office (see Appendix F).
The curator, archivist, archivist’s assistant, or myself identified potentially relevant documents at the Kitimat Centennial Museum. With supervised access to the
Museum’s archival database, I searched using a number of keywords (e.g. “mental,”
“health,” “psych*,” “econom*”) to determine relevant collections, as outlined in
Appendix C. I also searched for more specific terms (e.g. “schizophrenia,” “depression,”
“recession”) to determine if they produced different results. The curator, who had read
40 ! ! ! ! my project proposal, then recommended additional sources she thought might have been of interest. Of the collections identified, those that were used needed to be onsite and retrievable. Some sources were excluded from review because they were located in offsite storage, mislabeled, or missing. The curator, archivist, or her assistant pulled collections for my review, where I reviewed them during the Museum’s hours of operation.
At the District of Kitimat, the minute books of the Municipal Council were accessed through the Office of the Municipal Clerk. The Deputy Municipal Clerk retrieved minute books for my review from the District’s vault, located within the
Municipal Hall. After reviewing each book and noting content relevant to the selection criteria outlined below (Section 2.2.1.2), I exchanged minute books with the Deputy
Municipal Clerk and she retrieved new ones. Access was not granted to the minutes of in-camera meetings of the Municipal Council. Minute books were reviewed onsite at the
Municipal Hall during its hours of operation. Municipal Council minutes published after
2008 were available online in portable document format; therefore, these minutes were reviewed offsite from the District office and were not subject to its hours of operation.15
Archives reviewed from the Kitimat Public Library came from the Library’s
Special Collections, which collects resources related to the history of and operations in
Kitimat. Archives of interest were identified through the library’s online database.16 In addition to a keyword search (as above), I also searched the call number “SpC” to browse the entire Special Collection for archives of interest. Once identified, I informed the
!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!! 15 “Council Minutes,” District of Kitimat, last modified 2013, accessed May 27, 2013 from http://www.kitimat.ca/EN/main/municipal/mayor-council/council-minutes.html. 16 “Kitimat Public Library Association,” Kitimat Public Library Association, last modified May 14, 2013, accessed May 27, 2013, http://kitimatpubliclibrary.org/. 41 ! ! ! ! librarian who retrieved resources for my review. Some materials identified were missing from the collection, thus not available for review. It was required to leave government- issued identification with the librarians for the duration of my review of archival documents.
2.2.1.2 Selection of Archival Materials
Archival materials regarding mental health were selected if they broadly addressed one or more of the criteria that make up the WHO’s holistic definition of mental health (Section 1.2.3): wellbeing; personal potential; life stress; work; personal productivity; contribution to the community. Additionally, as described in Section 1.2.3, some biomedical components of interest were also considered in understanding mental health through archival resources. Thus, archival materials were also selected if they addressed mental health services, or mental illness. Materials were selected this way to maintain consistency when interpreting definitions of mental health throughout Kitimat’s history.
Regarding economic change, archival documents were selected if they addressed economic development or recession, employment or unemployment, production, industry, or business. Materials were selected in this way to capture economic change through discussion of related activities, such as industrial projects, employment opportunities, or new business. Other documents included for analysis were those identified as essential background information to the history of Kitimat, such as the Master Plan that outlined the vision town planners had for Kitimat. These sources were abundant and easily found, thus they did not require specific search strategies. Nearly all of the archival documents
(e.g. pamphlets, articles, newspapers, letters, etc.) published before 1960 focus on
42 ! ! ! ! Kitimat as a planned urban development. Furthermore, the permanent exhibit at the
Kitimat Centennial Museum highlights the Kitimat Project and directs visitors and researchers to pertinent materials.
2.2.2 Semi-Structured Interviews
Semi-structured interviews were conducted with eight long-term residents of
Kitimat to inform areas of my research that were not found in the archives, such as community perceptions of mental health and social services. This section will first describe the sampling methods used to select interview participants, followed by the approach used to analyze the transcripts from these interviews. Additional information describing interview participants can be found in Appendix U.
2.2.2.1 Sampling of Interview Participants
Potential interview participants were identified through conversations with
Museum staff and community members familiar with my project. The identities of interview participants were kept anonymous, and their participation never made known to those who had recommended them. To be considered, participants needed to be over the age of 18 and have lived in Kitimat since at least 1997. This year was chosen to ensure that residents had lived through at least one of Kitimat’s economic changes, for example, the industrial closures that occurred in the community during the 2000s.
I contacted participants directly, by email or telephone, introduced my project, and myself and requested their participation for an interview regarding the changes they have seen in the community. All eight participants contacted agreed to participate, thus there was no need for snowball sampling as initially intended. Interviews ranged from 30 minutes to 2 hours, and were recorded via digital audio recorder. Each participant
43 ! ! ! ! consented to the interview process (see Appendix G), according to a procedure approved by the Conjoint Health Research Ethics Board at the University of Calgary.17
Interviews followed a semi-structured format, and participants were asked a number of questions that spoke to economic and community changes. Initially, the questions asked were very open-ended to limit my influence on their answer; however, where I lacked a pre-established relationship with participants, this format proved difficult. As a result, I added questions and probes where necessary, drawing on a participant’s particular experience to an issue or event. New areas of interest that emerged from one interview would inform the questions asked in the following interview.
As well, when interviewing a participant who had experience with something specific that was not present in the archives, I asked more direct questions (e.g. “Can you tell me about your time on city council?” or “Do you remember a psychiatric unit in the hospital?”). The interview guide is appended in Appendix I.
Following each interview, I transcribed participant’s audio recordings and returned them to each participant electronically. This way, participants had the opportunity to exclude information they did not want included in my analysis. Following permission from participants, interview transcripts were considered as written text and analyzed for relevant content in the same way as archival documents.
2.3 Analytic Approach
The analytic approach used for this study follows the steps identified by
Krippendorff (2004) in his fourth chapter of Content Analysis: An Introduction to Its
Methodology, “The Logics of Content Analysis Designs”:
!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!! 17 See Appendix H for copyright permissions for images used. 44 ! ! ! ! 1) unitizing: compile texts of interest to analysis 2) sampling: limit texts to a manageable, representative set 3) recording/coding: transform unedited texts into analyzable representations 4) reducing: tabulate data where duplicates exist 5) inferring: interpret meaning of phenomena backed by context 6) narrating: make results comprehensible to others.18
I compiled all texts identified as relevant (500+) into the qualitative software, NVivo 9.
Using this software, I simultaneously conducted steps 2, 3, and 4. Through the coding of each document for content and themes of interest that emerged (e.g. unemployment; recession; stress; social; housing), I excluded documents that did not fit into an existing code/theme, and/or did not warrant the creation of a new code/theme. Eventually, this reduced my dataset to a more manageable size, as only documents that were included in an identified code or theme were considered for interpretation in step 5. Meaning was interpreted for each of the themes by first organizing all content chronologically, and interpreting mental health against the context of economic materials. Finally, through writing my results, I completed step 6 by constructing a historical narrative from my interpretations.
2.3.1 Bracketing
While the qualitative research paradigm holds that complete objectivity is not possible, researchers aim to “not allow their assumptions to shape the data collection process and…not to impose their own understanding and constructions on the data.”19 In this way, researchers use bracketing in an attempt to suspend their judgments about the phenomena under study, to maintain as natural a setting as possible. For this project, I !!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!! 18 Klaus Krippendorff, “Chapter 4: The Logic of Content Analysis,” in Content Analysis: An Introduction to Its Methodology, second ed. (Thousand Oaks: Sage Publications, 2004), pp. 81-96. 19 Kathryn Ahern, “Ten Tips for Reflexive Bracketing.” Journal of Qualitative Health Research 9, no.3 (1999): 497-411, p. 407, accessed January 2013, http://qhr.sagepub.com/content/9/3/407; Michael Crotty, Phenomenology and Nursing Research (Melbourne, Australia: Churchill Livingston, 1996). 45 ! ! ! ! used the phenomenological reductionist method of bracketing for this project, wherein “a researcher [attempts to suspend] his or her presuppositions, biases, assumptions, theories, or previous experiences…by placing them outside the brackets, which then facilitates a focusing in on the phenomenon within the brackets.”20
As outlined by social worker Robin Gearing, I used a reflexive form of bracketing, where I recorded my personal convictions and experiences throughout my research in an attempt to avoid making preliminary judgments about my data, based on my own role as a former member of my community of study. I recognized that some subjectivity would be unavoidable during my observations, as I had lived in Kitimat for over 22 years, prior to this study. I attempted to separate my personal opinions and presuppositions regarding mental health in Kitimat from this project as a whole, by recording them and reflecting on them as often as possible throughout the duration of my research. I used this reflexive form of bracketing in an attempt to recognize my place and role within my research, as well as to recognize the biases that may shape my interpretations, to the greatest extent possible. By acknowledging this personal bias, I was not only able to increase the scientific rigour of my study, but also draw on my own experience in understanding
Kitimat discourses of population mental health to the fullest extent possible.
!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!! 20 Robin Gearing, “Bracketing in Research: A Typology,” Journal of Qualitative Health Research 14, no.10 (2004): 1430-1431, accessed January 2013, http://qhr.sagepub.com/content/14/10/142. 46 ! ! !
Chapter 3: Economic Opportunity and Kitimat’s Construction, 1950 to 1957
Figure 3.1 Map of Kitimat in relation to British Columbia1
Prince!Rupert!
Terrace! Prince!George!
Kitimat&
Vancouver!
© Google Earth 2013 3.1 Background to the Kitimat Project
Following the Second World War (WWII) the Province of British Columbia (“the
Province”) sought to diversify its economic base to increase resilience against potential postwar economic recession (see Appendix J for an example advertisement BC circulated to potential investors).2 In 1952, the people of British Columbia (BC) elected Premier William
!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!! 1 Further maps of Kitimat and contextualizing images can be found in Appendices K-P. 2 Alan Elder, “On the Home Front: Representing Canada at the Triennale di Milano, 1957” (MA Thesis, University of British Columbia, 2000), p. 29.
! 47 !
Andrew Cecil “W.A.C.” Bennett (1900-1979) of the Social Credit Party, whose campaign policy was aimed at provincial development and prosperity.3 In concordance with the Post-war
Rehabilitation Council—established to report on BC’s social and economic needs following
WWII—Premier Bennett advocated for industrial development to open new areas of the province and “absorb and re-settle the postwar labor supply.”4 It was Bennett’s determination to create employment opportunities that set the stage for the Kitimat Project. This project would create jobs and stimulate economic growth through the construction of a new town and an aluminum smelter.
The aluminum industry was a well-reasoned choice for postwar development in BC, because it represented what the Province was trying to achieve: progress, affluence, and use of its natural resources. Following WWII, aluminum was considered the progressive, “magic metal of the 20th century”5 for its wartime use building ships, airplanes and bridges.6
Aluminum also represented postwar prosperity and affluence to Canadians, as it was used in many consumer goods associated with home ownership and a middle-class lifestyle, such as utensils, toys, kettles, tables, chairs, bowls, siding, and window frames.7 Museum exhibits and
Expositions during the postwar era highlighted the connection between aluminum, consumerism, and progress in Canada. For example, in 1945 the Royal Ontario Museum displayed household objects made of aluminum next to aircraft propellers that were made in the Kingston wartime factory.8 Later in the decade, aluminum and affluence were chosen by the National Industrial Design Council (NIDC) to represent Canada at the 1957 Triennale di !!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!! 3 Sean Markey, Greg Halseth, Don Manson, “Challenging the Inevitability of Rural Decline: Advancing the Policy of Place in Northern British Columbia,” Journal of Rural Studies 24 (2008): 409-421, p. 412. 4 Markey et al., “Challenging the Inevitability of Rural Decline,” p. 413. 5 As cited in a translated article from Le Nouvelliste: “Alcan at Kitimat an industry spans Canada,” Le Nouvelliste, 19 November 1960, p. 11. 6 Dietrich-Collins, The Alcan Story, n.p. 7 Dietrich-Collins, The Alcan Story, n.p.; Elder, “On the Home Front,” p. 26. 8 Elder, “On the Home Front,” p. 29.
! 48 !
Milano’s international design exposition.9 In his Master of Arts thesis for the University of
British Columbia, Alan Elder describes how the NIDC used aluminum to represent a modern product, because it was made with sophisticated smelting technology used in many consumer goods.10 Finally, aluminum supported postwar development in the province because it would make use of BC’s abundant natural resources—water and land.
The community of Kitimat, BC (see Figure 3.1) exists not only as an artifact of postwar societal ideology outlined above, but also of the political ideology of the Province for the time. Kitimat was created in accordance with the 1950s Municipal Town Act amendments, with the explicit purpose of developing northern BC. The amendments to the Municipal Town
Act allowed companies to purchase land and petition for its incorporation prior to developing an area’s resources.11 Incorporation was desirable for companies because it relieved them of the legal responsibilities that came with owning a town, which included the provision of services and accommodation such as medical services and housing. Planning for the Kitimat
Project commenced in 1951, when the Honorable Edward Tourtellotte Kenney (1888-1974),
BC Minister of Land and Forests and member of the Liberal-Conservative coalition, invited the Aluminum Company of Canada (Alcan) to survey the Kitimat and Nechako watershed on behalf of the Province, to explore its potential to provide low-cost hydroelectricity for aluminum production.12
!
!
!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!! 9 Ibid., p. 62. 10 Ibid., p. 67. 11 Greg Halseth and Lana Sullivan, Building Community in an Instant Town: A Social Geography of Mackenzie and Tumbler Ridge (Prince George: UNBC Press, 2002). 12 Lawrence Ecroyd, “Progress Report on the Alcan Project. [REPRINT].” Western Business & Industry 1953.
! 49 !
Figure 3.2 Sketch of the Kitimat Project from the Kenney Dam to Kitimat
© The Kitimat Centennial Museum 2013
3.2 The Kitimat Project
In 1951, Alcan and the Province signed an agreement: Alcan would begin the construction of a new northern BC town—Kitimat, and the Province would lease the water rights to Alcan for $200,000/year, charging just 10 cents per acre of land flooded in their development of the Kenney Dam. 13 Construction began in 1953 after Kitimat was incorporated under the new Municipal Act, petitioned to the BC Legislature by Alcan in
1952.14 Alcan and the Province both stood to benefit from the Kitimat Project. While Alcan would earn millions in annual profits, the Province would acquire a new city and industry, complete with jobs for those who settled in the town.15
The Kitimat Project included considerable engineering feats. One such example is the construction of the Kenney Dam—named for Mr. E.T. Kenney, the BC Minister of Land and
Forests who initiated the Alcan project. The Kenney Dam included a 10-mile tunnel through a mountain that contained the hydroelectric generators that would feed power from the Kenney
!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!! 13 Paul Clark, “Kitimat: A Saga of Canada,” Canadian Geographic Journal (October 1954): 2-23, p. 5. 14 Pixie Meldrum, Kitimat: The First Five Years, District of Kitimat, 1958 Council: 1958, p. 7-8. 15 Ecroyd, “Progress Report on the Alcan Project. [REPRINT].”
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Dam to Kitimat and the aluminum smelter (as shown in Figure 3.1).16 The technical feats involved in constructing Kitimat and its smelter are plentiful; however, the remainder of this section will focus on the physical and social plan that urban designers engineered for this new town, and the implications it held for residents’ understandings of mental health.
3.3 The Master Plan
Because both Alcan and the Province conceptualized Kitimat to be a modern and progressive postwar city, Alcan contracted New York-based architectural firm—Mayer &
Whittlesey—to design Kitimat’s social and physical landscape. The American town planners and architects Clarence S. Stein (1928-1975), Albert Mayer (1897-1981), and Julian
Whittlesey (1906-1995),17 were acclaimed internationally in the city design community for their focus on systematically divided neighbourhood units, each with its own playground, school, shopping centre, and “greenbelt” 18 area. 19 Mayer & Whittlesey developed pre- designed towns for the postwar age of the automobile, while at the same time mapping safe pedestrian routes that bypassed traffic, maximizing room for industrial growth, and creating sizeable greenbelt areas.20 Kitimat was designed with ample green space, pedestrian walkways, automobile routes, and separate neighbourhood blocks located away from the industrial site
(as shown in the plan pictured in Figure 3.3). In presenting Kitimat’s design plan to readers of the Boston-based Architectural Forum in 1954, the planners recognized that residents:
…must be given the utmost freedom to develop their lives and that of their community to fit their needs, their desires and their pocketbooks. And so the plans of Kitimat, both operational and physical, have been developed to serve as
!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!! 16 Clark, “Kitimat: A Saga of Canada,” p. 6. 17 Pictured in Appendix N. 18 A greenbelt area is land designated to remain undeveloped for recreational enjoyment. 19 Clarence Stein, Albert Mayer, and Julian Whittlesey, “Kitimat: A New City [REPRINT],” The Architectural Forum July 1954. Sponsored by the Aluminum Company of Canada. 20 Stein et al., “Kitimat: A New City,” n.p.
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a flexible setting for good living that is open to continuous growth and expansion.21
The above quote illustrates that planners incorporated ideas prevalent in postwar BC into their design of Kitimat; namely, consumerism, and economic development. In addition to representing economic development, however, Kitimat was also designed to reflect the social ideals of the postwar period.
Figure 3.3 Topography Model of Kitimat’s “Master Plan”
© Division of Rare and Manuscript Collections, Cornell University Library
3.3.1 Social Plan
Following the Second World War, Canadian society promoted social ideals that encouraged the nuclear family unit: Anglo-Saxon, white-collared, heterosexual, and middle-
!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!! 21 Stein et al., “Kitimat: A New City,” n.p.
! 52 ! class.22 As outlined by University of British Columbia scholar Mona Gleason in her PhD dissertation Normalizing the Ideal: Psychology, the School, and the Family in Post-World War
II Canada, 1945-1960, post-WWII families adjusted to the changeable conditions of modern life by adopting traits deemed desirable by affluent members of North American society.23 In particular, Canadian psychologists popularized and promoted this expectation of a normal and nuclear family to Canadian society through radio and television programs, newspaper and magazine articles, and popular literature.24 The nuclear family unit was promoted for the belief that it would protect Canadians against postwar anxieties: juvenile delinquency, women in the workforce, rising rates of divorce, and general anxiety about the ongoing Cold War.25
Furthermore, this family ideal was believed to provide security for the future, with emphasis on domestic tradition, home ownership, and child rearing. 26
While this the family unit described above, was promoted and encouraged as the ideal for Canadians to follow, some attention must be paid to the differing reality of the 1950s and the postwar period than currently exists today. In some ways, the family model simply reflected the reality of postwar conditions: women may not have had a choice but to remain !!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!! 22 As indicated in an Employment Agreement signed January 1954, starting wage was approximately $1.58 per hour. According to the average workweek and year, this would result in an annual wage of approximately $3,300. Room and board for Alcan workers who did not live in married quarters was supplied at the rate of $2.00 per day for a shared room, or $2.50 per day for a single room. In 1953, lots of land for those wishing to construct a home could be purchased from $75-350 per lot. The minimum cost of a Kitimat house (two bedrooms, no garage) cost approximately $15,000 in 1957. Of this, Kitimat home buyers were able to obtain a $10,500 loan through a National Housing Act, and obtain a second mortgage from the aluminum company for all but $750 remaining. Currently, the average starting wage for an entry-level position with Rio Tinto Alcan is $29.55 per hour, resulting in an annual salary of approximately $61,500. Today, 2 bedroom houses in the original Kitimat neighbourhoods (Nechako and Kildala) sell for approximately $200,000. Employment Agreement for “Electrode Baker,” signed by the Aluminum Company of Canada, Limited and Dierson, January 25 ,1954, Kitimat Works; Ecroyd, “Progress Report on the Alcan Project. [REPRINT]”; William Worden, “Incredible New Frontier,” Saturday Evening Post, February 9, 1957, pp. 36-37; 46; 49; 52, esp. p. 49; “Property Results: Kitimat” Realtor.ca, accessed September 9, 2013, www.realtor.ca.! 23 Mona Gleason, Normalizing the Ideal: Psychology, the School, and the Family in Post-World War II Canada, 1945-1960, PhD diss., Ontario, Canada: University of Waterloo, 1996. 24 Ibid., esp. Sec. 3.10. 25 Ibid., 435. 26 Tina Block, “’Families That Pray Together, Stay Together:’ Religion, Gender, and Family in Postwar Victoria, British Columbia," BC Studies 145 (2005): 31-54, p. 34.
! 53 ! home with the children, due to the impracticalities of obtaining and paying for childcare. With a family to support and the need for women to care for children, it simply made sense that a father would be the breadwinner. Of course, alternate experiences of family and gender roles for the time do exist, but the ideals promoted by planners for Kitimat likely were promoted due to their existence as a typical experience for individuals living in postwar, middle-class conditions.
Town planners Stein, Mayer, and Whittlesey drew on the postwar family ideal in their design for Kitimat, in hopes to attract and maintain a stable workforce for Alcan. As Stein et al.
(1954) noted in their article for the Architectural Forum, without sufficient social structure in place, the remote wilderness of Kitimat could create “frustrated and cross children [that] drive their mothers crazy; cross wives [that] frustrate their husbands.”27 Because Stein et al. recognized that unsatisfied residents would encourage labour turnover (families may give in to their frustrations and move away), they designed Kitimat in accordance with the postwar family ideal. They hoped to attract breadwinning husbands to work at the smelter and provide for their families financially, homemaking mothers to raise children and transform newly constructed houses into happy homes, and obedient children to make use of Kitimat’s new schools and playgrounds.
Stein, Mayer, and Whittlesey consulted with developmental psychologist Dr. Lois
Barclay Murphy (1902-2003) to help them achieve the postwar family ideal in their design for
Kitimat. Dr. Murphy recognized that Kitimat could not simply be dropped into the wilderness and its community left to flourish; rather, arrangements had to be made to provide workers and their families the resources to grow and develop physically, mentally, and spiritually. As recommended by Dr. Murphy, town planners incorporated Kitimat’s greatest and most !!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!! 27 Stein et al., “Kitimat: A New City,” n.p.
! 54 ! pervasive barrier—the remote wilderness—to mitigate feelings of isolation, restlessness, and loneliness. By boasting outdoor activities such as fishing, hunting, camping, skiing, or photography, the planners hoped to ease residents’ longing for metropolitan amenities such as zoos, museums, department stores, or theatres.28 Thus, as shown through the intentions of town planners, Kitimat was designed to attract and maintain the families of workers that fit the postwar family ideal.
3.3.2 Health Plan
Until the opening of the Kitimat General Hospital in 1960, health services in Kitimat during its first stage of construction were relatively scarce. Alcan owned and financed a temporary hospital at the smelter site, until the Kitimat General Hospital (KGH) was established.29 In 1955, the Smeltersite Hospital (pictured in Figure 3.4) consisted of a series of connected huts, which had an 11-bed capacity with medical services provided by seven nurses and one medical superintendent.30 By 1957, the medical staff at Kitimat had expanded to 32 beds, 43 nurses, and seven “medical staff”—likely the practicing general physicians, medical superintendent, and two public health nurses.31 These staff provided general medical care to residents, and if a serious medical condition arose (ex: surgery, polio) they would be transferred by plane to Terrace (~60km), Prince Rupert (~200km), or Vancouver (~650km).
Kitimat had no dedicated mental health services (e.g. psychiatric or psychological) during its first stage of development. In fact, until the establishment of the KGH in 1960,
Kitimat did not have a space dedicated solely to health services.32 Throughout its existence, the Smeltersite Hospital had served as the community’s local courthouse, bunkhouse, and
!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!! 28 Ibid. 29 “The Hospital-old Huts but Modern Treatment Methods.” Northern Sentinel. 1957, April 9 [clipping, n.p.]. 30 “Extensions to Give Kitimat Modern 32-Bed Hospital,” Northern Sentinel, March 3, 1955 [clipping, n.p.]. 31 “The hospital-old huts but modern treatment methods.” Northern Sentinel. 1957, April 9. 32 See Appendix K for a map showing Kitimat General Hospital’s central location in the town.
! 55 ! radio shack.33 The only known service available to residents during Kitimat’s first stage of development that addressed mental health was the local branch of Alcoholics Anonymous.34
No other evidence of psychologists, psychiatrist, counselors, or support groups were found for this time period in the archives or through participant interviews. When reflecting on the mental health services that were available before 1960, participants did not recall any. Chet, a resident since 1952, along with residents Maria and Anna who were raised in 1960s-Kitimat, agree that “back then you probably would have been referred to your priest of your family doctor.”35
Figure 3.4 The Smeltersite Hospital, ca. 1954
© Kitimat Centennial Museum 2013 ! A limitation to the study of health or mental health in Kitimat during its first stage of development is the potential presence of the healthy worker effect. The healthy worker effect is a type of selection bias that can occur when comparing study outcomes for a group of
!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!! 33 Ibid. 34 An ad for Alcoholics Anonymous appeared in the premier issue of the Northern Sentinel, prior to the establishment of even a liquor store. This supports the prevalence of alcoholism in the “early days” that was spoken of in qualitative interviews with Raymond, Chet, and Marie. 35 “Maria and Anna,” interview by the Author, Kitimat, BC, August 8, 2012.
! 56 ! workers to the general population.36 Because of the level of health needed to hold a job, groups of workers tend to be healthier than the general population.37 As a result, the outcomes from a study on a working population may be underestimated, in comparison to the general population.38 While this study is not epidemiologic in nature, the healthy worker effect did seem to have some influence on its findings.39 In 1950s-era Kitimat, information on adverse health outcomes are scarce, likely because the population consisted mainly of a healthy, working population. Workers who were hired by Alcan or Kitimat construction firms were required to pass a medical exam and be deemed well enough to work physically hard, and live in isolation.40 This potential bias was even incorporated into Kitimat’s design, as town planners attempted to design a town attractive to workers who were “young and energetic.” 41
While health and mental health services in Kitimat were in short supply during the town’s first stage of development, it is important to note that, initially, this was not an oversight in the town’s planning. Mayer, Stein, and Whittlesey incorporated the contemporary idea of health promotion into their design plan, to encourage overall health and wellbeing throughout the community. As defined in the 1974 Lalonde Report from the Government of
Canada, health promotion is defined as a strategy “aimed at information, influencing, and assisting individuals and organizations so they will accept more responsibility and be more active in matter affecting mental and physical health.”42 To facilitate walking, Mayer, Stein,
!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!! 36 William Oleckno, Epidemiology: Concepts and Methods (Long Grove, Illinois: Waveland Press, Inc., 2008), p. 202. 37 Ibid. 38 Ibid. 39 Ibid. 40 Aluminum Company of Canada, Limited, Meet the Company [Booklet for Personnel] (Canada, August 1957), p. 15. 41 Stein et al., “A New City.” 42 Marc Lalonde, “A New Perspective on the Health of Canadians: A Working Document,” Ottawa: Government of Canada, 1981, accessed April 11, 2013, http://www.hc-sc.gc.ca/hcs-sss/alt_formats/hpb-dgps/pdf/pubs/1974- lalonde/lalonde-eng.pdf.
! 57 ! and Whittlesey designed neighbourhoods to be synergistic rather than compartmental, with separate pedestrian routes to access all amenities within walking distance, including shopping, recreation, health, and schools.43 The planners envisioned a centralized community health centre in their design for Kitimat, to facilitate health and wellbeing. As they described their plan published in Architectural Forum:
In our health program, the combined hospital-health center is of course no new concept. But its location, quite handy to the mainstream, is new as far as we know. Why at the main stem? The overriding idea is to make it very convenient. It is really a sales proposition. When the family is downtown for a shopping visit or an afternoon movie, they should find it natural and convenient to run in for a health check-up. In fact, we have put the health center as near to the “100% area” as we could without making it too hectic. The doctors in the city will have their offices here. In short, it will be a complete health focus.44
The above quote illustrates how the planners conceptualized Kitimat to be a community where individuals would be interested in maintaining health. One of the ways they did this was by having doctors in Kitimat’s first neighbourhood (Nechako) establish offices in the Nechako shopping centre.45 Another example, planners encouraged walking in the community by safely separating foot traffic from automobile traffic, and placing amenities within walking distance of residential blocks. This supported walking and exercise, as well as a housewife’s ability to complete errands on foot while her husband took the family automobile to work at the aluminum plant.46 The planners’ design for the town encouraged healthy social and physical behaviours that were consistent with the postwar family ideal.
3.3.3 On Language and Mental Health
While isolated from mainstream Canadian society in a number of ways— transportation, telecommunication, etc., Kitimat residents in the 1950s were still aware of !!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!! 43 Stein et al., “Kitimat: A New City,” n.p. 44 Ibid. 45 Such as Dr. Landsall, as announced in the Northern Sentinel May 19, 1955, p. 9. 46 Meldrum, The First Five Years, p. 7.
! 58 ! significant events and ideas that occurred around the world, including the state of the field for mental health. The Northern Sentinel kept the Kitimat population informed with reports on current events, as well as providing residents a forum through which to publish thoughts and grievances (ex: letters to the editor; news articles; feature stories). It is important to note that although Kitimat residents did not have access to psychological services, they were aware of the language and theory used in the field. This is shown by residents’ incorporation of psychological terminology into their authored texts. For example, a 1957 editorial reporting on an international event—the sinking of the Italian passenger ship, Andrea Doria, made mention of “psychological” damages such trauma could inflict on surviving children.47 In another example, psychological terminology is used by a local columnist “Kornelius K. Karpenter” in
1957, to describe his rejection of those who lived in Kitimat but did not appreciate it: “I’m getting pretty tired of people who are putting Kitimat on the psycho-analyst’s couch and telling it what’s wrong with its personality and why it feels frustrated.”48 In this quote,
Karpenter alludes to psychoanalytic theory49 in expressing his dislike of those complaining about life in Kitimat. These two examples highlights a trend common in 1950s-era texts;
Kitimat residents use words that are explicitly associated with mental health (e.g.
“psychology”), but do not use them to describe their own mental health. It is likely that this is reflective of the time; in a middle-class, working society with Christian values, mental health
—and health in general—was considered a private matter, and simply not something that was discussed openly. As a result, this makes it difficult to examine mental health in Kitimat,
!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!! 47 “A Unique Reporting,” Northern Sentinel, December 30, 1957, p.2. 48 Kornelius K. Karpenter, “Kitimat Kolumn,” Northern Sentinel, June 4, 1957, p. 4. 49 Psychoanalysis, broadly defined, is a psychological theory developed by Sigmund Freud (1856-1939) in the late 19th century. The theory holds that personality and behaviours are unconsciously determined by childhood events and irrational drives that, when repressed, can result in mental disturbance. See Irwin and Barbara Sarason, “Freud and Psychoanalysis,” in Abnormal Psychology: The Problem of Maladaptive Behaviour, 9th ed. (Upper Saddle River, New Jersey: Prentice Hall, 1999), p. 72-77.
! 59 ! where it is not represented in the data. This led to my adoption of a holistic and interpretive perspective of mental health for this early period of Kitimat’s history. For this reason, the following analysis of mental health focuses on interpreting the ways of being that speak to the community as a whole, as residents experienced and defined their own wellbeing.
3.4 Mental Health During Stage 1: Construction, 1950 to 1957
As the permanency and security of Kitimat is fundamentally tied to industrial and economic development, irresolute feelings about its future have persisted throughout this town’s history, which have been shown to have implications for what we identify as holistic mental health. When interpreting understandings and communications of mental health amongst Kitimat residents during the town’s first stage of development, it becomes clear that this community depicted mental health through its daily ways of living, rather than the explicit discussion of psychiatric or psychological “issues.” During analysis, multiple discourses— such as work as security or the ideal family unit—emerged that identified the different ways through which residents experienced “a state of well-being in which every individual realizes his or her own potential, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to her or his community.”50
3.4.1 Mental Health and Social Ideals
In Kitimat’s first stage of development, mental health was represented in accordance with the ideals that were shared and promoted in postwar Canadian society. Kitimat residents experienced mental health within the context of the ideal social roles for one’s gender, family, home, or employment. However, Kitimat’s existence as a town under construction in the remote wilderness provided barriers to residents trying to live within set social standards. In
!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!! 50 “What is Mental Health,” World Health Organization, last modified September 2009, accessed December 5, 2011, from http://www.who.int.
! 60 ! the sections to follow, mental health will be discussed within two different contexts through which residents experienced it: work as security, and the ideal family unit. While other discourses that simultaneously document community experience did exist for this time, they were not considered for this project, as they spoke more to specific groups (ex: children or the
Filipino community) and not the community as a whole. The discourses of work as security and the ideal family unit were focused on because of their intersection of multiple themes, which embody the widest range of community experience. Focus on these two discourses will illustrate how themes identified across each group—such as (in)security, gender ideals, progress, or domesticity—were embodied in the everyday experience of mental health.
Residents’ ability to conform to what they expected and accepted for these roles affected their experience of mental health; they viewed deviations from social ideals as problematic to a good and functional mental wellbeing, for it impeded their ability to cope with life stresses, work productively and fruitfully, and contribute to their community.
3.4.1.1 Work as Security
As a discourse around holistic understandings of mental health in the community, work as security supported the postwar social ideals that Kitimat residents identified as desirable and healthy. Employment allowed male residents to provide for their families, purchase a home, and participate in the ideal postwar family structure that was promoted at the time. The idea that work paralleled security was emphasized by the influx of migrant workers to Kitimat, from countries that faced serious hardship after the war. Immigrants’ experiences promoted the necessity of work for Kitimat men, and the attitude that if one were working, they had no reason to complain.
! 61 !
One smelter worker, George Mitchel, came to Kitimat in the 1950s after having survived a Japanese Concentration camp in the Dutch Indies. In an Alcan publication, Mitchel is described as follows:
[Mitchel] deplores the mentality of those who complain about life here; instead, he feels there is much to be thankful for. ‘This country gives opportunities to anyone who wants to work. The possibilities are there,’ he says.51
From this quote, one sees that for Mitchel work offers an income, but also freedom, opportunity and safety in comparison to the time he spent imprisoned. Another worker, Joe
Herzberg, came to Kitimat in 1957 after coming across a Northern Sentinel in his home country of Germany. He explains that for him and others who experienced war, work provided a sense of emotional security:
When you go through a war, it gives you a certain mentality. In Europe, after World War II, you couldn’t rely on anything. Emotionally, you were very mobile—you could easily pack up and leave.52
While Kitimat males, such as Herzberg above, emphatically voiced work as essential to a secure life in Kitimat, it is important to note, that the understanding of work as security did not apply to the entire population Kitimat. Of those who engaged in the work as security understanding of mental health, many were not permanent residents of Kitimat, but single workers who would leave Kitimat once their employer’s construction project was complete.
Because this project is interested in determining how discourses of mental health changed over time for the population of Kitimat, it is necessary to focus on the permanent residents of
Kitimat to allow for consistency when interpreting their experiences. As such, the following section examines the discourse of the socially ideal family unit, which was the dominant discourse for the period 1950 to 1957. !!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!! 51 Alcan, 25 years, p. 31. 52 As quoted in Alcan, 25 years, p. 18.
! 62 !
3.4.1.2 The Socially Ideal Family Unit
Jobs in Kitimat during the 1950s were predominantly intended for men, who sought work as physical labourers at the smelter site, or in auxiliary industries, such as concrete or construction. During this initial period, there was plenty of work available in Kitimat, as well as above-average wages for the time.53 High wages allowed Kitimat families to engage in the ideal of men-as-provider and women-as-homemaker, for a family was able to live off of a single breadwinner’s earnings. Housewifery was adopted as the desirable norm amongst
Kitimat’s female residents, with women focusing their attentions on child rearing and homemaking. For the most part, during the first phase of construction Kitimat women made their role as homemaker both meaningful and admirable. Women took pride in domesticating the wild, turning newly cleared land to garden, and decorating recently constructed houses into homes.
In a 1955 article, local homemaker Margaret Bailey writes of her friend, whose “mad, romantic husband has given [her] five yards of topsoil for a present on our tenth wedding anniversary,” and that “new homemakers will appreciate the lovely thought behind such a gift.”54 Advertisements in the Northern Sentinel highlighted events for the large population of housewives, such as the opening of Super Valu—a modern supermarket with refrigerated aisles, music for shoppers, and grocery carts with baby seats.55 In addition to town planning for housewives, the organization of the community’s most effective communication line—the
!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!! 53 The hiring wage for Alcan, as indicated in a 1954 employee agreement between the company and an entry- level labourer, was $1.58/hour. When minimum wage laws came into effect in British Columbia fifteen years later, it was set at a minimum of only $1.00/hour in the province. Government of Canada, Human Resources and Skills Development Canada, “Hourly Minimum Wages in Canada for Adult Workers,” last Modified March 2, 2012, accessed April 11, 2012, http://srv116.services.gc.ca/dimt-wid/sm-mw/rpt2.aspx?lang=eng&dec=1,; Employment Agreement for “Electrode Baker,” signed by the Aluminum Company of Canada, Limited and Dierson, January 25 ,1954, Kitimat Works. 54 Margaret Bailey, “Margaret Bailey Writes…” Northern Sentinel, May 19, 1955, p. 5. 55 “Nechako Centre Food Store Open November 26,” Northern Sentinel, November 18, 1954, p. 1.
! 63 !
Northern Sentinel—was also structured according to postwar masculine and feminine ideals.
While the men’s section of the paper had columns on fishing, sports, and history, the
“Women’s Page” had recipes, housekeeping tips, fashion commentaries, wedding announcements, and gossip columns (pictured in Figure 3.4).56
There were, of course, exceptions, and some Kitimat women were not married and did not work as wage earners. In most cases, however, these women still worked in ways that were considered gender appropriate, and compatible with the expectations for feminine domesticity. Some examples include, widowed women who worked as boarding house
“mothers,” 57 staff-house matrons, 58 babysitters, 59 telephone operators, 60 dress shop attendants,61 or waitresses.62
What becomes clear in the lives of Kitimat residents for this time, is that femininity was expected and idealized as submissive, delicate, homemaking wives and mothers, and masculinity as dominant, strong, wage-earning husbands and fathers. Postwar masculine and feminine gender roles were performed relatively unquestioned in 1950s Kitimat, as outlined by the types of occupations and activities in which they participated. Boys and men participated in activities perceived as strong, risky, skillful, and “masculine,” such as contact sports (e.g. football, hockey, etc.), fishing, rifle shooting, woodworking, metal working, etc.,63 while Kitimat women participated mainly in feminine hobbies such as cooking, crafting,
!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!! 56 See the Northern Sentinel. 57 Kornelius K. Karpenter, “Kitimat Kolumn,” Northern Sentinel, October 21, 1954, p. 9. 58 Margaret Bailey, “Margaret Bailey Writes…” Northern Sentinel, August 18, 1955, p. 4. 59 “Classifieds,” Northern Sentinel, November 18, 1954, p. 9. 60 Advertisement by the B.C. Telephone Company recruiting girls to work as full-time or part-time telephone operators in the Kitimat exchange. Northern Sentinel, October 28, 1954, p. 2. 61 Advertisement for Iona’s Dress Shop, Northern Sentinel. February 2, 1956, p. 5. 62 Pixie Meldrum, “Eat and Be Merry—but It’s Going to Cost More,” Northern Sentinel, April 18, 1957, p. 1. 63 As evidenced in the Northern Sentinel, and District of Kitimat Recreation Department, Kitimat Residents Community Achievements: 1957-1998, prepared by Daniel Kotai, Youth Options BC Program, Community Work Experience & Credit for Post-Secondary Education, 2001.
! 64 ! shopping, fashion, social events, and non-contact sports, such as cricket, tennis, swimming, curling, bowling, or badminton.64
Kitimat women were mostly dependent on their husbands for income, and identified most prominently as a wife and mother. 65 Idealized domestic traditions and clearly defined gender roles were meant to construct an institution of family that provided security against the social problems that ailed Kitimat residents and North Americans at large: divorce, alcoholism, 66 and juvenile delinquency—along with their considerable implications for holistic mental health.67 As the following section will illustrate, because of the unique social and economic conditions responsible for creating Kitimat and its first stage of construction, residents’ ability to conform to social ideals affected their experiences of mental health.
!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!! 64 As suggested for women by the Young Men’s Christian Association in the Northern Sentinel, September 4, 1958, p. 7. 65 Carol Matusicky, (proceedings, BC Coalition for Safer Communities: Building a Safer Community Conference, Kitimat, BC, May 10-11, 1991), p. 14. 66 Alcohol abuse (305.00) is defined by the American Psychological Association (APA) as a maladaptive pattern that leads to impairment or distress within a 12-month period, manifested by one or more of the following: recurrent use of alcohol (1) resulting in a failure to fulfill major role obligations at work, school, or home; (2) in situations in which it is physically hazardous; (3) which leads to alcohol-related legal problems; (4) leading to social or interpersonal problems caused or exacerbated by the effects of alcohol. Alcohol dependence (303.90) is defined by the APA similarly, as a maladaptive pattern of drinking that leads to impairment or distress in a 12-month period, manifested by at least three of the following: (1) increased amount of alcohol needed to achieve desired effect; (2) symptoms of withdrawal from alcohol; (3) drinking larger amounts over longer periods than intended; (4) desire or unsuccessful efforts to cut down on drinking; (5) activities given up because of drinking; (6) time spent in activities to obtain or recover from the effects of drinking; (7) a continuation of drinking regardless of the physical or psychological problems it causes. These definitions are adapted from: American Psychiatric Association, Diagnostic and Statistical Manual of Mental Disorders, 4th Text Revision ed. (Washington, DC: APA, 2000), Codes 305.00 and 303.90. 67 Gleason, Normalizing the Ideal, p. 435.
! 65 !
Figure 3.5 Image of the Northern Sentinel’s “Women's Page” illustrates gender-ideal topics such as fashion, or homemaking
© Northern Sentinel 1957 ! 66 !
3.4.1.3 Barriers to Mental Health, as Understood Through the Ideal Family Unit
Kitimat’s status as a town under construction provided the greatest barrier to residents’ ability to participate in the ideal family unit, and participate in the discourse that most strongly represented mental health. This “under construction” label was used most commonly as the venue through which residents expressed their frustrations and feelings. Slower-than-expected construction often kept families apart, by distances as near as one town over to as far as overseas. This, in turn, prevented women from engaging in the woman-as-homemaker ideal.
Where homes were available for families, they were often inadequately constructed, or poorly linked to the community, for the goal of construction was to build neighbourhoods first and community infrastructure second.
Figure 3.6 A young family and their new home
© Kitimat Centennial Museum
! 67 !
3.4.1.4.1 Housing Shortages
Because Kitimat was constructed in stages by neighbourhood units, residents had to wait for entire streets to be completed before they could move in. In 1954, approximately 400 residents lived in temporary shelters at the Smeltersite camp while waiting for the 68 houses planned for construction were completed.68 The next year, Alcan financed the building of
1,400 houses, for the population of 8,000.69 Building the town in stages was a strategy suggested by the town planners, for they believed such control of development would prevent substandard housing from being constructed.70 In reality, however, the sheer quantity and demand for housing developments by residents caused great pressure and time constraints.
Once finally occupied, the houses—and the families living within them—sometimes suffered from loneliness and isolation.
The main problem that housing shortages caused for Kitimat residents in the 1950s was that it separated families, which prevented residents from participating in the gender and family ideals they had been promised in their commitment to settle. One employee, Ernie
Johnson, came from Winnipeg in 1957 to work for Alcan. Unable to find accommodation for his family to live, Johnson was placed on a waitlist of 400 other persons awaiting homes.71
Another smelter worker, Rudi Can Der Hulst, explained that workers were so desperate for housing that their were willing to take any vacancy, at any price, in order to they could bring
!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!! 68 Paul Johnston, Rocque Berthiaume, and Bill Horswill, Makin’ Metal: Technological Change Impact Study, (Canadian Association of Smelter and Allied Workers Local One, 1985, p. 45; Population estimates from “Population Estimates and Census Counts: 1953 to Date,” District of Kitimat, Department of Community Planning and Development, accessed May 2013, http://www.kitimat.ca/assets/Residents/PDFs/population- table.pdf (see Appendix T). 69 Staff and Secretary Treasurer, School District No. 80, Ktiimat. B.C, Education in Kitimat, Kitimat, BC: Northern Sentinel Press, 1956. 70 Stein et al., “Kitimat: A New City.” 71 Alcan Smelters and Chemicals, Ltd., A Tribute to 25 Years, p. 6.
! 68 ! their family to settle.72 Thus, as becomes apparent in local discourses, the issue of limited housing caused many families to experience periods of stress, loneliness, and frustration.
Many wives remained in Portugal with their children, while their husbands worked in Kitimat and waited for housing to become available. One woman, Herminia,* describes her immigrations experience from Portugal to Kitimat in May 1958:
I came to be with my husband. After being married only for a month he came back [from Portugal] to Kitimat. It was three years later [that] I came to join him. When I arrived I found there were very little homes here and a lot of forest. It didn’t really bother me since I came to be with my husband. That’s all I wanted.73
Another example comes in the form of a letter to the editor of the Northern Sentinel, from a
“Very Lonely Family in Terrace”—Kitimat’s neighbouring town. While today, Terrace is approximately a 45-minute drive from Kitimat, during the first construction phase there was no highway connecting the two towns, and residents had to travel by rail, boat, or plane to get in and out of Kitimat. Some Canadian wives settled in Terrace or other “nearby” communities, hoping to keep the family unit connected as much as possible with occasional visits. The following wife of a smelter worker voices her frustration and near-desperation with housing shortages:
Dear Sir: Did [y]ou ever hear the heart-breaking cry every Sunday, “Daddy don’t go”, by three kids who miss their Dad? Why can’t [the] company’s [sic] at Kitimat build houses for decent married people? Why all the places for single men? They only stay a few months anyway, where a married couple would settle there IF there was a place to live. People who are just shacking up to get places to live. You buy a trailer to move in, big joke, where? Or why can’t the train run late on Sunday evening so we could at least have a Sunday together? Isn’t there anyone in the whole town of Kitimat who would except 3 kids, nice kids, just average kids anyway, two going to school and one at home 3 years old?74
!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!! 72 Ibid., p. 26. 73 “Portuguese Women,” Exhibition File from The Kitimat Centennial Museum, 293 City Centre Kitimat, B.C. Canada V8C 1T6, July 2012. Note: The names of “Portuguese Women” have been changed from the originals that appeared in the Museum Exhibition, to protect the identity of those involved. 74 “Letter to the Editor,” Northern Sentinel, August 17, 1956, p. 2.
! 69 !
A number of points that support the family ideal become apparent in “Very Lonely’s” letter, above. First, we see the desire for families to be together, living under one roof with both a mother and father—the social ideal for a nuclear family. Second, we see the emphasis on marriage; the author pleads for a rental unit, as a “decent married couple,” in contrast to those
“who are just shacking up to get places to live.”75 Finally, in the content of this letter, we see that the slow construction of Kitimat causes stress with housing shortages and feelings of isolation.
The following account by Antina, an immigrant Portuguese housewife, exemplifies how traditional domesticity was maintained, even in circumstances unfamiliar to family ideals where families lived with other couples, or boarders:
When my brother left back to Portugal, I had other boarders since no one had family here. I would cook for them, wash their clothes and make up their rooms. It was hard work with two little children around. Sometimes I would have to get up a 3 a.m. to iron clothes. At that time, there was no laundry around so other men would ask if I could iron their shirts for them.All my rooms had been taken up and only one bathroom for all. I would take a big tub to my bedroom to wash my children in. They [the boarders] would be on nights [shift] and I had to keep the children quiet so they could sleep. Life was like that back then...It was all that I knew at the time—to help the ones that had no family here.76
From the example above, it becomes apparent that housing shortages required families to negotiate their ways of living, their definition of family, and their expectation that Kitimat would provide them the opportunity to conform to social ideals. Thus, as residents attempted to achieve good mental wellbeing by participating in social ideals, the unique economic circumstances that led to Kitimat’s construction—a booming aluminum industry—also created life stresses that residents could not easily cope with—namely, overcrowding and housing shortages. !!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!! 75 “Letter to the Editor,” Northern Sentinel, August 17, 1956, p. 2. 76 “Portuguese Women,” Exhibition File from The Kitimat Centennial Museum.
! 70 !
3.4.1.4.2 Substandard Housing Construction
Aside from housing shortages and overcrowding, residents that occupied Kitimat houses in the 1950s were subject to poor living conditions, as a result of rushed construction done to meet residents’ demands for housing. With the family ideal as the focal discourse of mental health for this first time period, inadequate housing conditions provided residents with a forum through which to discuss their inability to cope with life stresses, and the resultant dissatisfaction, depression, and frustration.
The very first individuals lucky enough to occupy homes in 1954 lived without a water supply, asphalt roads, or concrete sidewalks for weeks, with garbage cans filled with water delivered three times a week by the Municipality.77 For most, however, in contrast to the dry conditions of the first inhabitants, the second group of residents to occupy homes were subject to extremely damp conditions and routine basement flooding, as houses were not designed to bear the load of Kitimat’s heavy rain and snowfall. In April 1955, the Northern Sentinel writes:
Kitimat is not California and it’s not part of the Dry Belt…We should never again have a condition in which surface water seeps into basements and into sub-floor heating ducts because somewhere else that kind of set-up would work without perimeter drain tiles to carry away the rain and melt in snow water.78
What the article is referring to is the “320 Skyline Bungalow” design that occupied much of the first neighbourhood. Houses were initially prefabricated in milder and drier climates (like
California), and shipped into Kitimat’s port. The Municipality had even sued town contractors in 1955 for causing dampness in the basements of 220 brand new homes. 79 Other examples of
!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!! 77 Meldrum, The First Five Years, p. 18. 78 “Variety in Home Design,” Northern Sentinel, April 7, 1955, p. 4. 79 "Municipal Code is Violated, Council to Sue,” Northern Sentinel, October 20, 1955, p. 1.
! 71 ! poor and rushed workmanship included blocked sewage pipes,80 trashed streets,81 cracked steps,82 muddy yards, and at times, an open stream of raw sewage in the newly constructed
Neighbourhood:C.83 In reference to unsatisfactory living conditions, Reverend Tucker, a columnist and clergyman, writes to the Sentinel in 1955, a “factual statement of conditions as they exist,” describing that, “…it must be mentally depressing to have to live in a house in which water streams down the inside walls…heightened by the fact that the house is brand new and is costing a lot of money.”84 Residents embodied housing inadequacies as unmet expectations that prevented them from participating in the social ideals they had intended to, upon moving to Kitimat.
In his 1957 article, “Incredible New Frontier,” journalist William Worden writes that
Kitimat failed to become the dream community in the wilderness it was meant to be, due mostly to the inability of workers’ wives to be content with conditions of living. Kitimat’s
City Manager, Cyril Henderson (1918-1978), explained to Worden that problems settling were brought on by husbands overselling the town to their wives, resulting in their arrival to unmet expectations, such as mud and rain. While many wives expected to arrive in a modern paradise,
Henderson explained:
If they hit town in the rainy season and are led to some unfinished house with a sea of mud for a front yard, the shock can be nearly fatal. This is a workingman’s town, a good one, we think, but not a fancy suburb.85
The above quote explains how husbands overzealously convinced their wives to come to
Kitimat, by describing what the town would be, rather than its current state. One housewife !!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!! 80 "Sewer Block Floods into Grouse Homes,” Northern Sentinel, October 16, 1956, p. 1. 81 Houses were handed to tenants by contractors often in messy conditions; workers and tradesmen would leave a number of used items: pipes, old toilet bowls, or paint cans. As described in, “Letter to the Editor,” Northern Sentinel, April 18, 1957, p. 4. 82 Worden, “Incredible New Frontier,” p. 49. 83 ”Letter to the Editor,” Northern Sentinel, February 15, 1957, p. 5. 84 "Letter to the Editor,” Northern Sentinel, February 3, 1955, p. 8. 85 Worden, “Incredible New Frontier,” pp. 36-37; 46; 49; 52, esp. p. 52.
! 72 ! describes to Worden her unmet expectations in Kitimat, unprepared to arrive in a community under construction:
To think I left a good home and brought my children out to this! Mud in the front yard, and the neighbors don’t even speak English. Don’t ask me about Kitimat. I’m getting out just as fast as I can. If my husband stays here, [he] will be alone.86
Thus, the above excerpts illustrate that inadequate construction caused residents turmoil in their daily lives. Muddy conditions, due to unpaved roads, provided substantial barriers to women who tried to engage in the domestic duties necessitated by their women-as-homemaker social roles.
3.4.1.4.3 Isolation
While housing and living conditions did improve through large-scale repairs, paving and draining initiatives, the wilderness provided residents with a perceived barrier to wellbeing that could not so easily be alleviated. Living in the wilderness was meant to be exciting and adventurous, but residents were unprepared for the difficulties that such an experience would provide. In the 1950s, choosing to move to Kitimat was considered by new residents to be on par with choosing to live the modern lifestyle rooted in traditional, domestic families that town planners had so ambitiously advertised by radio, television, and the press.87 As described by the District of Kitimat in its 1986 Economic Development Strategy, the District of Kitimat explains that, “Kitimat was cut out of a vast wilderness area for the express purpose of creating a city so attractive that it would draw the needed workmen with their families and encourage them to establish a permanent residence.”88 Initially, the wilderness aspect drew
!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!! 86 Ibid., p. 49. 87 “Portuguese Women,” Exhibition File from The Kitimat Centennial Museum. 88 District of Kitimat, KITIMAT: Economic Development Strategy [Annual Report], p. 15. Accessed through Kitimat Public Library’s Special Collections.
! 73 ! new residents to Kitimat with the appeal of a modern pioneering adventure, but it soon became a burdensome factor in residents’ lives, due to its isolating properties.
One interview participant—a local schoolteacher and counselor—Maya, discusses the lengths that Alcan went to, to ensure their workers were resilient enough to handle the isolation that wilderness provided. She speaks of the hiring conditions as she remembers for power operations settlement, Kemano,89 whose remote conditions—accessible only by air or sea—were similar to that of Kitimat’s in its first stage of development.
Yes. To work at Kemano, [Alcan] did psychological testing because, because Kemano is a perfect example of absolute isolation, right? So there’s no…there is no fast way out. I mean, of course there’s the helicopter in emergencies, but it’s a helicopter, right. And it’s long winters, lots of snow. And you’re, you’re working in a cave,90 right? And uh, so. You know, they did the testing to see whether, what, whether you were able to cope and tolerate the isolation factor, eh? So they had some sort of profile set out. You know, like this would be the perfect person to work in this sort of setting…91
The “isolation factor” that Maya describes is an extremely pervasive theme in Kitimat’s early history. New families that moved to Kitimat left their previous social connections to start in a community where everything was brand new, and where communication (ex: telephone, mail) services were limited. One woman, a Portuguese immigrant wife, described the overwhelming experience of arriving to a new home in an unfinished community, a common occurrence for
Kitimat newcomers during this initial stage of development:
I started to unpack my suitcase, and found my glass dome that I brought had broken, and began to cry. I went to the door and opened it and saw only forest and Sagimat homes. I had a heavy weight in my heart and started crying– thinking, I see nothing that I recognize and no familiar faces around.92 !!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!! 89 Kemano was a small settlement located 75 km from Kitimat, owned and operated by Alcan, to house the servicemen and their families needed for Kitimat’s hydroelectric power station. The town site of Kemano was closed in 2000, and it now operates by workers who live in Kitimat and spend alternate weeks at a time working at the power station. When inhabited, it was only accessible by boat or air. 90 The “cave” that Maya refers to is the underground tunnel in Mt. Kenney that houses the hydroelectric generators. 91 “Maya,” interview with the Author, August 3 & 5, 2012. 92 “Portuguese Women,” Exhibition File from The Kitimat Centennial Museum.
! 74 !
The isolation and unfamiliarity that new residents felt, as illustrated in the above quote, was pervasive amongst new residents, especially those who came from different settings, climates, countries, and customs. In her 1976 paper on “New Frontier Towns,” Urban Reader contributor Anne Kloppenborg discusses issues of isolation in Kitimat and other remote
Northern towns:
Those who don’t have enough social contact, especially women who can’t get out of their homes, begin to feel lonely and depressed. Cabin fever is one of the hazards of northern living and it has been alleged that alcohol and drug use in northern towns is higher than in the south, and is a result of the loneliness and isolation.93
To mitigate the effects of isolation, as described by Kloppenborg, Kitimat residents involved themselves in the community by participating in church groups, clubs, and sporting leagues.
Additionally, residents relied on the wilderness, itself, to escape the longing for urban infrastructure. Children and their families replaced metropolitan activities with skiing, picnicking, fishing, hunting, climbing, hiking, camping, etc., and challenging the wilderness barrier that caused so much unrest by engaging with it.
3.5 Summary
Kitimat was established after WWII to develop a hinterland area of Northern BC. After constructing a hydroelectric dam and aluminum smelter, Alcan built the new community of
Kitimat, which they had promised to the Province. The town was well thought out; New York planners Clarence Stein, Albert Mayer, and Julian Whittlesey had incorporated the ideals for the postwar family unit into Kitimat’s Master Plan. Residents who moved to Kitimat were attracted to the opportunity to live in a new and modern community that espoused the social ideals for families at the time. As well, the population for this period (1950-1957) was made
!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!! 93 Anne Kloppenborg, “New Frontier Towns,” Urban Reader 6, no. 6 (1976): 25-30, p. 26.
! 75 ! up of predominantly young families who could physically handle manual work. For the accompanying wives, this meant transforming a new house—often a pre-built unit—into a home; while for men it meant working at the aluminum smelter. A strong and healthy population of early residents may have contributed to the apparent absence of mental health problems for this period, in addition to the town’s lack of mental health services, or discussion of mental health during the 1950s.
While an explicit discussion of mental health did not emerge from the archives, implicit understandings can still be understood by interpreting the lives of Kitimat residents, in accordance with a holistic understanding of mental health. Based on how residents understood the ways of being productive, contributing to the community, and coping with stress, they understood mental health as something that could be achieved and maintained by conforming to the social ideals of family and work. Consequently, barriers to mental health were identified as things that prevented participation in these ideals, such as unemployment, or housing shortages. For housewives in particular, unmet expectations that prevented them from achieving the family ideal (e.g. rain, mud, and snow) upon their arrival in Kitimat resulted in their feelings of isolation and depression. The main way that Kitimat residents overcame the barriers for mental health was by establishing a strong and close-knit community. This community would be an integral part of future understandings of mental health, even after
Kitimat was past its construction phase.
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Chapter 4: Economic Diversification, 1957-1979
4.1 Overview
Following its initial construction phase (1950-1957), Kitimat experienced an economic recession that would affect the town’s development and understandings of mental health for the next twenty years. As illustrated in Figure 4.1, economic recession hit Kitimat in mid-1957 and lasted for the next two years. With the onset of recession, work became considered as the essential component to mental health. Subsequently, residents formed community initiatives to provide working opportunities in the town, and encourage economic development. Residents took a grassroots approach to economic development in Stage 2, because they did not receive support from the Province. These circumstances foreshadow how Kitimat would respond to its failure to obtain mental health services from the Province, during Stage 3. This section outlines Kitimat’s economic histories during periods of recession and growth from 1957 to 1979, and comments on how these conditions influenced understandings of mental health.
Figure 4.1 Timeline showing conceptual stages of economic development in Kitimat
Economic Growth
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4.2 Understandings of Mental Health during Economic Recession, 1957-1959
In 1957, Kitimat experienced the delayed economic effects of the Eisenhower
Recession that began in the United States (US) in 1953. No longer facing the threat of war, 1 the US reduced its demand for primary resources, which they had used to manufacture aircrafts and artillery.2 As the production of these wartime materials required an abundance of metal, when the US reduced their demand for it, a number of metal- related industries were affected (e.g. mining and smelting).3 Industries sought to recover the costs of reduced demand by laying off employees or reducing their wages. 4
Subsequently, this led to Americans limiting their consumer spending, which negatively affected the consumer-driven industries that also used metal (i.e. automotive, manufacturing).5 Because Alcan relied on exporting aluminum to US manufacturing industries in the 1950s (see Section 3.2), Kitimat was negatively impacted by this recession.
!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!! 1 Note: In 1953, the United States signed the Korean Armistice Agreement, ending their involvement in the Korean War. As well, the US was still adjusting their economy from wartime production, following the end of WWII. Richard Gable, “The Politics and Economics of the 1957-1958 Recession,” The Western Political Quarterly 12, no. 2 (1959): 557-559, accessed March 25, 2013, http://www.jstor.org.ezproxy.lib. ucalgary.ca/stable/443992?seq=3. 2 Gable, “The Politics and Economics of the 1957-1958 Recession.” 3 Ibid. 4 Al Fenn, Walter Sanders, Stan Wayman, Robert W. Kelley, Thomas D. McAvoy, Francis Miller, “The Recession of 1958 [Photo Essay],” Time Magazine: Time Photos, 2013, accessed March 25, 2013, http://www.time.com/time/photogallery/0,29307,1850639,00.html; John A. Heitmann, “The American Automobile Industry and the “Eisenhower Recession” of 1957-8,” SAH Biennial Automotive History Conference, Tupelo, MS, March 24-27, 2010, accessed March 25, 2013, http://automobileandamericanlife.blogspot.ca/2010/03/final-version-of-my-sah-paper-american.html; T.N. Vance, “The Eisenhower Recession,” New International, (Winter 1958): HTML Format, accessed February 11, 2013, http://www.marxists.org/history/etol/writers/vance. 5 “Labor Force Statistics from the Current Population Survey,” Bureau of Labor Statistics, United States Department of Labor, Seasonal Unemployment Rate, 1956—1960, accessed March 25, 2013, http://data.bls.gov/pdq/SurveyOutputServlet; Fenn et al., “The Recession of 1958”; Heitmann, “The American Automobile Industry and the “Eisenhower Recession” of 1957-8,”; Vance, “The Eisenhower Recession.”
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In response to the reduced US demand for aluminum imports, combined with the resultant oversupply and reduced sale of aluminum, in 1957 Alcan reduced its production6 and curtailed plans for expansion in an attempt to save costs. Referred to as “Dark
Monday” by The Northern Sentinel, on October 28, 1957 Alcan announced its dismissal of 1,767 workers (of a total population of 13,800).7 By the next year, conditions still had not improved and Alcan laid off 60 more workers in January, followed by an additional
20 in July.8 By February 1958, there were 835 jobless individuals in Kitimat (of a total population of 8,781) who were registered with the National Employment Service, compared to the 508 registered just one year prior.9
The effects of the Eisenhower Recession on Kitimat’s economic development were far-reaching and long lasting. Kitimat did not grow as planners and the Province had intended. As a result, industrial investors withheld development projects in Kitimat, due to their uncertainty of the town’s economic future. A second major industry would not settle in Kitimat until 1969, when the Eurocan Pulp and Paper Mill commenced operations. While its effects on economic development were perhaps the most visible in
Kitimat, the recession also affected understandings of mental health during the 1957-1959 period of economic decline.
!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!! 6 “Alcan Cuts 60 Workers: Layoffs Within Three Weeks as Company Plans Experiments,” Northern Sentinel, January 16, 1958, p. 1; 7 Hal Malone, “Sagimat Near Halfway Mark on Shutdown,” Northern Sentinel, January 16, 1958, p. 1; “Population Estimates and Census Counts: 1953 to Date,” District of Kitimat, Department of Community Planning and Development, accessed May 2013, http://www.kitimat.ca/assets/Residents/PDFs/population- table.pdf. 8“Alcan Cuts 60 Workers: Layoffs Within Three Weeks as Company Plans Experiments,” Northern Sentinel, January 16, 1958, p. 1; “Population Estimates and Census Counts,” District of Kitimat. 9 “Jobless Ranks Rise Steadily,” Northern Sentinel, February 10, 1958, p. 1.
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4.2.1 Child Behaviour and Mental Health
In the late 1950s, Kitimat residents used the terms “mental health” with reference to the social ideals and expectations that Canadian parents—and society at large—held for their children. These terms appear in archival documents where adults describe the undesirable behaviours in which children partake, and their potential influence on mental illness. An example of this is apparent in the October 6, 1958 issue of the Northern
Sentinel, where the editors ran an announcement advertising an upcoming Canadian
Broadcast Corporation radio program on “a look into the minds of emotionally disturbed girls.”10 The advertisement explained to readers that the two “mental health broadcasts” in the program each focused on a different case; the first, on a group of argumentative girls living at the Toronto-area residential treatment facility for children, Warrendale,11 and the second case on a girl who lived in foster care and enjoyed playing with and tormenting frogs, toads, and snakes.12 While the article does not provide enough information to speculate on whether or not they were mentally ill, there are some interesting factors to note, by its mere existence in the Kitimat newspaper.
First, both of the girls chosen to represent “child problems”13 did not adhere to the socially ideal family unit that was predominant in Kitimat discourses of mental health during the 1950s, as described in Section 3.4.1.2. The girls did not live with at home with their parents in a family unit, which already set them apart as abnormal and outside of the family ideal. Second, both girls represent strong characteristics inconsistent with the ideal
!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!! 10 “CBC Series on Child Problens [sic],” Northern Sentinel, October 6, 1958, p. 2. 11 Ibid. 12 Ibid. 13 Ibid.
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gender roles for feminine children of the time: gentle, passive, and obedient.14 By playing
(roughly) with frogs, toads, and snakes, the girl described in the article differed from nice, feminine interests which Kitimat residents identified as the norm for female behaviour, such as visiting, cooking, or sewing.15
Another example where the terms “mental health” are used in reference to behavioural problems in children appears in an April 1958 edition of the Northern
Sentinel, which summarizes a presentation given to the high school Parent-Teacher
Association [PTA] on mental health by local doctor Paul J.V. Woollacoot (1925-2001).16
Dr. Woollacott’s “talk on mental health,” as reported by the Northern Sentinel, presented on the warning signs of mental illness in children, which included “fixed behaviour problems [like] persistent lying, cheating or stealing.” 17 Each of these behaviours contrasts sharply with the norm of obedient children that was part of the socially ideal family unit in the 1950s. Therefore, through these two examples we see how the terms
“mental health,” where used verbatim by Kitimat residents, may imply an understanding that reflects an inconsistency with the socially ideal family unit that was prevalent in
1950s Kitimat. Another, more implicit form of mental health existed also existed for
Kitimat residents, where its understanding focused on the importance of work.
!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!! 14 Mona Gleason, Normalizing the Ideal: Psychology, the School, and the Family in Post-World War II Canada, 1945-1960, PhD diss., Ontario, Canada: University of Waterloo, 1996. 15 As outlined in Section 3.4.1.2. For an illustrated example, see Figure 3.5 in its representation of female children on the Women’s Page of the Northern Sentinel. 16 High School P-TA Hears Talk on Mental Health,” Northern Sentinel, April 24, 1958, p. 10; “’Mental Health’ P-TA Topic,” Northern Sentinel, April 14, 1958, p. 4. 17 Ibid.
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4.2.2 Work and Mental Health
During the recession period, Kitimat residents were confronted with one major realization: work was a vital component of their mental wellbeing. For Kitimat residents, work fulfilled the criteria which residents identified as necessary to achieve mental health, understood holistically as a state whereby individuals are productive and fruitful, and are able to contribute to their community.18 Therefore, when unemployment occurred in
Kitimat in 1957, it adversely affected that sense of productivity. As an illustration, an article entitled, “As Labour Sees it - -,” by E. P. Rodda—a local representative for
Alcan’s union, the United Steelworkers of America International Union—explains the problem of the unemployed, in light of Alcan and Kitimat's 1957-9 recession. Rodda writes:
Nobody, except the unemployed, knows of the mental suffering, dejection and desolation when the breadwinner is unable to find employment... The hell of unemployment is not only an actual wretchedness for those who fall into it; the constant fear of it darkens the life of the workers when in unemployment.19
As it was the first time that widespread unemployment existed in the town’s short history, the community took notice. An unemployed and dejected population was incompatible with the idea of a prosperous, productive, mentally healthy community that had attracted residents to Kitimat in the first place. As such, Kitimat residents came together to find community-provided solutions to return wage earners to work, where they could again participate as productive members of the community.
The existing unemployment assistance provided by the Province was viewed by residents as inadequate, and later was deemed too “bound up by policy and regulations in
!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!! 18 See Section 1.2.3. 19 E.P. Rodda, “As Labour Sees It,” Northern Sentinel, May 21, 1959, p. 4.
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what it can and cannot do” to provide any relief to workers.20 Residents were frustrated with the timely review process that the unemployed in need of assistance had to undergo from the provincial Unemployment Insurance (UI) Commission. Additionally, they deemed the provincial allowances for the unemployed to be inadequate: a worker could collect $6-23 UI per week, or $8-30 UI per week if he had dependents.21 Therefore, the
Municipal Council provided the unemployed with supplementary assistance, up to an additional $25 per month for each family on UI.22 The Municipal Council also provided part-time work for those unemployed, through a $137,700 Works Plan they devised with the Federal Government, constructing roads, parks, waterworks, and sewers for the community.
The 1957-1959 recession made clear to Kitimat residents the vulnerabilities of living and working in a resource-based community, as market fluctuations had resulted in massive unemployment—which prevented many from experiencing holistic mental health.
An unnamed construction worker interviewed by local reporter Pixie Meldrum regarding the recession describes, “I’m not looking for the big money anymore, what I want is a good steady job and I don’t feel like getting started all over again in a new place.”23 The sentiment shown by this man—that work provides feelings of security and productivity, would persist in Kitimat even during times of economic growth.
!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!! 20 Note: Eventually, residents’ frustrations with the inadequacy of Provincial unemployment services would prompt the community of Kitimat to provide its own financial assistance programs for the unemployed. “A Helping Hand,” Northern Sentinel, December 21, 1966, p. 2. 21 “Jobless Plan to Remain,” Northern Sentinel, November 21, 1957, p. 1. 22 Municipal Council Minutes, March 12, 1962. 23 Pixie Meldrum (former Northern Sentinel editor) in writing to Nat Cole of the Canadian Press in response to his request for information regarding Kitimat after the 1957-1959 recession, Spring 1960.
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4.3 Economic Recovery and Diversification, 1960 to 1979
From 1960 to 1979, Kitimat experienced economic recovery and diversification of its economic base as the result of industrial expansion and new development opportunities.
The first major developments occurred after a June 1958 announcement by Alcan that they would be increasing production and later expanding their facilities.24 This helped to pull the Kitimat economy from the 1957-1959 slump they were currently experiencing, with the creation of 50 new jobs.25 In their year-end editorial for 1958, the Northern
Sentinel announced, “BC OUTLOOK BRIGHT FOR 1959,” in prediction of the economic upturn that was taking place province wide, and was soon expected to spread to
Kitimat by its residents.26 In relation to global economic trends, another 1958 editorial in the Northern Sentinel reported that “1959 should be a year of recovery;” and, indeed
Kitimat’s economic conditions did improve.27 During mid-1959, Alcan signed a deal with
Chrysler to produce aluminum for use in its North American automobile factories.28 By the close of 1959, Alcan had announced two more aluminum-related production boosts, which resulted in Kitimat Works operating at 595,000 of a possible 770,000 tons per year.29 As a result, population growth recommenced, unemployment shrank by 50 percent, and houses vacated from the recession were again occupied in Kitimat by 1959, in sharp contrast to the conditions just two years earlier.30
!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!! 24 “New Work Week Means More Jobs,” Northern Sentinel, June 12, 1958, p. 1. 25 Ibid, p. 1. 26 “BC OUTLOOK BRIGHT FOR 1959,” Northern Sentinel, December 30, 1958, p. 1. 27 “A Brand New Year,” Northern Sentinel, December 30, 1958, p. 2. 28 “Kitimat Boost Ahead in New Call on Metal,” Northern Sentinel, June 25, 1959, p. 1. 29 “Kitimat Works Gets Third Production Boost,” Northern Sentinel, December 3, 1959, p. 1. 30 “Year Ends,” Northern Sentinel, December 31, 1959, p. 7; “Jobless Total Drops Sharply,” Northern Sentinel, July 23, 1959, p. 1; Following the 1959 recession, Alcan published an article in the Sentinel, “Empty Houses,” explaining that any person wishing to settle in Kitimat now had a choice of housing, in stark contrast to the early settlers who made do with inadequate conditions that “caused hardships and inconveniences for many.” Alcan, “Empty Houses,” Northern Sentinel, May 7, 1959, p. 2.
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The second major development that contributed to economic growth was the establishment of a pulp and paper mill in 1969. The Eurocan Pulp and Paper Mill project, valued at $100 million, began in the summer of 1969 and created 800 jobs for the community.31 The Eurocan Project contributed to Kitimat with employment opportunities, and a boost to the Municipal tax base.32 The new mill also restored feelings of growth and prosperity in Kitimat’s economic future, by supporting the community ideal of economic development. This is illustrated in excerpts from Northern Sentinel articles published during the time when Eurocan was first considering Kitimat as its new site for operations.
In 1962, Northern Sentinel editors emphasize the importance of securing a large industrial project, such as Eurocan, to support the community ideals of economic development, growth, and prosperity:
Whatever happens to increase the economy of Kitimat is good news for the town. Even if the project be mooted for a certain future, it bodes well for Kitimat’s recovery to a 10, 15 and eventual 50 thousand population.33
By 1963, the town believed that a pulp mill, specifically, could set the community back on the path towards economic growth. As cited in the Northern Sentinel year-end editorial for 1963:
It is urgent that every interest here—and potentially here—be united to deal with any danger that opposition may make it impossible for us to have the resource base to support a truly great and perpetually-lasting pulp and paper mill.34 By 1968, Eurocan had confirmed their establishment of a pulp and paper mill in Kitimat, which restored local confidence regarding the town’s future as a productive and
!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!! 31 “Direction: Forward,” Northern Sentinel, December 31, 1968, p. 1; A.L. Farley, July 1965, Impact of Industry on the Municipality of Kitimat, Developed for Eurocan Pulp & Paper Co., Ltd., p. i. 32 Ibid. 33 “1962 in Kitimat,” Northern Sentinel, December 27, 1962, p. 2. 34 “Our Most Promising New Year,” Northern Sentinel, December 27, 1963, p. 2.
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prosperous town. This is reiterated in the 1968 year-end editorial of the Northern
Sentinel, which declares:
What all of these things add up to, in the opinion of The Sentinel, is grounds for optimism. New businesses are on the way, a new hotel at City Centre is scheduled for an early spring start and—above all else—the pulp mill has moved from the paper stage to one of steel and concrete. Bring on 1969!35
Indeed, there was reason for the optimism suggested above, for the establishment of
Eurocan expanded and diversified Kitimat’s economy, which contributed greatly to its economic growth and recovery.
As a second industry, the presence of a pulp and paper mill provided some protection against market fluctuations. While the town would still suffer from the declines of primary resource markets (i.e. aluminum or pulp and paper), the diversification of their economic base meant that they would not be as severely impacted, as the community had an alternate source of revenue. Indeed it was for these reasons that the Northern Sentinel proclaimed, “This is the year [(1968)]—first in all too many—when Kitimat ends on a note of push rather than promise.”36 Throughout the 1970s, Kitimat would focus its energies on securing large-scale industrial development projects to further diversify its economic base. While Kitimat would never grow to be as large as residents had anticipated, the town remained in a steady state of economic recovery until the early
1980s.
!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!! 35 “Direction: Forward,” Northern Sentinel, December 31, 1968, p. 1. 36 Ibid., p. 1.
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4.4 Mental Health during Economic Recovery and Diversification, 1960 to 1979
4.4.1 Industrial Development and Holistic Mental Health
From 1960 to 1979, Kitimat residents understood mental health in relation to the economy, although with different priorities than during times of recession. Because new developments had contributed to decreased unemployment, Kitimat no longer focused on returning individuals to work. Rather, the community sought to attract new opportunities for economic growth, to continue growing towards the population size of 50,000 as the planners had initially proposed.37 Holistic mental health for Kitimat residents during this period was understood as a state achieved through work opportunities in the community, provided by industrial development. This understanding is best exemplified through examining what residents understood as a barrier to holistic mental health, the Province.
Throughout the period of 1960 to 1979, the Province supported industrial development in areas that did not include Kitimat. Residents were particularly upset when the Province supported development in other Northern BC communities. As a result, based on the relationship between holistic mental health and industrial development for this time, Kitimat residents identified the Province as their main source of discontent.
One example of this is the construction of the Vancouver Coliseum in 1962, which inadvertently led to feelings of resentment and betrayal among Kitimat residents.38 When the Province used plastic instead of aluminum as the building material for the Coliseum’s roof, residents took offense. As reported in the Northern Sentinel:
B.C. has at Kitimat a large aluminum smelter which provides bread and butter for a city of 7,000 people. It seems strange for the PNE [Pacific National Exhibit], which calls itself the showmart of this province, to thus !!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!! 37 Clarence Stein, Albert Mayer, and Julian Whittlesey, “Kitimat: A New City [REPRINT],” The Architectural Forum July 1954. Sponsored by the Aluminum Company of Canada. 38 “The Plastic Roof [Reprint]” Northern Sentinel, December 27, 1962, p. 2.
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ignore the products of a B.C. Industry. It's strange too for the B.C. Government which is giving a substantial grant toward the coliseum, to countenance the non-use of Kitimat aluminum in the project.39
As illustrated above, residents interpreted the use of plastic in place of aluminum as a hindrance to their community’s livelihood. While it is unknown as to whether or not the use of aluminum would have actually improved economic opportunities in Kitimat, the decision solidified Kitimat’s labeling of the Province’s as unsupportive of industrial development in Kitimat, and what they experienced as holistic mental health.
A second example occurred in 1972, when the Province announced that they would be developing Prince Rupert as a deep-sea harbor instead of Kitimat.40 Residents were convinced that Kitimat should have been chosen, so that they (Kitimat, BC, and
Canada) could benefit from the economic benefits of being the nation’s gateway to Asian markets.41 Residents and the Council wrote letters to Members of Parliament, Cabinet members, and the Prime Minister in protest of the Province’s decision.42 Some archival documents, such as the 1972 Northern Sentinel article, “It’s a Conspiracy—Pure and
Simple,” went so far as to claim that Prince Rupert had been chosen as the result of
“backroom political dealings” by a number of key players.43 Regardless of whether
Kitimat was victim to conspiracy or not, it is important to note that residents felt they were being held back from achieving holistic mental health, which at the time they understood as on par with industrial development.
!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!! 39 “The Plastic Roof [Reprint]” Northern Sentinel, December 27, 1962, p. 2. 40 “In 1971 Let’s Speed the Inevitable,” Northern Sentinel, January 6, 1971, p. 1-2. 41 Ibid., p. 1-2. 42 Ibid., p. 1-2. 43 Note: Residents hypothesized that Premier Dave Barrett (1930-), Environment Minister Jack Davis (1916-1991), Premier W.A.C. Bennett, and the Canadian National Railway had conspired to establish Prince Rupert as the new transportation hub of the Province, at the disadvantage of Kitimat. “It’s a Conspiracy, Pure and Simple,” Northern Sentinel, December 28, 1972, p. 1.
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Additional incidents also occurred that contributed to Kitimat’s identification of the Province as a barrier to holistic mental health. For example, in 1976 a Japanese company (Nippon Kōkan KK [NKK]) abandoned its negotiations to establish a steel and coal mill in Kitimat because of the cost of labour that instilled by the BC government.44
While not directly the Province’s fault, its association with missed opportunity for industrial development added to the discontent that Kitimat was feeling towards them.
The proposed Alaskeyan Trans-Mountain Pipeline—intended to carry Alaskan oil inland from Alaska to Kitimat, to Edmonton—was another industrial development project that was abandoned due environmental concern, causing the Province to terminate the project in 1979.45 In their eyes, Kitimat residents believed that the Province had thwarted their opportunities for industrial development. Consequently, residents came to the realization that if they wanted to secure industrial development opportunities—essential to achieving holistic mental health—they would have to pursue them for themselves.
The perceived lack of Provincial support for industrial development in Kitimat contributed to the community’s grassroots approach to pursuing employment, industrial development, and later, health services. The Municipal Council, Chamber of Commerce, and small business owners participated in activities that promoted investment and would provide work opportunities for their community. These initiatives began at the close of the 1957-1959 recession, with the Chamber of Commerce hosting a convention to promote industrial investment in Kitimat. Invited Premier W.A.C. Bennett did not attend the town’s convention, which contributed to the unsupportive reputation that the Province was getting in Kitimat—especially considering that the Prime Minister of Canada, John !!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!! 44 “Looking Back at Kitimat’s Role in 1977,” Northern Sentinel, January 6, 1977, p. 1-2; Municipal Meeting Minutes, February 24, 1975. 45 “Looking at Kitimat’s Role in 1977,” Northern Sentinel, January 6, 1977, p. 1-2.
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Diefenbaker (1895-1979) of the Progressive Conservatives, had made time to attend.46
Another example of a local industrial development initiative took place in 1971 when members of Municipal Council attended the Northern Economic Development conference to explore new development opportunities, and financed its own feasibility studies for potential industries.47 The Municipal Council also took the initiative to write letters to the
Ministers of Transport, Public Works, Industrial Development, and Trade and Commerce, as well as the Premier of BC and the Prime Minister of Canada, to express discontent with the Province, having not supported the community with industrial development opportunities.48 Finally, when Kitimat was passed over in favour of Prince Rupert to develop a federal shipping port in 1972, Kitimat’s Municipal Council sought designation as a public harbor through national legislation; namely the Canada Shipping Act.49
4.4.2 Biomedical Mental Health and Community Services
Kitimat’s community-based approach to securing economic development eventually leaked into the town’s pursuit for mental health services, an important component to their understanding of biomedical mental health. Some community-based assistance programs were developed to address biomedical mental health and illness, which residents understood primarily to be influenced by childhood development. One example includes the Kitimat Association for the Mentally Retarded (1972), which sought to improve the quality of life for those with developmental impairment. Another example
!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!! 46 “Diefenbaker to Visit Here Aug. 24,” Northern Sentinel, May 21, 1959, p. 1. 47 Municipal Meeting Minutes, July 14, 1971. 48 Municipal Meeting Minutes, October 12, 1972. 49 Ibid.
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is the Kitimat Community Services Society, (1974), which provided aid to developmentally disabled children, in addition to other employment-related services.50
4.4.3 Background to Clinical Mental Health Services
An important backdrop to the community-based pursuit of clinical mental health services, which is the focus of the next chapter, is the establishment of the $3.5 million- dollar hospital, on which construction began in 1958.51 The Kitimat General Hospital had four levels, a 219-bed capacity and was designed to be “community health focused” where residents could go for all medical services.52 An overview of these services and their location within the KGH are shown in Table 4.1, and a picture of the completed hospital is shown in Figure 4.2.
Figure 4.2 A snow-blower working in front of the Kitimat General Hospital, 1964
© The Kitimat Centennial Museum 2013
!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!! 50 When Kitimat Community Services opened in 1974 they offered community help (employment services), help with the handicap, a child development centre, consumer services, debt counseling, and well as justice, youth, housing, and mental health. They also worked with the Foster Parent Association and Big Brother. “Kitimat, British Columbia,” Outwest Magazine 1, no. 1 (September 1975), p. 28. 51 “Now They’ve Started Something—A Hospital!” Northern Sentinel, April 3, 1958, p. 1; The Province of British Columbia granted $1.395 million to the project; the Federal Government granted $293,000; and, the Municipality of Kitimat provided $1.5 million towards the project. Alcan donated $290,000, and miscellaneous donations and revenues from residents provided $12,000. (Speech by DA Robertson). 52 “Chet,” interview by the Author, Kitimat, BC, August 9, 2012.
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As illustrated in Table 4.1, clinical mental health services (i.e. psychiatric services) were not included in the KGH. However, qualitative interviews with long-term residents who had experience working in the hospital during the 1970s, as a board member or Candy Striper, reveal how severe mental health cases were dealt with— information not found in other archival sources. According to participants, the KGH kept two padded, barred rooms reserved for “very wild” patients where they would be dressed in a straight jacket or guarded by an RCMP officer.53 Long-term resident and former hospital volunteer, Maria, explains that “There’s people there, like waiting to get shipped out elsewhere because it’s a temporary solution, right?...If somebody had presented as being, really severely psychotic, they would have been gone. Very quickly.”54 As she described, mental health patients in Kitimat would be kept at the KGH until they were no longer deemed a threat to their own safety, after which they were then transferred to the
Mills Memorial Hospital psychiatric unit in the neighbouring town of Terrace, or possibly the Riverview Psychiatric Hospital located in Coquitlam.55
!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!! 53 Ibid. 54 “Maria and Ann,” interview by the Author, Kitimat, BC, August 8, 2012. 55 “Chet,” interview by the Author, Kitimat, BC, August 9, 2012.
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Table 4.1. Health Services and their Location with the KGH, 196056
Area Services Mental Health Services 4th Floor Nurses’ accommodations Doctor’s office* Medical offices Dental offices 3rd Floor Delivery Area Padded rooms* Nursery Maternity Unused space (for expansion)
2nd Floor Temporary paediatrics Suicide watch* Medical ward Surgical Ward Operating Room CNR (unclear)
1st Floor Paediatrics X-Ray Lab Physiotherapy Administrative Services Emergency Department
Basement Dietary Public Health Staff quarters Laundry Maintenance Boiler Room Sub-Basement Store Rooms Storage Generator Electrical *Unconfirmed in archives.
4.5 Summary
After experiencing economic recession and unemployment in the community for the first time, Kitimat residents came to identify work as an essential component of holistic mental health, which could be achieved through industrial development. During the 1957 to 1959 recession, Kitimat residents understood holistic mental health in relation to the social expectations and ideals they held for children and adults. For children, this !!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!! 56 Adapted from Robertson, “Speech at the Opening Day for the Kitimat General Hospital [Transcript].”
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meant that a normal, mentally healthy child was an obedient member of an ideal family unit. For adults, this meant that a mentally health individual was one who supported the ideal family unit, through employment. Kitimat residents, and their Municipal Council, spent the period of 1960 to 1979 seeking opportunities that would support holistic mental health, through the creation of jobs generated by industrial development. Where the
Province supported the development of industries in other communities and at times prevented development in Kitimat, residents interpreted this as a barrier to holistic mental health. In response to this, the community hosted its own development initiatives to encourage industrial development and job creation.
Biomedical understandings of mental health also existed for the time, although they were not reflected in the existing health services of the time, nor included in public discussions regarding the construction of the Kitimat General Hospital. During the 1970s, however, community organizations did provide some services that addressed a biomedical understanding of mental health, which they understood as some impairment of the mind.
The community’s support for biomedical and holistic mental health, either through the child development programs or work opportunities they created, remained during times of economic recession and growth. Eventually, this support would evolve into a grassroots approach to obtaining mental health services during Kitimat’s third stage of development, where residents came to understand mental health through a combination of both the biomedical and holistic perspectives.
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Chapter 5: Economic Development and Community Services, 1980-2010
5.1 Introduction
During Kitimat’s final stage of development, 1980 to 2010, residents understood mental health primarily in relation to the services they did or did not have. In response to the absence of the clinical services which residents considered necessary (e.g. a resident psychiatrist), the community shifted their focus from obtaining these services from provincial or regional health authorities, such as the Skeen Health Unit or the BC Ministry of Health, to providing their own services from within the community. Kitimat’s transition reflects an overarching theme of population health: improving health through upstream interventions that address social determinants.
This section is divided into two periods: (1) 1980-1989 and (2) 1990-2010. The first period focuses on the pursuit of Kitimat residents to acquire clinical mental health services, in correspondence with the economic downturn and high-profile events that occurred within the community. The second period explores the economic circumstances and absence of clinical services, which led the community to establish and provide holistic and preventive mental health services (“community-provided services” [CPS]).
5.2 Economic Circumstances, 1980 to 1989
In 1980 and again in 1981, Canada experienced deep economic recessions that majorly affected its manufacturing industries. This “Double Dip” Recession, as termed by economists, resulted from the attempts of the United States Federal Reserve and other centralized banks, to control inflation by reducing the monetary supply.1 Credit controls
!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!! 1 Peter Nicholson, “The Growth Story: Canada’s Long-run Economic Performance and Prospects,” International Productivity Monitor 7 (2003): 3-31, p. 4.
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imposed by the US economy affected Canadian industry, because high-interest rates and inflation reduced market potential for Canadian exports, particularly in manufacturing- related industries.2 Because Kitimat relied on exporting products produced by its primary industries (e.g. natural gas, pulp & paper, aluminum), the town was greatly affected by the unemployment and decreased production introduced by these industries.
The first sign of economic decline came in November 1982, when Eurocan closed the wood mill facility it operated as part of its Kitimat pulp and paper plant.3 This closure resulted in the loss of 490 jobs in the community.4 This led to former Eurocan workers and their families leaving town to seek work opportunities outside of Kitimat, which is reflected by 3,000 residents who left Kitimat between 1982 and 1986.5 Maria, a long-term resident (since 1960) explains her family’s decision to leave for a more urban area, after her husband was dismissed from Eurocan.
Eurocan sawmill closed, and that’s where [my husband] was working. And they laid off, I would say, about a hundred—two hundred guys?6 And we had the option to hang around and wait to be rehired or for him to be hired at Alcan. So we hung around for about a year, and then uh, I was working but I was just waitressing so I wasn’t making a lot of money. And um, he had the opportunity to go to Prince George to do a steam-engineering course, as part of his EI [Employment Insurance] benefits, and so we did that. And while we were in Prince George his dad had a rather serious accident at the mine he was working at, and so we decided we would make that move and would go and spend some time in Ontario, because he knew he could work there. So, we did that.
!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!! 2 Philip Cross, Phillippe Bergevin, “Turning Points: Business Cycles in Canada since 1926 [Commentary],” C.D. Howe Institute 266 (2012): 1-24, accessed May 2, 2013, http://ezproxy.lib.ucalgary.ca/ login?url=http://search.proquest.com.ezproxy.lib.ucalgary.ca/docview/1130215805?accountid=9838. 3 District of Kitimat, “Population Estimates and Census Counts, 1953 to Date,” District of Kitimat, accessed April 22, 2013 from http://www.kitimat.ca/assets/Residents/PDFs/population-table.pdf; District of Kitimat, Economic Development Strategy (District of Kitimat: Kitimat, 1986), 10; Minutes of the Municipal Council, Kitimat, B.C., December 5, 1983 (hereafter cited as: Municipal Council Minutes, “date”). 4 Ibid. 5 Local estimates show a population of 14,000 in 1982, and 11,196 in 1986. See District of Kitimat, “Population Estimates and Census Counts.” 6 Actual number of jobs lost was 490. See District of Kitimat, Economic Development Strategy, 10; Municipal Council Minutes, December 5, 1983.
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While Maria did leave (in 1982), she returned to Kitimat (in 1992) when work in the community was again picking up. Maria’s friend, Anna, also followed this pattern of leaving and returning to Kitimat based on work opportunity. Anna and her family, residents since 1962, left town in 1985 and returned in 1990. She and Maria discuss the reasons below:
Maria: Well, my husband lost his job [at Eurocan], I lost my job. I had two small kids, and no family nearby. Like, my immediate family nearby, so it was basically—I like to laugh and say, “I wanted my mother.” So we came back [to Kitimat] because my mom and dad were still here, we could live with them. And Alcan was seen as a stable employer. Anna: Yeah, that’s funny eh? You and I came back at the same time, too. It’s basically the same thing. Interviewer: Same reason? Anna: Yeah, well we had two small kids, the same reason. And um, things were starting to look up in Kitimat again. We left because they weren’t looking up, because my husband was in construction.7
As they describe above, Anna and Maria’s decision to leave Kitimat was influenced by economic circumstances, in particular the Eurocan layoffs and limited opportunities in construction.
Apart from the Eurocan closure, the year 1982 also marked the completion of the
Ocelot Methanex project. On the one hand, the opening of Ocelot Methanex was a positive thing for the Kitimat economy, for it further diversified the town’s economic base and increased the municipal tax base. On the other hand, the completion of this natural gas plant meant that it no longer needed to employ the manpower that had been required during its construction. As a result, Ocelot Methanex laid off the 900 construction and
!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!! 7 “Maria and Anna,” interview by the Author, Kitimat, BC, August 8, 2012.
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start-up workers that had built it.8 This is reflected as well in Kitimat’s population count, for it contributed to the 3,000 residents who between 1982 and 1986.9 In fact, it was the completion of this project that initially prompted Anna’s family to leave Kitimat. Anna’s husband, who worked construction, had tried to get work in the Methanex project for a number of years:
Anna: Ocelot Partech10 had the contract and things were booming here, so [my husband] decided to quit [his old] job, and put his name on the union list [for construction jobs], and poor guy. Never, ever got called. His name was on the list, but he’d get called to other [construction] jobs. And he never got that big job, and so he had had it. He got frustrated—with two small kids— our, in those days, our payments were high. [To Anna:] Do you remember?
Anna then went on to discuss with Maria the financial stresses that their families faced, that encouraged them to seek work opportunity outside of Kitimat:
Anna: …things were so high, we couldn’t make our payments… Maria: On the house, car, anything. Anna: Anything. Maria: Cost of food.
Thus, once the Methanex project was completed, Anna and her family left Kitimat, convinced that there would be no work opportunity, outside of major industrial construction projects. Anna’s experience shows that it was not only residents who worked for major employers, like Ocelot Methanex or Eurocan, that were affected by economic downturn, but also those who worked in peripheral industries and supporting businesses, like construction. Local retail businesses were also affected, as indicated by the Kitimat
!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!! 8 District of Kitimat, Economic Development Strategy, 10; Municipal Council Minutes, December 5, 1983; “Methanex: Corporate History,” Methanex Corporation, accessed April 22, 2013, http://www.methanex.com/newsroom/documents/MX_Corporate_History_2012.pdf. 9 District of Kitimat, “Population Estimates and Census Counts, 1953 to Date.” 10 Also known as Ocelot Methanex.
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Chamber of Commerce newsletter, which identified members as feeling the “pinch of the economy.”11
The effects of the Double Dip Recession on Kitimat industries continued throughout the 1980s. First, Alcan withdrew its plans to expand hydroelectric facilities at
Kemano in 1984.12 In pulp and paper, Eurocan laid off an additional 126 employees in
1986, adding to the 490 previous layoffs.13 Even the newly operating Ocelot Methanex was affected; for they delayed the construction of a new ammonia plant they had planned to 1987, when the economy was more stable.14 As a result of these recessionary events, unemployment in Kitimat reached the highest point in the town’s history at 10.6 percent.15
The following section will explore how Kitimat residents understood mental health from
1980 to 1990. As will become apparent, the Province of British and its regional health boards also faced economic difficulties, which had implications for the mental health of
Kitimat residents.
5.3 Mental Health from 1980 to 1989: The Pursuit of Psychiatric Services
During the period of 1980 to 1989, Kitimat residents espoused mainly a clinical understanding of mental health (see Section 1.2.3) that focused on the acquirement of psychiatric services. This marked a shift from the holistic understanding of mental health that residents had adopted in decades prior (i.e. following work or family ideals to achieve mental health). The move towards a more clinical understanding follows the trend of deinstitutionalization that was occurring across Canada during the 1980s in the field of
!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!! 11 Kitimat Chamber of Commerce, Chamber Pot [Newsletter], June 82. 12 Alcan, Alcan in Kitimat-Kemano [Booklet], (Kitimat, BC: Public Relations Department, ca. 1985). 13 Paul Johnston, Rocque Berthiaume, and Bill Horswill, Aspect Consultants Inc., Makin’ Metal: Technological Change Impact Study (Canadian Association of Smelter and Allied Workers Local One, February 1986). 14 Methanex Corporation, “Methanex: Corporate History.” 15 Municipal Council Minutes, May 25, 1983.
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psychiatry. With mental health proponents encouraging rehabilitation of patients into society through community-based treatment, communities across the country became witness to mental illness and its treatment.16 The result of this was an understanding of mental illness and health that was defined by those who treated them—medical professionals like psychiatrists, psychiatric nurses, and psychologists.
5.3.1 Psychiatric Services Prior to the Pursuit, (pre-1980)
There is little information available regarding the psychiatric services that existed in Kitimat prior to 1980. The Municipal Council meeting minutes for September 25, 1978
(discussed in detail, Section 5.2.2) indicate that Kitimat had been without psychiatric services since 1974—which suggests that some had existed in previous years.17 Historical trends of medical services of Kitimat are able to give some insight into the possible psychiatric services that Kitimat may have had. Based on Kitimat’s history of practicing medical professionals, it is likely that a visiting consultant would have provided psychiatric services. As shown in Table 5.1, Kitimat has had a number of consulting, visiting specialists to supplement the practice of their general practitioners (GPs). The following information is compiled from the District of Kitimat’s annual reports, 1961 to
1981.18
!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!! 16 James Moran, 2009, “History of Madness and Mental Illness: A Short History of Care and Treatment in Canada,” The History of Madness in Canada, accessed April 22, 2013, http://historyofmadness.ca/index.php?option=com_ content&view=article&id=80&Itemid=109&lang=en. 17 Municipal Council Minutes, September 25, 1978 18 Note: Information prior to 1961 does not exist in the District of Kitimat holdings, for the Aluminum Company of Canada provided services privately at the Smeltersite Hospital until 1958 when the Kitimat General Hospital was established. It is likely that reporting of doctors by type changed in 1969 when Kitimat was incorporated into the Skeena Health Unit, whose resources (such as a Medical Officer for Health) served all regional health boards (e.g. Terrace, Kitimat, Prince Rupert).
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Table 5.1. Number of doctors reported in District of Kitimat
Total Practicing General Practitioners Consultant “Doctors” (unspecified) 1961 7 - -
1962 10 - -
1963 9 - -
1964 10 - -
1965 10 - -
1966 9 - -
1967 - - -
1968 9 - -
1969 10 - -
1970 15 8 7
1971 17 9 8
1972 16 9 7
1973 15 7 8
1974 - - -
1975 13 7 6
1976 14 8 6
1977 14 7 7
1978 17 7 10
1979 21 11 10
1980 - - -
1981 18 8 9
- = Report or finding not available.
Prior to 1969, archival documents only show counts of doctors without further classifying them as a general practitioner or consultant. From 1969 to 1981, however, the numbers
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are reported for each general practitioners and consultants. As psychiatrists fall into the specialist category of medical doctors,19 if psychiatric services were provided then it is most likely that they would have would have been included as a specialist doctor that visited/consulted with Kitimat patients regularly. This is further supported by an article on
Kitimat’s development in Outwest Magazine, which reported that the town had services of one visiting psychiatrist in 1975.
Based on the information that does exist for psychiatric services in the region of
Northwest BC prior to 1980, it is probable that if a psychiatrist did visit Kitimat they would have come from the psychiatric unit of Mills Memorial Hospital in Terrace. This is based on the town’s relatively close proximity (56km), and the Mills Memorial Hospital supplying Kitimat with a visiting psychiatrist once per week later on, in 1986.20 The frequency of existing services prior to 1978 is unknown, but might have been similar to those reported in 1987, which were as little as one time per month (Hospital
Administrator, Ron Burnett) and as much as one to two times per week (Northern Sentinel reporter, Jeffrey Taylor).21 While the information provided here is speculative, it is meant to provide background information to the pursuit of psychiatric that Kitimat residents engaged in, beginning in 1978.
5.3.2 The Pursuit Begins, 1978
The pursuit to obtain local psychiatric services for Kitimat began in 1978 and continued throughout the 1980s. It began during a Municipal Council meeting held
September 25, 1978, the proceedings of which reads as follows:
!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!! 19 According to the Canadian Psychiatric Association and the Royal College of Physicians and Surgeons of Canada. See “How Do you Become a Psychiatrist?” Canadian Psychiatric Association, 2012, accessed June 8, 2013, www.cpa-apc.org. 20 Ibid. 21 Jeffrey Taylor, “Mental Health SWAT Team Comes to Kitimat,” Northern Sentinel, April 10, 1987, p. 1.
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Alderman Buschert [of Kitimat] stated that she would like [the Municipal] Council to approach the Skeena Union Board of Health and the local administration at the hospital to find out what, if anything, is being done to re- institute psychiatric services in Kitimat. She also said that she has waited for the better part of a month for the Government to make a move, but so far nothing had happened.
Mayor Thom stated that he had written a letter to the Honourable Bob McLellan [ca. 1933], which was given to him by hand on his recent visit to Kitimat.
Alderman Buschert went on to say that budgets [for the Province and the Skeena Health Unit] are now being drawn up, and therefore we must move quickly in order to have these services re-instituted this fall.
The above passage reports that Kitimat’s mayor—Mr. George Thom—had written to the
BC Minister of Health in 1978, the Honourable Robert Howard McLellan (ca. 1933) to request psychiatric services. By January 1979, the Municipal Council still had not received a reply, and rewrote.22 They received a response from the Ministry of Health in
February 1979, of which no details were recorded other than its subject, “regarding the unfilled mental health worker positions in Kitimat.”23 The correspondence described above between the Municipal Council and the Ministry of Health signifies the start of a long and frustrating struggle in Kitimat’s pursuit of psychiatric services, which is summarized below in Table 5.2.
Table 5.2 Timeline of the Pursuit for Psychiatric Services in Kitimat
Year Service Event 1975 1 visiting psychiatrist 1978 Council complains of need to reinstate psychiatric services in Kitimat 1979 (Jan) No mental health worker in the Regional District of Kitimat-Stikine 1979 (Feb) BC acknowledges 1979 (Aug) Psychiatric social worker was in town for the summer, need permanent replacement
!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!! 22 Municipal Council Minutes, January 9, 1979. 23 Municipal Council Minutes, February 26, 1979.
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Year Service Event 1979 (Aug) Terrace Mental Health Institute says Kitimat will have full time Psychiatric Social Worker by Oct.1 1982 Terrace Mills Memorial Hospital reduces number of beds in psychiatric unit 1984 Town begins looking for psychiatrist 1985 (Jan) Resident psychiatrist delayed due to immigration; never arrives 1985 (May) 2 visiting psychiatrist BC send 2 psychiatrists to Kitimat 1985 (Jun) Skeena Union Board of Health advocates for funds for psychiatric services to Associated Boards of Health Ministry of Health will assist in recruiting and 1985 (Jun) screening a psychiatrist 1985 (Oct) Skeena Board of Health has vacancy for Medical health Officer; takes priority over psychiatrist for Kitimat 1985 (Dec) Still no MHO 1986 (Jul) Council writes Province – still no psychologist, still no psychiatric social worker 1986 (Sep) Province still looking for psychiatric social worker 1987 (Feb) General Practitioners Still no psychiatry services, Council writes Ministry of One RN who deals with all Health mental health-related cases at *psychiatrist visits Kitimat from Terrace 2x a week the hospital social worker and psychologist visit same day weekly 1987 (Apr) No resident psychiatrist in recruitment 1987 Mental health SWAT team in response to a double murder, 2 suicides, and 3 attempted suicides in a 3- week period 1987 (Mar) Minister of Health writes that he is doing all he can 1987 (Jul) No psych. services; write to clinical director in Mental Health Services to meet with Council 1988 (Jan) No psychiatric services 1988 (Apr) Kitimat Task Force on Drug and Alcohol 1992 Resident psychiatrist Visiting psychiatrist 1993 Resident psychiatrist takes position in lower mainland 1996 Psychiatric nurse Youth and child counsellor Visiting psychiatrist Visiting child psychiatrist
Municipal Council shelved their pursuit until May 1982, when the neighbouring city of Terrace announced the reduction of their psychiatric services.24 The board of the
Terrace Mills Memorial Hospital, which at the time provided specialized services for the entire region of the Skeena Health Unit (including Kitimat), announced that they would
!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!! 24 “Kitimat to Protest Cuts in Region’s Psychiatry Unit,” Northern Sentinel, May 26, 1982, p. 1.
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be reducing the number of beds in their psychiatric ward.25 Having yet to obtain clinical services of their own, the community was disappointed with this news. In writing to the
Terrace Mills Memorial Hospital board, the Municipal Council pointed out that the reduction of beds in Terrace would reduce the chances of acquiring future psychiatric services for the region, as it had taken so long to initially establish a unit in Terrace.26 At the time, the psychiatric facilities at Terrace were the only formalized services of this type that were available to Kitimat residents, and to the Skeena Health Unit as a whole.27 Even prior to announcing their reduction of beds,28 facilities at Terrace were inadequate—its psychiatric unit had been operating without a permanent director for over a year.29
Kitimat’s Municipal Council worried that this, along with a reduction in services, would negatively affect their pursuit in obtaining their own psychiatric services.
5.3.3 Provincial Support to the Pursuit of Psychiatric Services
After trying unsuccessfully to recruit a psychiatrist, Kitimat’s community organizations (Municipal Council; Kitimat Hospital Board of Trustees; Skeena Health
Unit; School District 80 [Kitimat]) again wrote the Provincial Ministry of Health throughout the early 1980s, repeatedly requesting assistance in their search.30 Eventually, the Ministry responded. In 1985, Social Credit Party Member and BC Health Minister Jim
Nielson (b. 1937) appointed a team to review Kitimat’s request, the results of which
!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!! 25 Ibid. 26 Ibid. 27 Ibid. Note: The Skeena Health Unit provided a form of health care that split specialties amongst its various community. For example, Kitimat housed the orthopedic surgeon for the region until the mid-1990s, when they were moved to Prince Rupert. 28 Note: There is no mention of how many beds were actually cut, though today the facility operates with a 10-bed psychiatric unit. See “Health Facilities in Terrace,” Northern Health, accessed May 31, 2013, northernhealth.ca. 29 “Kitimat to Protest Cuts in Region’s Psychiatry Unit,” Northern Sentinel, May 26, 1982, p. 1. 30 “The Psychiatrist Search Resumes,” Northern Sentinel 1986 [clipping accessed from archives, no date].
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supported Kitimat’s beliefs.31 As reflected in a front-page 1985 headline of the Northern
Sentinel: “Review Team says Kitimat Needs Full time Psychiatrist.”32
In response to these findings, the Ministry of Health had agreed to provide funds to recruit a psychiatrist for Kitimat, lobby qualified doctors, and send out a job application in addition to what the Skeena Health Unit had tried.33 By 1986, Kitimat still was unsuccessful in their recruitment attempts. This spurred school board chairman, Richard
Wozney (b. 1944), to again write the Honourable Jim Nielsen restating Kitimat’s need for a resident psychiatrist. Unfortunately, even with Provincial aid, the search was futile and
Kitimat went without clinical mental health services. What did come out of the search, however, was the increased discussion and prioritization of psychiatric services in Kitimat.
Groups such as the school board, hospital, Municipal Council, and administration all spoke to the Northern Sentinel in support of Kitimat’s urgent obtainment of a psychiatrist. 34 During these discussions, Kitimat residents also linked economic circumstances with mental health. For example, in a comment on the need for psychiatric services in Kitimat, Alderman Joanne Monaghan explains to reporter Jeffrey Taylor of the
Northern Sentinel that, “living in an isolated community causes problems. This situation is compounded when there is an uncertainty of work and the local economy is suffering.”35 Thus, Kitimat residents recognized that the effects of economic downturn, such as unemployment, impacted mental health. Generally speaking, one might consider the recognition of a problem as a step towards a solution. Regarding the pursuit of mental
!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!! 31 Jeffrey Taylor, “Review Team says Kitimat Needs Full Time Psychiatrist,” Northern Sentinel May 23, 1985, p. 1. 32 Ibid., p. 1. 33 Ibid. 34 Ibid. 35 Ibid.
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health in Kitimat, however, the situation was only get worse. As the community failed to secure psychiatric services, residents’ understandings of mental health and its related services came to center around the issues of tragedy and crisis response.
5.3.4 Tragic Events and Mental Health
During the month of April 1987, Kitimat experienced a chain of tragic events that drew attention to clinical mental health services as a matter of urgent priority for its residents. Within a matter of weeks, Kitimat experienced: the killing of a teen (details not provided), a suicide by fire, the drowning of two young children by their mother, a suicide by overdose, and two attempted suicides.36 The community associated these events with mental illness; for the woman who drowned her children was later found to be schizophrenic,37 and suicide is often associated with depression.38 Thus, it was these events, after more than ten years of the community lobbying the Province for psychiatric services that renewed discussion of clinical mental health in Kitimat.
During his inquest into the cause of the tragic events, hospital administrator and coroner, Ken Last, shared his theories with the community in an interview with the
Northern Sentinel. Last drew on the same connections regarding economic circumstances and mental health as Alderman Monaghan had, just two years prior. In consideration of the tragic deaths, Last names the “pinch of the economy,” “high unemployment rate, declining retail sector, inclement weather and ‘end of the road’ syndrome” as potential
!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!! 36 See “The Psychiatrist Search Resumes,” Northern Sentinel 1986 [clipping from accessed from archives, no date]; Jeffrey Taylor, “Search for Psychiatrist Stepped up in Wake of Deaths,” Northern Sentinel, April 2, 1987, p. 1. 37 Taylor, “Search for Psychiatrist Stepped up in Wake of Deaths.” 38 Romain Gatelet, P. Hardy, and C. Bungener, “’Suicidal Intentions:’ Literature Review and Perspectives [Article in French]” Encephale 38, no. 2 (2013): 118-125; Zoltan Rihmer, Peter Dome, and Zenia Gonda, “The Role of General Practitioners in Prevention of Depression-Related Suicides,” Neuropsychopharmacologia Hungarica 14, no. 4 (2012): 245-251.
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causal factors.39 It is important here to note that Last was described in this article as a long-time advocate for improved clinical mental health services in Kitimat. However, he does not name the lack of psychiatric services in Kitimat amongst potential causes of deaths. Rather, Last’s identification of employment, economic circumstances, and isolation point to a more holistic and social determinants view of mental health. However, this connection—mental health and economic circumstances—was not yet made the focus of mental health in Kitimat. Instead, the tragic events prompted short-term, crisis- response services (e.g. Crisis Support hotline) and also reaffirmed Kitimat’s desire for a resident psychiatrist.
Specifically, The Ministry of Health dispatched a “SWAT [Special Weapons and
Tactics] team of mental health professionals,” as termed by the Northern Sentinel, from the Vancouver Lions Gate Hospital to Kitimat to consulted with Kitimat residents and began a cycle of monthly visiting psychiatrists that still exists for the area. 40 However, while the services were appreciated, they remained insufficient. Ron Burnett, a local leader and community advocate for business and economic development, and former chairman of the Kitimat hospital board, pointed out that, “the problem with doctors coming in once every four to six weeks is that patients will have to plan their breakdowns for when the doctors are in town. The program doesn’t solve the overall problem.”41
Burnett’s statement marks an important point in the history of mental health in Kitimat.
By identifying a need to solve the “overall problem” of mental health in Kitimat, and by rejecting psychiatric services as the only solution, Burnett and his community moved
!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!! 39 Jeffrey Taylor, “Coroner’s Service Undertakes Study,” Northern Sentinel, April 23, 1987, p. 1. 40 Jeffrey Taylor, “Mental Health ‘SWAT’ Team Comes to Kitimat,” Northern Sentinel, April 10, 1987, p. 1. 41 Ibid.
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towards finding longer-term solutions that could be provided without medical intervention and reliance on medical professionals.
5.3.5 Mental Health and Community-Provided Services
Facing the limited and insufficient provision of mental health services, the town took a different tack in their pursuit of mental health services. Throughout the 1980s, a variety of local organizations stepped in to fill the lack of provincially provided mental health services, to provide psychological and support services for their community. For example, local unions provided counseling and peer support, 42 Kitimat Community
Services Society (est. 1979) continued to provide support for the unemployed,43 the Crisis
Line (est. 1984) assisted depressed, addicted, or abused callers, and the Tamitik Status of
Women counseled, supported, and referred women in need to Terrace’s psychiatric unit.44
By the time that Kitimat reached its next stage of economic development, residents had shifted their understanding of mental health from something achieved only through
Provincially-provided, clinical services, to community-run, preventive services. This shift is especially apparent during 1990 to 2010, when Kitimat residents faced unrealized industrial developments, new expansion plans, and unanticipated industrial closure.
5.4 Economic Circumstances, 1990-2010
From 1990 to 2010, Kitimat experienced periods of both economic development and decline. One project that exemplifies both of these circumstances is the Kemano
Completion Project (KCP). The KCP was an attempt made by Alcan to increase its
!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!! 42 Counselling services were and paid for by both Eurocan and Alcan. Currently, Rio Tinto Alcan continues this service for its employees. See Section 2.1.2 for more information on Kitimat’s CAW Local 2301 union and how they support mental health. 43 “History,” Kitimat Community Services, accessed April 22, 2013, http://www.kitimatcommunity services.ca /History.html. 44 “About,” Tamitik Status of Women, accessed April 22, 2013, http://www.tamitik.ca/about.html.
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smelting capabilities and profit from surplus power sales, by expanding the hydroelectric facilities that powered its operations at Kitimat.45 The project would have created 2000 permanent jobs for northern BC, and provided enough power to build two new smelters the size of Kitimat’s.46 Planning and negotiating for the KCP began in 1980 between
Alcan and the Province, and construction commenced in 1988. 47 Kitimat residents supported the KCP, 48 for they believed that it would bring economic growth and opportunity to the area; especially important considering the layoffs that had happened in the 1980s (see Section 5.2). The project, however, was cancelled in 1995 due to environmental concerns raised by the Department of Fisheries and Oceans regarding the region’s salmon stocks.49 The cancellation of this project meant two things; first, that
Alcan had to find a way to recuperate the $500 million it had invested into the project, and second, Kitimat could no longer count on the KCP as a way of improving the town’s economic circumstances.
In an attempt to regain lost investment,50 in 2000 Alcan announced that it would cut aluminum production at Kitimat and sell the surplus power to US customers.51 The
!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!! 45 Paul Wilcocks, “Killing Me Softly,” BC Business, March (2004): p. 18-27; Municipal Council Minutes, September 11, 2006. 46 Municipal Council Minutes, Feb. 25, 1980; Province of British Columbia—Ministry of Industry and Small Business Development, The Northwest Region: A British Columbia Regional Economic Study, 1982 (Economic Development in Northwest British Columbia: Challenges and Opportunities), (Interministry Working Group on Northwest British Columbia, May 1982), p. 100; Alcan, Alcan in Kitimat-Kemano [Booklet], (Kitimat, BC: Public Relations Department, ca. 1985). 47 Bev Christiansen, Too Good to Be True: Alcan’s Kemano Completion Project (Vancouver, BC: Talonbooks, 1996); Government of Canada, Commission of Inquiry into the Decline of Sockeye Salmon in the Fraser River, Policy and Practice Report: Regulation of Water Uses in the Fraser River Watershed, August 18, 2011, accessed April 22, 2013, http://www.cohencommission.ca/en/pdf/PPR/PPR21- RegulationOfWaterUses.pdf. 48 For example, it is foreseen as a positive boost to the local economy for 1984, in the March 1984 edition of the Kitimat Chamber of Commerce’s newsletter, The Chamber Pot. Kitimat Chamber of Commerce, The Chamber Pot, March (1984). 49 Christiansen, Too Good to Be True. 50 Following the Province’s announcement of its termination of the KCP, Alcan sued the Province at the Supreme Court. In 1997, the Province and Alcan settled out-of-court, wherein which it was agreed that 1) BC would grant Alcan water rights to the Nechako river; 2) Alcan would modernize the Kitimat smelter and
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Municipal Council feared that if Alcan downsized, their community would lose the jobs and economic opportunities that the company and Province had agreed to develop in northern BC, after the termination of the KCP.52 These fears led the Municipal Council to challenge Alcan in front of the Supreme Court in 2005, in an attempt to stop the company from profiting from Kitimat’s natural resources (Nechako lakes area) with no benefit to the town.53 Following a verdict that favoured Alcan, tensions between the community and the company remained high, for Kitimat residents no longer trusted that the town’s largest employer had their best interest at heart.54 Therefore, it was with mixed feelings that
Kitimat residents received the news of Alcan’s planned modernization (a project estimated at $1.8 billion) for the Kitimat smelter in 2006, which would create local jobs and secure aluminum operations in Kitimat for the long-term.55
!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!! ! expand its capacity; 3) BC Hydro would pay Alcan $111 million pending modernization; and, 4) the Province would share the cost of environmental facilities required for Alcan to expand. See: Kathryn Harrison, “Environmental Protection in British Columbia: Postmaterial Values, Organized Interests, and Party Politics,” in R. Kenneth Carty, ed., Politics, Policy, and Government in British Columbia (Vancouver: UBC Press, 1996), p. 302; Dennis Wood, “Alcan Smelters and Chemicals Ltd Feeds While Nechako River Chokes,” Watershed Sentinel, n.d., accessed April 22, 2013, http://www.watershedsentinel.ca/content/alcan-smelters-and-chemicals-ltd-feeds-while-nechako-river- chokes; Province of British Columbia, British Columbia Utilities Commission, Filing of Energy Supply Contract with Alcan Inc. LTEPA Amending Agreement, Amended and Restated Long-Term Electricity Purchase Agreement [Response to District of Kitimat’s Application for Information], December 2, 2006, accessed April 22, 2013, http://www.bcuc.com/Documents/Proceedings/2006/DOC_13676_C3-3_SCCBC- IR1-to-DoK.pdf; Government of Canada, Commission of Inquiry into the Decline of Sockeye Salmon in the Fraser River, Policy and Practice Report: Regulation of Water Uses in the Fraser River Watershed, August 18, 2011, accessed April 22, 2013, http://www.cohencommission.ca/en/pdf/PPR/PPR21RegulationOf WaterUses.pdf. 51 Paul Wilcocks, “Killing Me Softly,” p. 22. 52 Province of British Columbia, Filing of Energy Supply Contract with Alcan Inc.; Wood, “Alcan Smelters and Chemicals Ltd Feeds While Nechako River Chokes.” 53 “Social,” Rio Tinto Alcan, Performance Reports, n.d., accessed April 22, 2013, http://www.riotintoalcaninbc.com/performance-reports/2004/pages/soc_SE.html. 54 Municipal Council Minutes, April 10, 2007. 55 Rio Tinto Alcan, “Alcan Announces Modernization Plan for Kitimat, BC Smelter” [Press Release], August 14, 2006, Kitimat Modernization Project, accessed April 22, 2013, http://www.kitimat worksmodernization.com/pages/media/ press-releases.php.
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Two major industrial closures occurred in the second half of the 2000s, resulting in substantial job loss for the community. The first closure occurred in 2005 when Ocelot
Methanex closed its petro-chemical facility due to high production costs brought on by rising natural gas prices. This closure resulted in the loss of 127 jobs.56 These jobs, as well as the 200 dismissed by Alcan in the same year, contributed to Kitimat’s 12.6% loss in population between 2001 and 2006 census periods, as workers and their families moved away in search of work.57 The second industrial closure took place in 2009, when the
Eurocan Pulp and Paper Mill announced it would be closing its facilities at Kitimat and laying-off the 535 workers employed there.58 A 2009 community stakeholders meeting estimated that 2000 individuals throughout the northern BC region would experience negative effects of the Eurocan closure, particularly regarding the job security of those who worked in industries that supported the plant’s operations.59
The Eurocan closure was caused by a number of different factors, and had the potential to have detrimental effects on the community. This closure was the result of the global economic recession of 2008, a high US dollar, and competition from other paper- producing companies.60 However, despite these economic conditions and the new stresses of unemployment and job insecurity, residents were able to mitigate negative effects of the Eurocan closure based on the coping strategies the community had developed for
!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!! 56 “Methanex Announces Plans to Close Kitimat Plant” [Press Release], Methanex Corporation, August 30, 2005, accessed April 22, 2013, http://methanex.mwnewsroom.com/manual-releases/2005/Methanex- Announces-Plans-to-Close-Kitimat-Plant. 57 Statistics Canada, 2007, Kitimat, British Columbia (Code5949005) [Table], 2006 Community Profiles, 2006 Census, Statistics Canada Catalogue no. 92-591-XWE, Ottawa. Released March 13, 2007, accessed April 22, 2013, http://www12.statcan.ca/census-recensement/2006/dp-pd/prof/92-591/index.cfm?Lang=E. 58 Minutes of the Community Impact Meeting, Kitimat, BC, November 9, 2009. 59 Ibid. 60 West Fraser Timber Co. Ltd., “West Fraser (“WFT”) to Permanently Close Eurocan Operation in Kitimat, B.C.” [Press Release], October 28, 2009, Marketwire, accessed April 22, 2013, http://www.marketwire.com/press-release/West-Fraser-WFT-to-Permanently-Close-Eurocan-Operation-in- Kitimat-BC-1067288.htm.
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mental health throughout the decades prior. Thus, this final section explores the past twenty years in Kitimat’s history, and how the grassroots initiative of community- provided services avoided major devastation within the community, regarding mental health.
5.5 Mental Health in Kitimat, 1990 to 2010
As industrial projects were announced, pursued, and terminated, residents of
Kitimat coped with changing economic circumstances by relying on the network of community-provided services that first emerged in the 1980s (see Section 5.3.5). The provision of mental health services was one area where community groups helped residents cope and adjust to new standards of living that accompanied sudden economic change, such as unemployment. By the 1990s, community groups had gained experience working to improve mental health in Kitimat, they shifted their focus from providing reactive, crisis-support services (e.g. Tamitik Status of Women referral services; Kitimat
Crisis Line) to preventing mental health problems by addressing its social determinants.
Residents and community groups sought to identify the conditions that could worsen mental health by providing services that address its social determinants. This shift in perspective is exemplified in the 1990 Community Health Plan proposed by the Kitimat
Health Management Resource Group,61 which identified existing mental health problems
(e.g. substance abuse and addiction) and also potential ones (e.g. chronic mental illness, like depression).62 Having realized that the services of a resident psychiatrist were not a realistic solution, the Resource Group instead proposed a “community-wide strategy…to
!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!! 61 The Kitimat Health Management Resource Group consisted of residents who volunteered and were chosen by hospital administrators. 62 Health Management Resource Group, Kitimat Community Health Plan (North Coast Regional Health Plan Steering Committee, 1990), p.14.
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meet a continuum of mental health needs; including prevention, the chronic mentally ill, the acutely mentally ill, adjustment problems, children and families.”63 Thus, while the community still recognized mental illness as an area of importance, they also acknowledged underlying issues, such as the need to address the conditions that affect the mental health of children and families.
One example of the community’s adoption of the holistic and preventive mental health perspective occurred during the proceedings of Kitimat’s 1991 “Building a Safer
Community Conference,” hosted by Dr. Carol Matusicky, executive director of the non- profit organization the BC Council for Families.64 In a 2013 interview accepting a
Lifetime of Distinguished Service to Families Award from the BC Council for Families,
Dr. Matusicky described her philosophy in promoting a healthy society:
We know what it takes to support the healthy development of people, but I think we’re a very reactive society. We pay attention to something when it’s broken, but where were we along the way?...I’ve been very much focused on supporting people along the way, not waiting till they’re broken till we pay attention to them.65
By choosing to host Dr. Matusicky and her conference, Kitimat residents chose the preventive approach to health and mental health that she endorsed. The conference addressed mental health issues, such as suicide, by discussing contributive factors within the community. Local and regional organizations met to discuss their group’s experience working with community members who were negatively affected by various circumstances. For example, included in the discussion of sexual abuse, suicide prevention, and social support were the Child Development Centre, Mental Health, BC
!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!! 63 Ibid. 64 Carol Matusicky, BC Coalition for Safer Communities, Building a Safer Community Conference, Kitimat, BC, May 10, 1991 [unpublished proceedings]. 65 Jennifer Moreau, “A Lifetime Spent Helping Families,” Burnaby Now, June 5, 2013, accessed June 6, 2013, http://www.burnabynow.com/life/lifetime+spent+helping+families/8480832/story.html.
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Council for the Family, Kitimat Group Home, Skeena Health Unit, Kitimat Community
Services, Victim Services, Haisla Women’s Group, Youth Worker, Social Services and
Housing, Kitimat Crisis Line.66 The interaction of the abovementioned groups represents a broad and holistic view of mental health. The involvement of Mental Health and the
Kitimat Crisis Line suggests that some discussion took place of available mental health services for those who are already mentally ill, while the Kitimat Group Home and BC
Council for the Family suggests discussion of how the social environmental (e.g. poor family life) can affect one’s mental health.
5.5.1 Interagency
A holistic perspective of mental health continued in Kitimat through the 2000s, with the establishment of the Kitimat Interagency Committee (“Interagency”). The function of this organization was to bring together stakeholders from a number of fields within the community for monthly discussions on how to improve the quality of life for
Kitimat residents. 67 As indicated by the Interagency director for 2012, Margaret
Warcup,68 these groups were all interested in improving the social and mental health of the community, by addressing the issues that influence mental health (e.g. unemployment,
!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!! 66 Ibid. 67 Margaret Warcup (director of Interagency) in discussion with the Author, August 2012. 68 Margaret is a Terrace resident, but longtime community supporter of Kitimat. She was voted a “Top 5 Mover and Shaker” for Kitimat in 2010, for establishing the Kitimat Community Foundation and organizing the local Telethon community fundraiser. Outside of her work for Interagency, Margaret is the Executive Director at the Kitimat Child Development Centre. See Walter McFarlane, “Year in Review: Top 05 Movers and Shakers in Kitimat,” Kitimat Daily, December 30, 2010, accessed June 6, 2013, http://www.kitimatdaily.ca/go4033a/YEAR_IN_REVIEW_TOP_05_MOVERS_AND_SHAKERS_IN_KIT IMAT.
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stress, abuse).69 Interagency initially began in 2007 through grants from the University of
British Columbia and the District of Kitimat.70 As described by Margaret in 2009:
Our vision is to have Kitimat dedicated to sustaining and investing in the quality of life and that we can work collaboratively [businessmen, politicians, service providers, educators, etc.], communicate and problem solve together.
Since they began, Interagency has worked towards achieving their vision, by commissioning studies and initiatives that support and promote health. Predominantly,
Interagency works to build a health community by addressing the social determinants of health, particularly education and early childhood development, as they recognize that they are “integrally linked to [Kitimat’s] economic success.”71 Recently, Interagency has initiated a pilot project to study how youth and families in Kitimat are dealing and living with mental illness.72
One example of Interagency’s function as an interdisciplinary organization that addresses the social determinants of mental health is seen through the attendees at a 2007 meeting. At this meeting, representatives from a number of organizations met to discuss youth and community needs, mental health, and support services with focus on various social determinants (indicated in brackets): the Kitimat alternative high school (education), the BC Schizophrenia Association (biological/genetics), Child Development Centre (early childhood development; biological/genetic); Tamitik Status of Women (income; housing; social support; employment); local developer (housing); RCMP (crime; security).73 It was
!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!! 69 Ibid. 70 “Walter McFarlane, “Kitimat Interagency Committee at Council,” Kitimat Daily, April 29, 2009, accessed June 6, 2013, http://www.kitimatdaily.ca/go1447a/KITIMAT_INTERAGENCY _COMMITTEE_AT_COUNCIL. 71 Ibid. 72 The results of this study are not yet available. For more information, see the Kitimat Child Development Centre website to navigate Interagency contacts at www.kitimatcdc.ca. 73 Minutes of the Kitimat Interagency Committee Meeting, Kitimat, B.C., December 12, 2007.
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this broad and holistic perspective of mental health that allowed the community to avoid detrimental effects of economic change, such as occurred with the 2010 closure of
Eurocan.
5.5.2 The Eurocan Closure as a Success in Preventing Community Crisis
The announcement of the Eurocan closure caused widespread feelings of grief throughout the community, as indicated through interviews with residents who were closely affected. Lifetime employee Raymond recalls his experience working on shift when Eurocan announced their intended closure:
People were just shocked and devastated. They felt like their whole world had come to an end. I walked in, my first aid attendant was bawling her eyes out. And I’m going, “What’s the matter?” And she says, “Well, we’re going out.”74
The negative feelings that Raymond describes above seem to have radiated outside the mill and into the community. Anne-Marie, another Eurocan employee and member of local social and sporting event committees, mentions how the community was “very, very gloom and doom.” 75 Interestingly, another participant, former schoolteacher and community leader, Laura, uses almost the same language to explain her perception of the community post-announcement:
After the closure of Eurocan was announced, the feeling in Kitimat, the outlook of people was very, very gloomy. And I would say that the, the mood of the community as a whole was very, very depressed.76
Laura’s mention of “the community as a whole” seems to hold true across all ages. School counselor, Maya, indicated that both children and adults visited her office to discuss the effects of the Eurocan closure. She explains:
!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!! 74 “Raymond,” interview with the Author, August 7, 2012. 75 “Anne-Marie,” interview with the Author, August 6, 2012. 76 “Laura,” interview with the Author, August 3, 2012.
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It affected kids because they didn’t really understand what was going on. They knew that their dad was losing their job, or their mom was losing their job, and so they were experiencing tensions in the family but not, weren’t really. Like when, ‘cause I did ask those questions—like, “do you know what’s happening?” and “why it’s happening?” And they didn’t really have those answers.77
As shown through recollections by local residents and Eurocan employees, it is apparent that when the closure of Eurocan was announced, residents experienced feelings of worry, stress, and depression. When asked about the potential detriments the community anticipated as a result of the closure, Anne-Marie and Laura named unemployment and divorce, as well as mental-health specific problems, such as substance abuse, family violence, and increased stress.78 At the Community Impact Meeting, local organizations discussed how the closure (and modernization of Alcan) could impact local stress levels, employment, income, housing, children, education, substance use, family violence, and health services.79 Therefore, Interagency organizations responded preventively to the above-named concerns by providing a number of resources that addressed the social determinants of mental health. One of the services provided by Interagency was the hosting of workshops regarding stress, grief, and loss, to increase the community’s ability to cope with the Eurocan closure, and prevent potential mental health outcomes such as depression or suicide.80
An example of community-provided mental health services that address the social determinants is the educational support services that Interagency organizations provided former Eurocan employees. In working with the Ministry of Education, Interagency
!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!! 77 “Maya,” interview with the Author, August 3 & 5, 2012. 78 “Anne-Marie,” interview with the Author, August 6, 2012; “Laura,” interview with the Author, August 3, 2012. 79 Minutes of the Community Impact Meeting, Kitimat, BC, November 9, 2009. 80 Ibid.
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members, the Mount Elizabeth Secondary School, and Northwest Community College granted equivalent credits to dismissed workers for industrial courses they had trained for during their time at Eurocan. Maya, a high school counselor who dealt with many of the unemployed Eurocan workers, explains that this helped many overcome the panic they initially felt after losing their job. In the following quote, Maya describes the stress that laid-off workers felt, in particular those who had low education (Grade 10) and little work experience outside of the pulp mill. She also mentions the new graduation requirements that were subsequently being introduced throughout the Province, which could have prevented many laid-off workers from receiving their diploma:
I mean I had men crying in my office, because it was like, “Why is this [closure] happening to me?” Right? The other thing that was happening at the same time was that the provincial government decided that that would be— that summer, that June would be—the last June that the 1995 grad[uation] requirements would be recognized. So anybody that wasn’t officially graduated by that time would have to graduate under the 2004 requirements which means the provincial exams at grade ten for Math, Science, English, right? And then Socials 11 and English 12. So, when you tell them that, well…these guys were panicking.81
Through the cooperation of CPS, and the Ministry of Education, local agencies were able to provide some relief to laid-off Eurocan employees, by reducing some of the anxiety they experienced following the loss of their jobs:
Well it meant that [Eurocan workers without the 1995 graduation requirements] didn’t have to go back to school, because if they weren’t graduated that meant that they couldn’t get into an apprenticeship program, or um, you know, apply to—I mean who looks at a non-grad? In industry, right? They want you, they want you to have a post-secondary degree now, you know? So it was terrifying for them, and they had to leave their community.82
!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!! 81 “Maya,” interview with the Author, August 3 & 5, 2012. 82 Ibid.
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While former Eurocan employees often had to leave Kitimat in pursuit of work or further training, as Maya suggests, having the high school requirements allowed them to do so without the added stress of returning to secondary school.
Other services that community groups provided to residents were help with resume writing and job interview skills, and applying for employment insurance, income or housing assistance.83 Anne-Marie expressed her gratitude to the individuals, who had worked in Eurocan’s human resources sector that provided this assistance:
They helped us tremendously, you know? to try and help us with the medical—what we were going to do. There were so many, so many decisions that you have to make. So in that sense, it clarified.”84
Because of the community’s various organizations, including industry-based ones as in the above example, Kitimat managed to avoid the detrimental effects of the Eurocan closure that residents had anticipated by improving residents’ access to housing, education, and employment. By the 2000s, residents had adapted to a life without permanent psychiatric services by focusing instead on long-term factors that influenced mental health (i.e. social determinants). This gave the community the ability to participate in and promote mental health even during times of economic change developed out of the support services the community provided.
Interview participants reflected on the results of the holistic and preventive approach to mental health in Kitimat, facilitated through community-provided services.
Julie, whose partner was laid off, described the Eurocan closure “almost like a blessing in disguise,” because it gave workers a chance to see new areas and experience new things
!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!! 83 Minutes of the Community Impact Meeting, Kitimat, BC, November 9, 2009. 84 “Anne-Marie,” interview with the Author, August 6, 2012.
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as they sought work opportunities in different areas.85 Former teacher Laura stated that
“things have not turned out, for the moment, as bad as people expected.”86 Finally, lifetime Eurocan employee, Raymond, describes that the closure “gave [laid off workers] an opportunity to go to school, get re-educated, and do something they like,” through benefits and educational programs provided by the community, union, and government.87
By establishing comprehensive community services, Kitimat residents incorporated previous holistic understandings of mental health (e.g. work and family in
Chapters 3 & 4) with new ones (e.g. economic conditions, early childhood development, education). The community worked to ensure that all families could experience holistic mental health, including those who were laid off and unemployed. This latest economic decline provided Kitimat the opportunity to showcase their community services, which transitioned to providing preventive care and support to those in need to avoid the development of mental health problems.
5.6 Current State of Community-Provided Services
At first glance, Kitimat’s shift towards a social determinants perspective of mental health, supported through community-provided services, appears idyllic. However, while
CPS have proven invaluable to mental health in Kitimat, there is a backstory to their organizations’ limitations and inadequacies. The main issues, identified by stakeholders as the cause of CPS’ shortcomings, are staffing shortages, population influx, and drug and alcohol abuse. In Kitimat, provincial mental health services are provided to the town and the Northern Health region; however, due to the high demand for and geographic dispersal of this region’s patients, these resources are not always available. Mental health !!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!! 85 “Julie,” interview with the Author, August 9, 2012. 86 “Laura,” interview with the Author, August 3, 2012. 87 “Raymond,” interview with the Author, August 7, 2012.
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professionals funded by provincial monies typically visit Kitimat weekly or monthly as consultants. Because the caseload for these workers and the needs for patients are so high, community groups and organizations step in to provide some mental health services to
Kitimat residents. The following section outlines some problems associated with this practice.
5.6.1 Staffing Shortages
Community service providers have identified staffing issues through shortages of service providers for their programs, especially those working in mental health. The following examples of staff shortages appeared during roundtable discussions of CPS at
Interagency meetings. In 2012, the Northwest Counseling Services reported staff shortages of counselors. Currently, this private organization brings in counselors two days per week, but recognized a need for more counselors, due to an increased use of its services.88 The Tamitik Status of Women, which provides counseling, support and shelter to survivors of abuse, also reported that their caseload had increased. In 2012, their transition house operated with an average 90 percent occupancy, their caseload was at full capacity, and all of its programs were busy.89 Other participants of Interagency also experienced limitations in their provision of services for mental health in Kitimat.
One example of a provincially-funded service facing limitations to meeting mental health needs in Kitimat, is the Kitimat branch for the BC Ministry of Child and Family
Development. In 2008, they have reported that their youth mental health worker was working at full capacity.90 However, in 2011 the Ministry made cutbacks to their services, which a representative for the Ministry of Child and Family Development sparked the !!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!! 88 Minutes of the Kitimat Interagency Committee, June 19, 2012. 89 Minutes of the Kitimat Interagency Committee, October 11, 2011; May 15, 2012. 90 Minutes of the Kitimat Interagency Committee, January 16, 2008.
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organizations need to “become more creative in supporting families,” due to manpower shortages.91 The Kitimat branch for the Adult Mental Health and Addictions—part of the
Northern Health Authority (see Appendix Q for a map)—also reported in 2010 that their office was at full staffing.92 By 2012, the program had recruited a former worker to come out of retirement to help with the heavy caseload.93
Recruitment of health professionals to Kitimat is as much of an issue today as it was throughout the 1980s and 1990s during the town’s pursuit of a resident psychiatrist.
One example that highlights the difficulties in recruiting health professionals occurred in
March 2013. The British Columbia Medical Association (BCMA) and the BC Ministry of
Health (under the leadership of the Honourable Margaret MacDiarmid of the BC Liberals, former president of the BCMA)94 agreed to provide a recruitment incentive of $100,000 to doctors who agreed to practice in Northern BC (including Kitimat) for three years.95
Thus, as it has become more difficult to recruit even basic medical health professionals, like general practice doctors, the pursuit of obtaining resident specialist services, like psychiatry, have often taken the backseat.
5.6.2 Population Influx
In considering the staffing shortages identified in Section 5.6.1, one asks why services—both community and provincially provided—are experiencing such a heavy caseload? Community groups and local residents identify the social factors associated with the recent economic growth in Kitimat as the main problem. Since the 2006 closure !!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!! 91 Minutes of the Kitimat Interagency Committee, October 11, 2011. 92 Minutes of the Kitimat Interagency Committee, October 19, 2010. 93 Minutes of the Kitimat Interagency Committee, January 24, 2012. 94 Cindy Harnett, “B.C. Doctors Offered $100,000 to Work in Rural Areas, Including Vancouver Island Towns,” Victoria Times Colonist, March 13, 2013, accessed June 6, 2013 from http://www.timescolonist.com/news/local/b-c-doctors-offered-100-000-to-work-in-rural-areas-including- vancouver-island-towns-1.90908. 95 Ibid.
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of Eurocan, Kitimat has become involved with a number of different industrial development projects, the details of which are listed in Appendix R. This has resulted in the influx of temporary workers, either unemployed or prospective, for which this well- planned community is not adequately prepared. Joanne Monaghan, mayor of Kitimat, estimates that nearly 12,000 new people will come through Kitimat over the duration of various industrial projects.96 This is significant, especially considering that Kitimat is designed for its current population of just 9,009.97 As a result, prospective workers have had difficulties finding housing within the community, resulting in a heavy caseload for the CPS that help them.
Kitimat is currently experiencing a problem with homelessness that has not received much attention outside of those uninvolved in community services. Maria describes that she witnessed panhandlers in Kitimat’s shopping mall, which has been nearly empty of shoppers and businesses for years.98 Anna described that she knew of people who were living in areas near abandoned buildings, and in “tent cities” around the forested areas of downtown.99 Kitimat Community Services Society (KCSS) identified this population in 2010 as those who “come to Kitimat for ‘cheap rent’ and job possibility.”100 KCSS recognized their shortages to provide for these people, and the need to establish new resources: a men’s housing shelter, soup kitchen, food and clothing, and mental health first aid training of their staff.101 Maria identified in her interview that part of the reason for this new population of unemployed, houseless workers is because, “a lot
!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!! 96 Minutes of the Kitimat Interagency Committee, April 7, 2012. 97 District of Kitimat, “Facts & Statistics,” 2013, accessed June 8, 2013 from www.kitimat.ca. 98 “Maria and Anna,” interview by the Author, Kitimat, BC, August 8, 2012. 99 Ibid. 100 Minutes of the Kitimat Interagency Committee, October 19 2010. 101 Ibid.
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of the social services ministries [i.e. Ministry of Social Development] are sending people our way, because they say it’s an inexpensive place to live, the boom in projects means you might get a job.”102 Maria went on to describe how the influx of workers can affect mental health:
And also, um, people who are coming in to have—the construction people who are coming in. Like they go ahead and they build that big camp down by Alcan, and they think that everything’s going to be all rosy and shiny, but a lot of these people have the same sort of mental health issues that the population have [e.g. addiction, anxiety, interpersonal violence].103
In particular, Anna makes mention of the drug and alcohol addiction problems which she believes is influenced due to the number of bored, young workers with discretionary income, and the few places to spend it.104 Her experience—as a resident, mother, and community volunteer—is supported by the 2012 report of the Adult Mental Health &
Addictions services. They reported to Interagency that for the year 2012 they “increased referrals [to doctors, rehabilitation facility in Prince George] from 1-2 per week to 2-3 per day.”105 It is difficult to comment on this problem, as it has not received much attention in the archival materials reviewed up until recent years. However, the following section attempts to provide a glimpse into the situation, with implications for future research.
5.6.3 Drug and Alcohol Abuse
The 2012 increase in treatment for drug and alcohol abuse identified by Adult
Mental Health & Addictions has contributed to the increased demand for mental health services. However, it is not clear whether the problem of drug and alcohol abuse in
Kitimat has actually increased, for while it has been an issue in the community for years,
!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!! 102 “Maria and Anna,” interview by the Author, Kitimat, BC, August 8, 2012. 103 Ibid. 104 “Maria and Anna,” interview by the Author, Kitimat, BC, August 8, 2012. 105 Minutes of the Kitimat Interagency Committee, May 15, 2012.
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it has just recently received attention, and a day program treatment facility. In relation to the research question for this project, alcohol and drug abuse or addiction did not emerge as a dominant understanding of mental health for Kitimat residents at any point of time in the materials reviewed. While I can only speculate based on my personal experience as a resident of Kitimat during both childhood and adulthood, this may be in part because of the normalization of drug and alcohol abuse into Kitimat’s social life. This came up in many of the conversations with residents, who acknowledged that drugs and alcohol were simply a part of life in Kitimat. During his interview, Raymond—a former alcoholic— described his experience in the 1970s and 1980s:
If you wanna be social, there’s booze. Everywhere you go [in Kitimat] there’s booze, and there’s drugs. So if you want to stay away from that stuff, where do you go? And I know, [my drug and alcohol counselors] say, “You can’t go drink.” What the hell am I going to do? 19…78 I think. I quit drinking for 6 months. I worked…but I never went out. A guy comes up to me, goes, “When did you move back to town?” I never left, I just didn’t go to the bar. I didn’t go out to parties. I didn’t do anything.106
Raymond explains that drinking and drugs, are part of a normal social life in Kitimat. He suggests that if one attempts to avoid them by not going where they are (e.g. bars, house parties), they end up avoiding social life entirely. This is corroborated by Maya, a high school counselor, who observes drug and alcohol abuse as the major problem for Kitimat youth:
Every weekend is a party weekend, and uh, you know the tragedies connect to it. Or the bad scenarios connected to the “scene” are something that I hear about. So I know that there are young women out there being violated. I know that there are young people out there who end up in the hospital with overdoses or alcohol poisoning, right? I mean that’s information, you know, that maybe I’m—and people in the health community—are more privy to, but it’s there. 107
!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!! 106 “Raymond,” interview with the Author, August 7, 2012. 107 “Maya,” interview with the Author, August 3 & 5, 2012.
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Maya recognizes that as a counselor she may be more informed about the extent of the drug and alcohol problem in Kitimat, than the general public. The lack of public knowledge on this subject may contribute to its lack of attention in archival materials.
Both Maya and Raymond’s accounts also support the idea that information regarding drugs and alcohol is a normalized part of Kitimat’s social life.
As a final point, interview participants connected the widespread drug and alcohol abuse in Kitimat with the high wages provided by local industries (e.g. Rio Tinto
Alcan lowest starting wage is $31.94 an hour for union employees).108 A recent report by the Northern Health Authority, which did not have aggregate information regarding alcohol consumption or sales, reported that 55.0 percent of families in Kitimat earned over $80,000 per year, in comparison to the 38.1 percent provincial average.109 This is something that Maya associated with drug and alcohol abuse in youth:
…because parents are so, so busy—both parents working in industry, who raises their children?[...] And lots of money flowed into the hands of children because it was a way of compensating for not spending time with their children. And so, when you have children who have money, who are not supervised, well then that equals a whole gamut—opportunity—to explore, and not always positive things.110
While Maya speaks about drug and alcohol abuse use in youth, the problem also seems to affect the adult population. A group of researchers at the Centre for Addictions
Research of BC at the University of Victoria (UVIC) produced a report (ca. 2009) on the prevalence of alcohol and illicit drug use by health authority in BC, by analyzing date from the Canadian Alcohol and Drug Use Monitoring Survey. The study found for !!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!! 108 National Automobile, Aerospace, Transportation and General Workers Union of Canada (CAW Local 2301), Collective Agreement, 2007, accessed June 8, 2013 from www.caw2301.ca. 109 Northern Health, Healthy Northern Communities 2011: District Municipality of Kitimat, last modified August 6, 2011, accessed June 8, 2013 from http://chip.northernhealth.ca/Portals/2/Document%20Repository/2011%20Updates/Community%20Profiles %202011/LHA%20080%20-%20Kitimat%20DM.pdf. 110 “Maya,” interview with the Author, August 3 & 5, 2012.
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2008/2009, 83.6 percent of Kitimat/Queen Charlotte (see Appendix Q for map) residents reported using alcohol in the past 30 days, compared to the provincial average of 62.1 percent.111 For illicit drug use, the Northern Health region showed a 27.44 percent lifetime illicit drug use, higher than any other region in the Province, and higher than the provincial average of 20.2 percent.112 This UVIC prevalence study, as well as the findings from this thesis which provide some qualitative insight to the problem, lend well to future research regarding drug and alcohol abuse in Kitimat. Implications for future research of particular interest include longitudinal assessment of drug and alcohol use, as well as its correlation to Kitimat’s various stages of economic change.
5.7 Summary
During the period 1990 to 2010, Kitimat experienced two major stages of economic change: economic recession and its related effects (e.g. unemployment, population loss) from 1980 to 1989, and economy recovery and growth (e.g. industrial development, employment, population influx) from 1990-2010, and to the present day.
Regarding mental health, during the recessionary period residents understood mental health in the context of psychiatric services. Although residents struggled to recruit a resident psychiatrist for more than ten years, their pursuit would end in vain, despite
Provincial, Municipal, and community support. Even after experiencing a string of community tragedies (i.e. murders and suicides) that brought a sense of urgency to their predicament, they never would obtain a resident psychiatrist.
!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!! 111 Jinhui Zhao, Gina Martin, Scott Macdonald, and Tim Stockwell, “The Prevalence of Alcohol and Illicit Drug Use in British Columbia [PDF],” University of Victoria Center for Addictions Research of BC, no date, accessed June 8, 2013, www.carbc.ca “General Population Surveys,” p.5 of report. 112 Ibid., 20.
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Eventually, the inability to obtain a psychiatrist would lead to the establishment of community-provided services. New organizations (e.g. such as the alliance of community and social services that made up Interagency) emerged to meet the mental health needs of residents by addressing the social determinants that affect them, particularly housing and employment. Community-provided services were able to successfully mitigate negative effects of economic decline for its residents (i.e. Eurocan closure). However, in more recent years, community-provided service organizations have met new challenges related to economic growth. In particular, many organizations have reported the inability to meet caseload demand, due to staffing shortages and population influx.113 The limits of community-provided service organizations have brought new attention to an ongoing issue in the community, drug and alcohol abuse.
While this issue never did appear as a dominant understanding of mental health—likely due to its normalization in Kitimat social life, it is important to note as an area for future research.
!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!! 113 Discussed in full, Section 5.6.
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Chapter 6: Discussion
6.1 Study Results
This study found that understandings of mental health changed through Kitimat’s different economic stages of growth, depending on what residents prioritized as ways of achieving mental health. For example, during Stage 1: Construction (1950-1959) when economic conditions were booming, individuals flocked to Kitimat with the intention of participating in the ideal family unit. Mental health was understood at this time to be an obtainable state that could be achieved through this participation in the ideal family unit; likewise, barriers to mental health were identified as factors that prevented participation in this ideal, such as housing shortages or unemployment brought on by the 1957 Recession.
During Stage 2: Diversification (1960-1979), after having experienced economic downturn,
Kitimat residents recognized that employment was essential for the economic and mental wellbeing of their community. As a result, residents sought to diversify their economic base as much as possible to keep residents working, and maintain a desirable state of mental health. For the final period analyzed, Stage 3: Development (1980-2010), residents initially adopted an understanding of mental health that was more consistent with a clinical perspective than in stages prior. Residents sought to achieve mental health by obtaining psychiatric services for Kitimat. Once it became clear that this would not be possible, however, the community returned to a holistic understanding of mental health. Consequently,
Kitimat residents took a grassroots approach to improving and maintaining mental health, as exists in the community today.1
!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!! 1 For a listing of community-provided mental health services in Kitimat, see Appendix J.
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It is important to note, as described in Chapter 3, that the results regarding mental health in Kitimat may not have been representative of the province as a whole, based on the potential presence of a healthy worker bias. Workers who moved to Kitimat did so with the intention to work in manual labour, often with the promise of a job. As such, workers were required to perform job tasks that spoke to their physical and mental competence. This may contribute to the absence of discussions of mental health in Kitimat in the early years, for it is likely that there was a very low presence of mental or developmental disorders in this working population, due to the potential inability of such individuals to hold a job—a requirement for obtaining housing in Kitimat. As well, due to its isolated location, individuals who moved to Kitimat that required ongoing psychiatric or psychological treatment may have been deterred from doing so based on the nonexistence of these services in the town’s earliest history. However, while this may be unrepresentative of the general population, it is likely that this is representative in other resource-based towns, with similar histories where the community was structured around industrial work.
6.1.1 Results in Context of Deinstitutionalization
A discovery from this study was that understandings of mental health, illness, and its treatment developed in Kitimat alongside the trend of deinstitutionalization that occurred in the history of psychiatry for the rest of Canada. As described by Canadian psychiatric historian James Moran (2009), deinstitutionalization began in Canada during the 1960s, when psychiatric patients were moved out of institutions and into the community—often to psychiatric units within hospitals.2 Reasons for deinstitutionalization were due in part to the
!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!! 2 James Moran, “History of Madness and Mental Illness: A Short History of Care and Treatment in Canada,” The History of Madness in Canada 2009, accessed June 3, 2013, http://historyofmadness.ca/index.php? option=com_content&view=article&id=80&Itemid=109&lang=en.
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development of psychopharmacological drugs that could help patients live independently, and government cutbacks to operation costs of institutions.3 Moran notes that:
Unfortunately, the rate of deinstitutionalization was much faster than the organization of community services [which] has led to enormous difficulties in providing adequate care at the community services level for those who need and want it.4
Moran’s description of supply and demand of community-based, psychiatric resources was part of the reason for Kitimat’s difficulty obtaining a psychiatrist throughout the 1970s and
1980s. The shift away from treating patients in institutions throughout British Columbia
(listed in Appendix S) increased the demand for psychiatrists to work in communities at local treatment facilities.5 It is unlikely that the Province would have prioritized Kitimat as a place in need of a psychiatrist, for the rural and remote area was not affected by deinstitutionalization to the same extent as were urban areas, where patients were released into community treatment facilities like Vancouver or Vernon.6 No mention of an influx of psychiatric patients as a result of deinstitutionalization was found in archival resources for
Kitimat, likely because the town lacked clinical mental health services. Nursing historian
Geertje Boschma’s (2011) work on deinstitutionalization in Alberta and British Columbia following WWII shows that a former military hospital in the neighbouring town of Terrace was converted to a Home for the Aged in the 1950s, to provide care for the elderly with
!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!! 3 Ibid. 4 Ibid. 5 Ibid.! 6 Geertje Boschma, “Deinstitutionalization Reconsidered” Geographic and Demographic Changes in Mental Health Care in British Columbia and Alberta, 1950-1980,” Social History 44, no. 88 (2011): 223-256, p. 240; Charlene Ronquillo, “Deinstitutionalization of Mental Health Care in British Columbia: Critical Examination of the Role of Riverview Hospital from 1950 to 2000,” in Lisa Petermann, Kerry Sun, and Frank Stahnisch (eds.) The Proceedings of the 18th Annual History of Medicine Days Conference (Newcastle: Cambridge Scholars Publishing, 2012): 11-26.
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mental illness.7 Kitimat’s lack of psychiatric services, which led to the establishment of community-provided services (see Chapters 4 & 5) rings true of Boschma’s (2011) finding that following deinstitutionalization, self-help and community-based services did materialize across the province in places where patients and families were unable to obtain clinical services.8
Kitimat’s history of mental health differs from those found in the Canadian psychiatric historiography, mainly because of its geographic remoteness. There was no psychiatric institution in or near Kitimat, with the exception of the Home for the Aged in
Terrace (see Appendix S); therefore, there was no opportunity to conduct a history based on its records, like much of the Canadian literature that has come before this study.9 Kitimat also did not have its own home for the aged or school for developmentally deficient children as in other parts of the province, as outlined in Boschma (2011).10 Thus, because they did not have clinical services, it is not surprising that understandings of mental health for Kitimat residents were not always based on a clinical understanding. While they did adopt a clinical understanding for a short time during their pursuit of psychiatric services, a holistic understanding of mental health occurred perhaps more often and earlier in Kitimat than in other areas of the province where clinical services were more readily available.
!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!! 7 Geertje Boschma, “Deinstitutionalization Reconsidered: Geographic and Demographic Changes in Mental Health Care in British Columbia and Alberta, 1950-1980,” Social History 44, no. 88 (2011): 223-256. 8 Ibid., p. 253. 9 For example, see Boschma, “Deinstitutionalization Reconsidered” for information on BC and Alberta institutions. Works by author’s in James Moran’s volume, Mental Health and Canadian Society: Historical Perspectives include’s Janet Miron’s work on 19th-century tourism of Ontario asylums (pp. 19-49), Geoffrey Reaume’s study on labour in Ontario asylums in the 19th Century (pp. 69-97), or Robert Menzies and Ted Palys study of Aboriginal patients in BC institutions from 1875 to 1950 (pp. 149-176). See James Moran Mental Health and Canadian Society: Historical Perspectives, edited by James Moran (Montreal: Mc-Gill-Queen’s University Press, 2006). See also the fine on psychosurgery in Ontario conducted by Brianne Collins, informed in part by the clinical records of leucotomy patients in the 20th Century: Brianne Collins, “Ontario’s Leucotomy Program: The Roles of Patient, Physician, and Profession,” (MSc diss., University of Calgary, 2012). 10 Boschma, “Deinstitutionalization Reconsidered.”
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6.1.2 Results in Context of the Social Determinants of Health
In the 1974 report, A New Perspective on the Health of Canadians, Marc Lalonde
(b.1929)—former Canadian Minister of National Health and Welfare, identified that four interdependent components make up health: (1) biomedical; (2) environmental; (3) lifestyle; and, (4) health care organization.11 Lalonde (1974) suggested that these factors be included in a population health approach to mental health, “so that programs of prevention and therapy can be launched that will attack principal underlying causes.”12 This approach—addressing the root causes of health or ill health—developed into what is today known as the social determinants of health (SDOH). As defined by York University scholar Dennis Raphael,
“social determinants of health are the economic and social conditions that influence the health of individuals, communities, and jurisdictions as a whole [that…] determine the extent to which individuals stay healthy or become ill…”13 This study aligns with the policy implications that Raphael and Mikkonen (2010) identify for unemployment and health, whereby “Workers, employers, government officials, and researchers need to develop a new vision of what constitutes healthy and productive work.”14 By linking understandings of mental health with broader economic cycles, this study has examined a number of social determinants of mental health throughout the various stages of Kitimat economic development, particularly unemployment. Some other determinants that have been explored
!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!! 11 Marc Lalonde, “A New Perspective on the Health of Canadians: A Working Document,” Ottawa: Government of Canada, 1981, accessed April 11, 2013, http://www.hc-sc.gc.ca/hcs-sss/alt_formats/hpb- dgps/pdf/pubs/1974-lalonde/lalonde-eng.pdf. 12 March Lalonde, A New Perspective on the Health of Canadians, p. 62. 13 Dennis Raphael, Social Determinants of Health: Canadian Perspectives, first edition, edited by Dennis Raphael (Toronto: Canadian Scholars’ Press Inc., 2004), p. 1, accessed June 2013, http://site.ebrary.com.ezproxy. lib.ucalgary.ca/lib/ucalgary/docDetail.action?docID=10191694. 14 Dennis Raphael and Juha Mikkonen, Social Determinants of Health: The Canadian Facts (Library and Archives Canada Cataloguing in Publication), p. 18, accessed June 2013, http://ywcacanada.ca/data/research_docs/00000131.pdf.
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in this study, and their influence on mental health in Kitimat include: health services, income, early childhood development, job security, gender, and housing.
As shown throughout the course of this study, the various economic conditions that
Kitimat experienced altered how residents understood mental health. Interestingly, the social determinants perspective was always a part of this understanding. In Chapter 3, where mental health was understood in relation to residents’ ability to establish and maintain a socially ideal family unit, an individual’s interaction with social determinants such as housing, unemployment, or gender norms, influenced their ability to participate in this understanding of mental health. Chapter 4 explored how social determinants such as job (in)security,
(un)employment, and the social safety net affected one’s ability to participate in mental health, which Kitimat residents then understood in relation to industrial development and work opportunities. In Chapter 5, as residents attempted to bring psychiatric services to
Kitimat and later established their own through community-provided services, a realm of social determinants were addressed: (un)employment, income, early childhood development, social safety net, food (in)security, housing, etc.
By gravitating towards a social determinants perspective of mental health throughout its history, Kitimat—and the community-provided services they established for mental health—represents an example of Geoffrey Rose’s population strategy of prevention, which aims to “move the whole distribution of a risk factor, including its low tail, in a favourable direction.”15 Rose suggests that the way to achieve this is by addressing the root causes of a
!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!! 15 Geoffrey Rose, “The Population Strategy of Prevention,” in Geoffrey Rose, Kay-Tee Khaw, and Michael Marmot (eds.) Rose’s Strategy of Preventive Medicine (Oxford Scholarship Online, 2009), n.p. (HTML format), accessed June 8, 2013, http://www.oxfordscholarship.com.ezproxy.lib.ucalgary.ca/view/10.1093/ acprof:oso/9780192630971.001.0001/acprof-9780192630971-chapter-7.
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health problem in an entire population, rather than focusing on treating individual cases.16 In
Kitimat, residents did not initially choose to adapt a population strategy for prevention of mental illness (i.e. they wanted clinical services that treated mental illness). However, the lack of available health services in Kitimat (i.e. resident psychiatrist) led community organizations to focus on a prevention strategy for mental illness that supports and improves mental health for all. An example of this is shown at the Community Impact Summary that took place in November 2009 amongst community organizations in preparation for the effects of the Eurocan Closure. The minutes of this meeting show a population-level approach to mental health among CPS, where they identify the “need to look at more than just Eurocan families being affected” by the closure.17 To erase any doubt regarding their focus on those at high-risk of mental health outcomes (i.e. former Eurocan employees), the minutes close with the following baseline message: “We want to have a health community!!
We want everyone to have good mental health in our community!”
6.2 Strengths and Limitations
6.2.1 Strengths and Future Research Directions
The main strength of this study is its contribution to the literature regarding economic change and mental health in resource-based communities. As outlined in Chapter 1, the existing research regarding this topic is extremely limited. While the findings of this study are informative and valuable regarding understandings of mental health in light of economic change, they also set the stage for further research in the field. Ideally, this study will provoke future research for this relationship for different population, periods of time, geographical settings, and economic activities.
!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!! 16 Minutes of the Community Impact Meeting, Kitimat, BC, November 9, 2009. 17 Ibid.
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Another strength of this study is its interdisciplinary approach. Mental health and economics are both complex components in our society, and vary amongst different communities, according to local circumstances. Approaching this relationship through the perspectives of population health, history, and economics has allowed for an understanding of mental health according to the particular social and economic realities in Kitimat, British
Columbia. While a study of the relationship between economic change and mental health using biostatistical or epidemiologic perspectives would have been valuable to this study, the use of an interdisciplinary, historical approach allowed for an in-depth understanding, despite limitations in the data (see Section 6.2.2).
Another strength of this study, produced in part by its interdisciplinary nature, is its ability to show patterns of experiences in areas peripheral to the research question. While not the focus of this question, the rich data source produced through collection of archival materials also show changes regarding Kitimat’s infrastructure, social groups, demographics, housing, and religion. One area of particular interest, is the effect of restructuring to the
Provincial health care system from 52 health units to just 5 geographic health authorities that occurred in the 1990s.18 In Kitimat, this shift towards more regionalized services appears to have lead to a “wagon wheel of care” in the Northwest, as described by study participant,
Maya.19 Other changes regarding the provision of health services, outside of mental health, are apparent, such as the current state of general practitioners who service Kitimat. In the town’s contemporary history, South African doctors have established shared practices where they rotate with colleagues, six months of the year. These, among other phenomena, are of
!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!! 18 Province of British Columbia, Ministry of Health Planning, A New Era for Patient-Centered Health Care: Building a Sustainable, Accountable Structure for Delivery of High-Quality Patient Services (Victoria: Province of British Columbia, ca. 2001), p. 1, accessed June 9, 2013, http://www.health.gov.bc.ca/socsec/ pdf/new_era_sustain.pdf. 19 “Maya,” interview with the Author, August 3 & 5, 2012.
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interest for future study of how communities adjust to deal with geographic isolation and restructuring of health services.
6.2.2 Limitations
Limitations do exist for this study, which have been alluded to throughout this thesis.
As indicated in Chapter 1, the literature reviewed is not entirely comprehensive. This is due in part to the search terms chosen to conduct the review, but also because of the scarcity of literature regarding economic change and mental health in resource-based towns. As very few studies exists for this topic, specifically, it was difficult to systematically search and retrieve published literature directly related to my research question. However, in conducting the literature review for this project, a substantial gap was identified in the literature: mental health and resource-based towns.
It is also recognized that further research and review could have been examined regarding specific mental health outcomes and specific economic indicators. However, the lack of commitment to a specific mental health outcome (such as depression, addiction, or suicide) allowed for themes (and outcomes) to emerge from the data through my analysis, consistent the qualitative research paradigm. As well, the sparse discussion of mental health outcomes throughout this thesis is a contingency of my data; with the exception of psychiatric services, Kitimat residents did not clearly focus on a single mental health outcome. The identification of some mental health outcomes in this study lends well to future research that focuses on particular mental health outcomes in Kitimat. A potential limitation to note regarding economic change, is that while this study has framed change most often in the context of economic downturn, this is not to say that the relationship between mental health and economic change only works in this direction. Economic upturn or sudden
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economic growth may also influence mental health and its services, in ways either positive or negative. For this study, emphasis was placed on economic downturn because it emerged most prominently from the data as the way through which economic change was discussed.
A third limitation to this study is the unavailability of data sources that would have contributed to the findings of this study. An informative way of assessing changes in mental health might have been achieved through examinations of psychiatric records or physician referrals to psychiatric institutions. However, due to the town’s short history, many of the earliest residents/patients are still living. In this case, the ethical considerations outweighed the potential benefit of conducting a medical chart review, in addition to the limited resources and timeframe of this project. Furthermore, as Kitimat is a small part of a geographically disperse health region, there are very few statistics that report on the state of mental health in Kitimat. While this is fully discussed in Section 1.5.1, I will again mention here that the qualitative methods used to address this research question resulted in a rich and complex understanding of mental health and economic change that would not have been captured through alternate means of analysis.
Other limitations to this study were assessed by the criteria for maintaining rigour in a case study, as identified in a review by Peta Darke et al. (1998) of Monash University. First, there are multiple interpretations of data, and evidence for rejecting certain perspectives must be clearly reasoned.20 Through the duration of this study, I have tried to maintain a population-level perspective that best represents Kitimat residents as a whole, and reasoned the exclusion of certain perspectives based on the geographical, temporal, and topical
!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!! 20 Peta Darke, Graeme Shanks, and Marianne Broadnent, “Successfully Completing Case Study Research: Combining Rigour, Relevance, and Pragmatism,” Information Systems Journal 8, no. 4 (1998): 273-289, p. 284, accessed June 8, 2013 from http://onlinelibrary.wiley.com.ezproxy.lib.ucalgary.ca/store/10.1046/j.1365- 2575.1998.00040.x/asset/j.13652575.1998.00040.x.pdf?v=1&t=hhpmcryu&s=53c57428f662d8940fe1ef59d568 52061f1c3fa8.
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boundaries of my research question (see Chapter 2). Second, the analysis of the data in case studies is subject to the interpretations of the researcher, which introduces the potential for a potential researcher’s biases.21 To overcome this limitation, I analyzed findings according to the steps of content analysis, as outlined by Klaus Krippendorff (Section 3.2). This allowed me to identify patterns in the data, “as a step towards producing a conceptually coherent analysis of the phenomenon being studied.”22
In an attempt to address Darke et al.’s third limitation, bias in collecting data, I used multiple sources of evidence to examine the same phenomenon (“triangulation”).23 While complete objectivity is not possible in any research study, triangulation is one way of ensuring that the information presented is as representative as possible. I analyzed mental health and economic change by analyzing a number of sources (primary and secondary), and including multiple perspectives of Kitimat residents.24 In this way, I attempted to gauge as complete as possible an understandings of mental health, and as representative of Kitimat’s long-term residents as possible.
A final limitation is that no interviews were conducted with health care professionals.
The sampling frame (Section 2.2.2.1) was designed to include long-term residents of Kitimat, which was successfully accomplished. However, by not focusing on health care professionals, it is possible that experiences regarding mental health services and the state of mental health in Kitimat were missed. The potential negative effects of this limitation were avoided through triangulation of data sources. By examining sources aside from just semi-structured interviews, accounts by health care professionals that appeared in health reports, newspapers,
!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!! 21 Ibid., p. 285. 22 Ibid., p. 285. 23 Ibid., p. 286. 24 Ibid., p. 286.
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or speeches were acknowledged and included in the analysis. In this way, issues such as mental health services and the state of mental health in Kitimat from the perspective of health care professionals were not missed.
6.3 Relation to Other Studies
The findings from this study are most informative to small, resource-based communities across Canada based on the shared characteristics of their economic histories and in particular, the resource-based communities built after WWII in isolated geographic locations of Western Canada (aka “New Towns”). New Towns were those built all-at-once in the remote wilderness, without a previous history of industry or occupation. It is for this reason that communities such as Mackenzie, BC (logging), Snow Lake, MB (gold mining),
Elliot Lake, ON (uranium mining), Tumbler Ridge (coal mining), BC, and Lynn Lake, MB
(nickel mining) differ from towns such as Stirling County in Atlantic Canada (fishing) or
Quesnel, BC (logging, mining). As identified by UNBC25 Chair in Rural and Small Town
Studies, Greg Halseth et al. (2004) and BC historian Alan Artilbise et al. (2012), these resource-based New Towns, like Kitimat were and are based on staples-extraction, and tended and tend to have: high wages, an isolated geographic location, reliance on international export markets, small populations, and a comprehensive town plan.26 Like
Kitimat, most New Towns are built in the remote wilderness, unattached from physical connections to other cities or resources. The result of this is that the workforce within these
New Towns are drawn from outside of the general area, and oftentimes from other countries, such as was the case with Kitimat and its large population of Portuguese immigrants in its
!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!! 25 University of Northern British Columbia. 26 Greg Halseth and Lana Sullivan, “From Kitimat to Tumbler Ridge: A Crucial Lesson Not Learned in Resource-Town Planning,” Western Geography 13/14 (2003/2004): 132-160; Alan Artibise and Gilbert Stelter, “Resource Towns,” The Canadian Encyclopedia, 2012, accessed June 2, 2013 from www.thecanadianencyclopedia.com/articles/resource-towns.
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first Stage of development. 27 Additionally, Kitimat shares the stages of construction, diversification, and development are similar as those that occurred for other resource-based
New Town communities. Therefore, it is likely that understandings of mental health in
Kitimat resemble those in communities that share some similarities in their economic histories and economic base, and the makeup of their social community.
The findings of this study for Stage 1 (1950-1959) are consistent with those identified by Mona Gleason in her 1996 work examining psychology, school and family in post-WWII
Canada. Gleason found that following WWII, psychologists promoted and discouraged certain behaviours in Canadian family life, derived from their Anglo-Saxon, middle-class ideals.28 Residents of Kitimat appear to have ascribed to the same ideals that Gleason identifies for the family unit: well-adjusted, obedient children; strong, breadwinning fathers; and gentle, homemaking mothers. These ideals were promoted as norms in postwar Kitimat as Gleason found they were across Canada, which contributes to further understanding regarding the historic relationship between social structures and mental health in Canada. As discussed in Chapter 3, due to the normalization of this family ideal and its conformance in response to the reality of postwar conditions (men worked outside of the home and women inside of it), it is likely that mental health was not explicitly discussed because at the time this was considered a private matter. While not to say that mental health did not exist, it may not have been considered by residents of the 1950s—who were preoccupied with finding and maintaining work and housing—as an area they determined worthy of their attention. As all of Kitimat residents were generally experiencing the same conditions of unhappiness and
!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!! 27 Artibise and Stelter, “Resource Towns.” 28 Mona Gleason, “Normalizing the Ideal: Psychology, the School, and the family in Post-World II Canada, 1945-1960,” (PhD diss., University of Waterloo, 1996).
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hardship with their new community, this further reduced the chance of such things being recognized as impediments to mental health, rather than just a challenging part of life.
It is difficult to comment on how this study relates to epidemiological studies due to the different measures, data sources, and methods available. As this study does not contain quantitative analysis, comparisons or causal claims of mental health outcomes, like suicide are not available. Likewise, because no information was found discussing Kitimat’s use of other institutions in the province (see Appendix S), it is not possible to compare their mental health service use to other areas. However, this study does lend some general support to the
‘provocation theory’29 proposed by Brenner in 1976—that during economic downturns, individuals seek treatment, and mental hospitalizations increase.30 For during Kitimat periods economic downturn, which resulted in widespread unemployment, residents understood work and the family ideal as the contemporary equivalent of holistic mental health. This, in turn, prompted residents to seek “treatment” for their situation—sometimes in the form of clinical mental health services, and others through community-provided initiatives to return the unemployed to work.
6.4 Future Research and Study Implications
There are many directions for future research from this study, as many valuable questions of interest have been raised through the duration of this thesis. Some major questions specific to Canadian, resource-based communities include: what happens to mental health in unplanned company towns when the company abandons the community? How can
!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!! 29 As the theory was referred to by George Dowdall et al., Economic Antecedents of Mental Hospitalization,” in reference to Brenner’s Mental Illness and the Economy as outlined in Section 1.3.3. See George Dowdall, James Marshall, and Wayne Morra, “Economic Antecedents of Mental Hospitalization: A Nineteenth-Century Time- Series Test,” Journal of Health and Social Behaviour 31, no. 2 (1990): 141-147 and M. Harvey Brenner, “Economic change and mental hospitalization: New York State, 1910—1960,” Journal of Social Psychiatry 2, no. 4 (1967): 180-188, for summarized results. 30 Brenner’s (1976) study focused on mental hospitalizations from 1841 to 1967 in the State of New York State.
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we prepare to maintain good mental health even after resources have been exhausted? Future research might consider how the relationship between economic change and mental health differs in alternate economic systems? How does this relationship play out, beyond North
America; do resource-based towns in developing countries have similar economic histories and understandings of mental health? It is recommended that future study conducted on resource-based communities and economic change seek to quantify the findings reported in this study, through use of statistical data sources or epidemiologic survey.
The implications of this study are particularly important considering the current state of economic development taking place in Kitimat, BC. A number of large industrial developments are co-occurring in Kitimat, contributing to the regions current boom period
(see Appendix R for a listing of current developments). As history has shown, this community is particularly vulnerable to resource-based business cycles and it can be assumed that this current state of growth will not last.
It is important that health authorities, such as visiting psychiatrists or community provided services, consider the influence of economic circumstances on mental health in resource-based communities, especially considering the recent trends reported for British
Columbia’s sixteen health service delivery areas. The overall ranking for the annual prevalence of depression in the Northwest region for 2007/2008 rates second in the province, with a crude prevalence of 23.2 percent.31 This is shown to be an increase by approximately 9 percent since 2001.32 As well, the proportion of self-perceived mental health in the province
!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!! 31 Provincial Health Services Authority, Summary Report on Health for British Columbia for Regional, Longitudinal and Gender Perspectives, Raymond Fan, Andrew Kmetic, and Kane McCarney, Vancouver, BC: Provincial Health Services Authority, 2010, p. 39, accessed June 9, 2013, ww.phsa.ca/NR/rdonlyres/...F19E.../BCHealth_Indicators_Report.pdf . 32 Ibid., p. 41.
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as “excellent or very good” was second lowest, next only to the Northern Interior.33
Compared to the national average of 74.6 percent, in 2008 only 67.8 percent of Northwest residents reported excellent or very good mental health.34 While not to speculate as to the causes of Northwest BC’s higher proportions, should economic circumstances influence mental health negatively, as the literature suggests, resource-based communities (especially in Northwest BC) should be prepared for these effects when economic downturn inevitably occurs.
!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!! 33 Ibid., p. 55. 34 Ibid., p. 55.
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Appendix A
Table A Summary of findings for literature regarding economic change and mental health at the population level.
Author & Year Population Discipline (indicated by Key Finding(s) journal of publication)
Adam & Flatau (2006) Australia employees Economics and Labour Relations • There is a strong significant relationship between job insecurity and employee mental health outcomes. Aldwin & Revenson (1986) 291 survey respondents in LA area Community Psychology • Economic stress positively related to increased psychosomatic symptoms (B=0.16; p<.001). Anaf et al. (2013) Laid-off workers in Southern Australia Biomedicine • Qualitative themes: o stress, o change of perceived control o loss of self-esteem o shame o loss of status, grief o financial strain Asgeirsdottir et al. (2012) Workers in Iceland Economics • 2008 economic crisis in Iceland led to reduction in health compromising behaviours (drinking, smoking, diet, sleep), which could predict mental health status. Bitter (2000) Hungary, during and after (1989) Global Health • After communism: communism o Increase in depression o Decrease in suicide o Increase in use of anti-depressants Bartley (2005) Civil service workers in London, Epidemiology and Community • Poor job quality may affect mental health as much as job England Health loss. Brand et al. (2008) US workers nearing retirement Aging • There was some increase in depression for men as the result of layoffs, but not plant closings. • The opposite effect for women. Catalano & Dooley (1977) Kansas City Health and Social Behaviour • Mood and stressful life events are related to unemployment.
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Author & Year Population Discipline (indicated by Key Finding(s) journal of publication)
Catalano, Dooley, and Jackson Nonmetropolitan community in Health and Social Behaviour • Economic conditions are significantly related to inpatient (1981) Washington County, Maryland admissions. o More so in public inpatient admissions than private inpatient admissions. Ceccherini-Nelli, Priebe & UK, US, France, Italy general Social Psychiatry and • Unemployment affect suicide rates (increase/increase, Stefan (2011) population Psychiatric Epidemiology decrease/decrease) over long periods of time in 4 national contexts. Coen et al. (2013) Men with depression in Prince George, Health and Place • Men experienced and coped with depression according to British Columbia the ideals of dominant masculinity: strength (muscularity, manual labour), stoicism (not showing feelings), working (employed). Doessel (2009) State of Queensland, Australia Economic History • Deinstitutionalization of psychiatric institutions began around 1952-3, earlier than the official policy in 1962-3. Dowdall, Marshal & Morra Three US state institutions, 1881 to 1891 Health and social behaviour • Economic change does not provoke first admissions to (1990) mental hospitals. Eriksson (2000) Denmark, from 1970 to 1983 Labour Force and Employment, • First admission for manic-depressive illness is not linked and Health Production to unemployment variation. • Weak correlation for psychosis diagnosis and unemployment. • Strong correlation for personality disorder and unemployment. Frank (1981) Hawaii state first admissions 1972 to Community Psychology • Female admissions increased with economic upturn. 1975 • Male admissions increased with unemployment. • Economic downturn increased admissions for middle income group. Gili et al. (2013) Spain primary care patients Public Health • Increase in proportion of mood, anxiety, somatoform, and alcohol-related disorders after 2006 economic crisis. Hadley & Patil (2008) Rural Africa (Pimbwe and Sukuma) Physical Anthropology • Food insecurity significantly predicts symptoms of anxiety and depression, across the seasons.
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Author & Year Population Discipline (indicated by Key Finding(s) journal of publication)
Hauksdottir et al. (2013) Iceland Epidemiology • Higher stress among women who were unemployed or in middle income bracket. o Especially among vulnerable groups. Kearns et al. (2012) 15 communities in Glasgow, Scotland Housing Policy • Home renters had lower mental wellbeing than home owners • Those living in houses had higher mental wellbeing than those living in flats. • Living in an attractive neighbourhood is strongly correlated with mental wellbeing (RR=3.25). Khan et al. (2012) Lahore, Pakistan Urban Affairs • Degraded urban environment caused psychological stress—reflected in prevalence of depression, loss of self- esteem, low resilience. Kiernan et al. (1989) United States Community Psychology • Service use increased rapidly following an economic stressor. Luo et al. (2010) United States Health Policy and Economics • Men and women who admitted for major depressive disorder were as likely to be in the labour force, employed, and working full time as those with no history of major depressive disorder. • MRecently remitted men for MDD increased likelihood of being unemployed. Madden (2009) Ireland Health Economics • Mental illness fell between 1994-2000. o Protective effect of income, education and marital status on mental health. Mandal & Roe (2008) Older, working-age Americans Mental Health Policy and • Involuntary job loss and retirement worsens mental Economics health. • Re-employment returns individuals to their previous mental health status.
Meltzer et al. (2010) Great Britain Psychological Medicine • Increased likelihood among those who were in debt or job insecure.
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Author & Year Population Discipline (indicated by Key Finding(s) journal of publication)
Milner et al. (2012) 35 Countries; Social Psychiatry and Psychiatric Epidemiology • Suicide rates higher with increased female labour force WHO participation, unemployment, and population over 65 years of age. Monahan & Vaux (1980) United States Community Mental Health • Policy needs to address mental health and factors that influence it: o economic change o Noise and crowding o Socioeconomic status o unemployment Murphy & Leighton (1989) Atlantic Canada Psychiatry and Epidemiology See Section 1.4.3. Nagata (2000) Japan Occupational Health and Health • Job stress increased after economic recession due to Promotion changes in the wage system, increased unemployment, and break-down of life-long employment system. • The Ministry of Labour found that in 1997, 62.8% of workers had anxiety/worry stress regarding work. • Very few companies 26% have measures in place to address workers’ mental health. Nicholson et al. (2008) Russia, Poland, and Czech Republic Affective Disorders • Depression more influenced by economic circumstances than early life or education. • Disadvantaged men 3.15 times more likely to be depressed Russia. O’Brien et al. (2011) Rural Russia Poverty and Public Policy • Incremental gains in income are associated with substantial gains in mental health outcomes. Paraschackis et al. (2012) Greece Psychiatry • Relatives of those who suicide, 31.1% identified economic difficulties as single event that provoked considerable stress the year before the suicide. Provan et al. (1996) United States Medicine • N/A
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Author & Year Population Discipline (indicated by Key Finding(s) journal of publication)
Sclar (1980) United States Health Services • The incidence and prevalence of dysfunction increases with both ups and downs in the economy Shah & Bhandarkar (2008) 27 countries Psychology • No significant correlation between suicide rates and unemployment, magnitude was small. Snipes et al. (2012) United States Economics and Business • As unemployment rate increases, probability of death being ruled as a suicide increases, from 1980-2006. Strazdins et al. (2011) Australia employees Epidemiology and Community • Depression and anxiety increased with job insecurity. Health Thomas et al. (2005) Britain Epidemiology and Community • Transitions from paid employment to unemployment or Health long-term sick leave associated with increased psychological distress for men and women. Trainor, Boydell, and Toronto, Ontario—Queen Street Mental Psychiatry • As unemployment increased, admissions and discharges Tibshirani (1987) Health Centre decreased. Viinamaki et al. (2000) Finland Psychiatry • Mental disorder more common among men, and the unemployed. • Poor economic situation associated with mental disorder in both sexes. Wang et al. (2010) Alberta employees Psychiatry and Epidemiology • 12-month prevalence of major depressive disorder increased after the 2008 economic crisis. o Not social phobia, panic disorder, or generalized anxiety disorder.
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Appendix B
Table B Summary of admissions to residential facilities and outpatient programs of the Mental Health Branch, in BC, 1945-1974 The following table, organized by Year of Annual Report for the BC Mental Health Branch, provides an overview of the number of institutionalization in BC from 1945-1974. Institutional information is adapted from Boschma’s (2011). 1 Proportion of the BC population was calculated using annual estimates for the provincial population, as reported by Statistics Canada.2
Admissions to Entries into No. Total Pop. of % of BC population Reporting Residential Outpatient Outpatient Institutionalized institutionalized or in Year Facilities3 Programs4 Centres Mentally Ill in BC outpatient programs 1945-46 834 1949-50 1,415 1951-52 2,175 5,738 (1953) 0.0045% 1955-56 2,855 6,331 (1955) 0.0047% 1958-59 2,993 6,227 (1959) 0.0039% 1960-61 3,924 1962-63 4,248 6,070 (1963) 0.0036% 1965-66 5,069 6,053 (1965) 0.0034% 1967-68 4,179 5,856 (1968) 0.0029% 5,903 (1970) 17 (1970) 0.0028% 1970-71 3,870 6,001 (1971) 20 (1971) 0.0027% 7,240 (1972) 23 (1972) 0.0031% 1972-73 2,650 9,326 (1973) 27 (1973) 0.0039% 1973-74 2,823 11,719 (1974) 32 (1974) 0.0048%
!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!! 1 Geertje Boschma, “Deinstitutionalization Reconsidered: Geographic and Demographic Changes in Mental Health Care in British Columbia and Alberta, 1950-1980,” Social History 44, no. 88 (2011): 223-256. 2 Prepared by BC Stats, Ministry of Labour, Citizens’ Services and Open Government, accessed June 10, 2013, http://www.bcstats.gov.bc.ca/StatisticsBySubject/Demography/PopulationEstimates.aspx 3 Includes: Riverview, Woodlands, Tranquille, Valleyview, and the Homes for the Aged in Vernon and Terrace. 4 Includes: Mental Health Centres, Outpatient Departments of Riverview, Woodland, and Tranquille, Waiting list for Woodland and Tranquille, BC Youth Development Centre, Community Care Teams.
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Appendix C
Table C List of reviewed archival materials, by collection and institution.
Author (Date) Call Number/Catalogue Record Institution Archive Title/Collection [where available] [where available]
Kitimat Public Library Special Collections, organized by call number
District of Kitimat, Recreation Kitimat Residents Community Achievements 1957-1998 SpC 001.4 Dis Department (1998) Annual Report Kitimat Public Library (1955) SpC 027.4 Kit Vol. 2 Northern Sentinel (1954-2010) SpC 071.11 Nor Minetown, Milltown, Railtown: Life in Canadian R. Lucas (2009) SpC 304.6 Mal Communities of Single Industry The District of Kitimat Neighbourhood Development Options (1995) SpC 307.12 Dis Study: Comparative Review Kitimat, B.C.: Report on Master Planning and City Mayer, Whittlesey, Architects SpC 307.12 May Development for the Aluminum Company of Canada (1953) British Columbia Population: Growth, Profiles, and Resource British Columbia Telephone Co. SpC 307.76 Luc Community Study Report on Single Industry Resource Communities: Kitimat, Northern British Columbia SpC 307.76 Nor B.C., Fraser Lake, B.C., Mackenzie, B.C. Women’s Task Force (1977) Resource Community Study Canstar Oil Sands Ltd. (1982) SpC 307.76 Rob Social Characteristics of One-Industry Towns in Canada: A A. Himelfarb (1976) SpC 307.76 Roy Background Report Economic Development of the Regional District of Kitimat- AVG Management Science Ltd. SpC 330.9711 AVG Stikine, British Columbia (1971) Impact of Industry on the Municipality of Kitimat A.L. Farley (1965) SpC 330.9711 Far Kitimat-Stikine Regional District 1996 Census Profile (1996) SpC 330.9711 Kit BC Ministry of Industry and Small The Northwest Region: A British Columbia Regional Business Development, Economic Economic Study, 1982: Economic Development in SpC 330.9711 Nor Analysis and Research Bureau Northwest British Columbia, Challenges and Opportunities (1982)
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Author (Date) Call Number/Catalogue Record Institution Archive Title/Collection [where available] [where available] The Highway 16 Labour Markets 1980: Prince George to Struthers Consultants (1981) SpC 331.11 Hig Prince Rupert Minette Bay Recreation Area Land Use Submissions District of Kitimat (1975) SpC 333.7 Dis The Kitimat River: Its Use and Its Importance to Residents of William F. Sinclair (1975) SpC 333.78 Sin the Kitimat Districts Kitimat Works’ Contribution to the Economy of British Alcan Smelters & Chemicals Ltd. SpC 338.09711 Alc Columbia Alcan in Kitimat-Kemano (1985) SpC 338.74 Alc A Celebration of Pioneering Spirit: A 50th Anniversary (2004) SpC 338.74 Alc Tribute: 1954-2004 Eurocan Pulp & Paper Co. Ltd. Eurocan Pulp & Paper Co.: 1970-2010 Story Book SpC 338.74 Eur (2010) Alcan Smelters & Chemicals Kitimat-Kemano: Five Years of Operation, 1954-1959 SpC 338.74 Kit (1959) Alcan Smelters & Chemicals Kitimat-Kemano: The First 25 Years, August 3, 1954-1979 SpC 338.74 Kit (1979) Mill Effluent Disposal: Submissions Made to the Council of (1968) SpC 338.74 Mil the District of Kitimat 1955: In Review Kitimat Works (1956) SpC 338.74 Nin 1956: A Year in Review (1957) SpC 338.74 Nin Ocelot Methanol Plant: Kitimat, B.C. March 1980-July 1982 Linda Steele (1982) SpC 338.74 Ste Building a Safer Community Conference, May 10th & 11th, (1991) SpC 364.4 Bul 1991 Swan Wooster Engineering Co. Master Plan Study for the Port of Kitimat, B.C. SpC 387.129 Swa (1977) A Biological Assessment of the Kitimat River Estuary (1974) SpC 574.52636 Bio Report on Health Study of Workers of Alcan Smelters and University of British Columbia SpC 616.9803 Uni Chemicals Ltd. (1980) Air Quality Assessment of the Proposed Integrated Steel Mill August T. Rossano (1975) SpC 628.53 Ros in Kitimat, British Columbia Project Market Place: Report on Retail Market Study Joann Norma Kerby (1986) SpC 656.8 Ker
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Author (Date) Call Number/Catalogue Record Institution Archive Title/Collection [where available] [where available] District of Kitimat, Recreation Recreation Survey 1998-1999 SpC 790 Rec Department (1999)
Regular Collections, organized by call number
Economic Development of the Regional District of Kitimat- E.M. Bauder (1971) 330.9711 BAUD Stikine, British Columbia Mancatcher Jack Fossum (1990) 363.2 Fos People of the Snow: The Story of Kitimat John Kendrick (1987) 917.1132 KEN c.2 Kitimat, My Valley Elizabeth Anderson Varley (1981) 971.132 Var Preliminary Hearings Into the Kitimat Oil Port Inquiry Proceedings (1977) Archive 338.3 Pre PAC-RIM LNG Assessment PAC-RIM LNG Project: Final Project Report Specifications Archive 665.744 PAC Committee (1996) Three Towns: A History of Kitimat Janice Beck (1983) CASSIDY 971.06 BEC Future Search ’96: Kitimat Valley in 2005: How do we District of Kitimat (1996) TC 658.4012 Fut Retain and Create Jobs in the Kitimat Valley? Enbridge Northern Gateway Project Enbridge (2011) Ref 665.744 Enb The Kitimat Provincial Forest: Its Past, Present and Possible Robert J. Wilson (1992) TC 333.7517 Wil Futures
Online Collections
Alcan Smelters & Chemicals The Ingot kitimatpubliclibrary.org (1954-1985; 2003-2010) The News Advertiser (1980-1995) kitimatpubliclibrary.org
The Northern Sentinel (1954-2010) kitimatpubliclibrary.org
Kitimat Centennial
Museum and Archives Kitimat General Hospital Box 10
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Author (Date) Call Number/Catalogue Record Institution Archive Title/Collection [where available] [where available]
Chamber of Commerce (1982) Box 16
The Chamber Pot — Chamber of Commerce Newsletter (1982-1985) Box 16 Government Services, Provincial (1960-) Box 418 Kitimat General Hospital Government Services, Provincial (1952-1960) Box 419 Smeltersite Hospital Old Books Box C-14 Royal Canadian Legion, Branch The Bugle – Royal Canadian Legion Newsletter CA KIT 250 (19809) Kitimat Citizenship Council Fonds CA KIT Kitimat Community Arts Council Kitimat Community Arts Council Fonds CA KIT (1970-1994) Kitimat-Kemano: the First 25 years CA KIT Kitimat-Kemano Reports Brochures CA KIT Northern B.C. Winter Games Northern B.C. Winter Games Committee (Kitimat) CA KIT Committee (1983-1985) Carolyn Connant van Clarcom Getting Ready to Be a Mother Box: Old Books (1947) Rural Health Practice Harry Mustard (1936) Box: Old Books Social Life and Religion of the Indians in Kitimat, British Ivan Lopatin (1945) Box: Old Books Columbia Dierson Collection (2009) 2009.1
Other, from undefined collections
Canadian Occidental Petroleum Prospectus and Conceptual Project Definition [Presented to Limited, Dome Petroleum Limited, the Province of British Columbia]: A Petrochemical Project Report Mitsubishi Companies (January for British Columbia 1981) The History of the First School in Kitimat, B.C.: Alcan’s Jennifer Young (1998) Report Smelter Site School
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Author (Date) Call Number/Catalogue Record Institution Archive Title/Collection [where available] [where available] The Book: Ocelot Methanol Plant, Kitimat. B.C. Linda Steele (March1982) Commemorative Book The Northwest Transportation and Trade Corridor Capability AGRA Earth & Environment Ltd. Report: Access, Capacity and Development Guide to One of Report (2000) Canada’s Best Kept Trade Secrets Kitimat: Tomorrow’s City Today B.J. McGuir and Rolad Wild (1964) Publication Canadian Association for Smelter Makin’ Metal Report and Allied Workers (1986) Project British Columbia Mike Meyer (1952) Report Interagency Meeting Minutes From curator Collection of documents from Meldrum Estate Pixie Meldrum, former editor for the Northern Sentinel Minute Book of the Corporation of the District of Kitimat, Commencing May 4, 1953 Onsite, District of Kitimat Council District of Kitimat Volumes 1-21 Terminating August 31, 1991 Chambers Commencing January 14, 2008 PDF Format, Online: Minutes of Meetings of Council Terminating December 20, 2010 www.kitimat.ca
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Appendix D
Access documentation to archival materials at the Kitimat Public Library.
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Appendix E
Access documentation to archival materials at the Kitimat Centennial Museum.
From: Angela Eastman Date: February 13, 2012 12:27:42 PM MST To: Kelsey Lucyk
Subject: RE: Research Request
Hi Kelsey, Thanks for the email. Your project sounds very interesting and informative. Our Research Request Charges remain the same $10.00/hr plus photocopy costs, however I discussed with Louise and you are welcome to access our archives on your own, if that fits with your schedule. We can set up a table in the gallery and you can make use of the photocopier as needed. Most of the material you will be interested in will be in our clippings and research files - anything else I can help you find. I wanted to mention that the Library has all of the Northern Sentinel (up to 2010) in a newspaper database on-line. You can search on key terms, names and dates. Regarding your second request, just let me know which images you need and I can send you the larger jpeg. Hope this helps, Angela
Angela Eastman Assistant Curator Kitimat Museum & Archives 293 City Centre Kitimat, BC V8C 1T6 Phone: (250) 632-8950 Fax: (250) 632-7429 Email: [removed] Website: www.kitimatmuseum.ca
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-----Original Message-----
From: Kelsey Lucyk Sent: February-09-12 4:12 PM To: Angela Eastman Subject: Research Request
To Louise and Angela,
Hello and I hope you both are well! I have meant to write to you for some time now, but am just getting to it now. I wanted to get in contact with the both of you, as I am planning to conduct research in Kitimat during the summer for my Master's project. I am studying at the University of Calgary, in the Department of Community Health Sciences. I am doing a Master's of Science in Population/Public Health, with a History of Medicine project. I am going to look at how discourses of public mental health-written or spoken attitudes, communications, and documents-have changed through Kitimat's periods of economic development and decline, since the town has existed. I will be looking at 3 periods of change, as well as the present day: pre-industrial/construction, "pioneer" years/growth, industry closure/population exodus, present day/looking for new economic opportunities. There are two components to my project. For the majority, I will be conducting archival research and document analysis to contextualize mental health in Kitimat's various economic realities, as well as to get an idea of how mental health was perceived at different stages. The second aspect is corroborating my findings with a limited number of semi-structured interviews. I am going through the process of gaining ethics approval now, but I am hoping to speak with patients who have been treated for mental illness or have treated mental illness in the town at different points in Kitimat's history. So, I am writing to request permission to access archives that relate to my project from the Kitimat Centennial Museum. I wanted to confirm if the cost is still $10.00 per hour for the staff to retrieve documents, and maybe a bit more about how this works (i.e., how far in advance do you need to know which documents are of interest). I also have a second request. I have read on the museum website that images may be reproduced and assessed on an individual basis. I am presenting at a few conferences in the coming months, and am interested in using a few of the images from the website in the presentation slides. This is a side project that is looking at discourses of mental health in Kitimat from 1954-9 by analyzing the Northern Sentinels. I would be more than happy to
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share a copy of the powerpoint with the museum, and would acknowledge your cooperation in the presentation.
Please let me know if you want more information, or have any questions. I am happy to answer! I look forward to hearing from you, Kelsey Lucyk
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Appendix F
Access documentation to archival materials at the District of Kitimat.
The following information has been extracted from the District of Kitimat website, and is available online at www.kitimat.ca: The contents of online Kitimat Council Meeting Minutes are for information and reference purposes only, and are not to be relied on as the complete or official version of Council Meeting Minutes…Certified paper copies of Council Minutes are available on request. Charges will apply [to copy]. Please contact the Office of the Municipal Clerk. 270 City centre Kitimat, BC V8C 2H7 Phone: (250) 632-8900
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Appendix G
Ethics consent form for Interview Participants.
TITLE: Growing Pains: an historical analysis of population mental health in Kitimat, British Columbia, 1940-2012
SPONSOR:
INVESTIGATORS: Dr. Frank Stahnisch (Primary Investigator) Dr. Lindsay McLaren (Co-Investigator) Kelsey Lucyk (MSc Student)
Dr. Stahnisch [contact information removed] Kelsey Lucyk [contact information removed]
This consent form is only part of the process of informed consent. It should give you the basic idea of what the research is about and what your participation will involve. If you would like more detail about something mentioned here, or information not included here, please ask. Take the time to read this carefully and to understand any accompanying information. You will receive a copy of this form.
BACKGROUND This study is designed to identify themes and trends regarding mental health that exist for residents of Kitimat, British Columbia. This study aims to give voice to Northern residents regarding their experiences with mental health and economic change, to inform policy makers and mental health care workers of the role that the economy plays in shaping mental health in industry-dependent communities.
Study participants were recruited through “snowball” sampling and word-of-mouth, through Ms. Lucyk’s contacts in Kitimat, BC.
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The number of participants is not fixed, to allow for the ongoing inclusion of participants throughout the researcher’s data collection process. Participants were selected based on their status as a long-term resident of Kitimat (minimum 15 years).
WHAT IS THE PURPOSE OF THE STUDY? The purpose of this study is to understand the experiences and perceptions of residents in Kitimat, British Columbia regarding how their mental health has been influenced by their specific economic changes. The interviews will then be analyzed to extract themes that connect economic changes with mental health care.
WHAT WOULD I HAVE TO DO? The interview will take approximately 1 hour. The study, itself, will continue until the completion of the interviewer’s Master’s program, expected for late 2013. Participants may request a copy of their interview transcript from the researcher, and will be allowed to exclude information that they are not comfortable including in the study.
WHAT ARE THE RISKS? There are no anticipated risks to participation in this interview; however, due to the semi- structured nature of interview, the participant may experience psychological stress if the interview enters subject matter that is sensitive for the participant. Should this occur, the interviewer will direct participants to relevant community services that may be of help to them. By signing this consent form, the participant acknowledges that they accept this risk and may decide which experiences they wish to talk about and which they do not. There is the potential that participants may be identified, depending on the information they disclose to the researcher. To prevent this, participant’s identities and other identifiers (place of work, names of co-workers, etc.) will be kept confidential, omitted, or assigned pseudonyms. WILL I BENEFIT IF I TAKE PART? If you agree to participate in this study there may be a direct benefit to you and your community. Based on the information collected from this study, it may help to inform policy makers of the unique social and economic factors that influence mental health in Northwest British Columbia. Eventually, this may lead to mental health taking a more prominent role in the discussion of economic developments that affect industry-dependent communities.
DO I HAVE TO PARTICIPATE? During the interview the participant may request to stop recording at any time to discuss or clarify how they wish to respond to a question or topic before proceeding. The researcher may withdraw the participant in the case of an unusable or offensive interview, or information that is non-relevant to the study. If any new information becomes available that
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might affect the participant’s willingness to participate, the participant will be informed as soon as possible. In the event you should wish to withdraw during the interview, any recording made of the interview will be destroyed, and no transcription of the interview will be made. If requested in a timely manner, the participant will be provided with the opportunity to make revisions or restrictions to the transcription prior to its inclusion in the researcher’s analysis. This must be requested within one week of the interview date.
WILL I BE PAID FOR PARTICIPATING, OR DO I HAVE TO PAY FOR ANYTHING? You will not receive any form of payment, nor do you have to pay for your participation in this study. WILL MY RECORDS BE KEPT PRIVATE? The interview process is anonymous. While participants will be assigned a pseudonym during the transcription phase and their identity kept confidential, participants are encouraged not to disclose information that would allow others to identify them, such as interpersonal details. Once complete, interviews will be transcribed and kept on file on the researcher’s computer upon which the participant will forfeit legal ownership and copyright of the material, unless requested otherwise. For use in analysis and publication supplementary to the thesis. Audio recordings will be erased. The University of Calgary Conjoint Health Research Ethics Board will have access to the records, as they constitute a major part of the researcher’s Master’s dissertation. By signing this form, you consent to having copies of the interview transcripts (with names omitted or changed) stored with institutions interested in the history of population mental health, such as Alberta Health Services, the Kitimat Centennial Museum, or the University of Calgary. SIGNATURES Your signature on this form indicates that you have understood to your satisfaction the information regarding your participation in the research project and agree to participate as a subject. In no way does this waive your legal rights nor release the investigators or involved institutions from their legal and professional responsibilities. You are free to withdraw from the study at any time without jeopardizing your health care. If you have further questions concerning matters related to this research, please contact:
Kelsey Lucyk [contact information removed] or Dr. Frank Stahnisch [contact information removed]
If you have any questions concerning your rights as a possible participant in this research,
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please contact The Chair of the Conjoint Health Research Ethics Board at the Office of Medical Bioethics, 403-220-7990.
Participant’s Name Signature and Date
Investigator/Delegate’s Name Signature and Date
Witness’ Name Signature and Date
The University of Calgary Conjoint Health Research Ethics Board has approved this research study. A signed copy of this consent form has been given to you to keep for your records and reference.
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Appendix H
Copyright for Images. Copyright for the Figures 3.1, 3.3, 3.5, K, R, and Q fall under the exception of Fair Dealing in the Copyright Act. The following is excerpted from Section 29, Exceptions: Fair Dealing from the Copyright Act, Statues of Canada 1985 C-42, s. 29, http://laws- lois.justice.gc.ca/eng/acts/C-42/index.html: Exceptions Fair Dealing Marginal note: Research, private study, etc. 29. Fair dealing for the purpose of research, private study, education, parody or satire does not infringe copyright. R.S., 1985, c. C-42, s. 29; R.S., 1985, c. 10 (4th Supp.), s. 7; 1994, c. 47, s. 61; 1997, c. 24, s. 18; 2012, c. 20, s. 21.
Marginal note: Criticism or review 29.1 Fair dealing for the purpose of criticism or review does not infringe copyright if the following are mentioned: (a) the source; and (b) if given in the source, the name of the (i) author, in the case of a work, (ii) performer, in the case of a performer’s performance, (iii) maker, in the case of a sound recording, or (iv) broadcaster, in the case of a communication signal. 1997, c. 24, s. 18.
The following list presents the source for each of the Fair Dealings figures used (no author was provided for any): Figure 3.1: Google Earth (see Figure K). Figure 3.5: Northern Sentinel Press [scan]. Issue 1. June 21, 1957. Accessed www.kitimatpubliclibrary.org. Figure K: Google Maps. www.google.ca.
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From their website [underline added]:
I'd like to use your maps in my project. What's the first thing I should know? To determine if your proposed use of Content is acceptable, you should first read closely the applicable Terms of Service:
Your use of Content, as defined in the Terms of Service, in anything from marketing and promotional materials to films and books is first and foremost governed by the license provided in the applicable Terms of Service for the product. In certain circumstances, Google may be able to grant you a broader license to use the Content in a manner not covered in the Terms of Service. Plus, apart from any license granted to you by Google, your use of Content may be acceptable under principles of "fair use."
Fair use is a concept under copyright law in the U.S. that, generally speaking, permits you to use a copyrighted work in certain ways without obtaining a license from the copyright holder. There are a variety of factors that affect whether your use of Content would be considered fair use, including the purpose and character of your use, the nature of the copyrighted work, the amount of the copyrighted material used, and the effect of your use upon the potential market for the copyrighted work. For example, there are differences between use in a for-fee service and use in a work of scholarship, or the use of a single map screenshot and the use of detailed map images for an entire country. There are similar, although generally more limited, concepts in other countries' copyright laws, including a concept known as "fair dealing" in a number of countries. That all being said...
Please do not request that we interpret whether your use of Content is fair use. Google cannot tell you if your use of Content from our products would be fair use or would be considered fair dealing; these are legal analyses that depend on all of the specific facts of your proposed use. We suggest you speak with an attorney if you have questions regarding fair use of copyrighted works.
Figure Q: “Quick Facts.” Northern Health. No date. Accessed June 11, 2013. http://www.northernhealth.ca/AboutUs/QuickFacts.aspx. From their website [underline added]:
Copyright
Unless otherwise noted, all content on this web site is copyright protected. All images, names and logos remain the property of Northern Health and require written permission for use.
Northern Health grants you a limited license to display on your computer, print, download and use the information contained in this site for your own personal, non-commercial or educational purposes only, provided that:
You do not modify the information; and All copyright and other proprietary notices are retained.
No other use of the information is permitted. Without limiting the generality of the foregoing, you may not: Use any of the information for any commercial purpose, or for any public display (commercial or non- commercial);
Include any of the information or reference thereto in or with any information, product or service that you create, distribute or provide;
Copy or transfer any of the information onto your own web site or any other web site or server.
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The following is an email communication regarding the copyright holder (Kitimat Centennial Museum) and the author. The invoice following shows proof of payment.
Hi Louise and Angela (and Zel),
Hope that everything has been well back home—the clouds we have had in Calgary certainly have reminded me on it!
I have a request for reproduction rights for some of the images from the Museum website in my thesis. For the images which you have holdings for, I would like you to please consider granting me permission, of course with my payment of the required fees as you see fit.
Some details to my request: I would credit the Kitimat Centennial Museum in the caption of the image, and would not misrepresent the image's content. Publication would be about six copies of my printed thesis, as well as an electronic PDF version that U.Calgary makes accessible to UC members at their online repository, "dSpace."
I am attaching a table with the images for which I am seeking permission. If you do not have the holdings, would you please direct me to the appropriate regulating body? (I purposely didn't pick any Alcan ones to try and avoid that).
Thanks so much for your consideration, take care! Kelsey
Hi Kelsey,
All is well here, gearing up for another round of 'Summer of Adventure'! We are happy to grant permission to you for the images you have requested. Please credit 'Kitimat Museum & Archives' and acknowledge Max Patzelt when appropriate.
Regarding fees, we generally charge $35.00/image ($10.00 ea. for the image at a higher res. than is on the website, and $25.00 ea. for publication fees.) If you are ok with the resolution of the images on the website then we will only charge the $10.00 per image for a total of $110.00 plus taxes. I can get Zel to send you an invoice.
Hope all is well with you, and we all wish you good luck in defending your thesis! Angela
Hi Angela and Zel,
Can I please sneak in this image to my image request list for an additional $10? If Angela permits this, I will call you this afternoon with payment, Zel!
Kitimat Town Plan Topography / Clarence S. Stein, Coordinator & Director of Planning;
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Mayer & Whittlesey, Town Planners; M. Milton Glass. -- 1952. (Roger Willcox Collection) Clarence S. Stein, Coordinator & Director of Planning; Mayer & Whittlesey, Town Planners; M. Milton Glass.
"A model of Kitimat's topography with the town in situ." http://www.kitimatmuseum.ca/images/BCDC_photos_highres/P00005.jpg
Thank you! Kelsey
Sorry Kelsey. Angela and I don't work Fridays so got this today. Yes, it is fine. Don't worry about the extra charge. Original invoice is fine....Just send me your credit card info and will get that paid up for you.... Thanks Zel
293$City$Centre$ Kitimat,$BC$ V8C$1T6$ Phone:$$250<632<8950$ Fax:$$250<632<7429$ Email:[email protected]$ www.kitimatmuseum.ca$
GST R11898 3626
INVOICE: 001186
May 29, 2013
Kelsey Lucyk
RE: Images from Museum website Qty Item Price Total 11 Images $10.00 $110.00
Sub-total $110.00 GST $5.50 PST $7.70 TOTAL $123.20
Thank you KITIMAT MUSEUM & ARCHIVES
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Appendix I
Interview guide for qualitative interviews. History of Community 1. What is it like to live in Kitimat? a. History of living in the area b. Employment/unemployment history c. Community (security; stability; services) i. People moving here/leaving ii. Is there enough to do? (entertainment) iii. How do you see yourself within the community?
2. How do you feel when you think about the past?
3. How do you feel about the changes that have occurred in the community? Do you feel like they affect you? a. Old Hospital b. Kemano closure c. Methanex closure d. Eurocan closure e. Alcan modernization f. LNG pipeline g. Enbridge pipeline
Concerns for the Community 4. What are things that have caused you stress living in Kitimat? Has this changed?
5. Do you worry about the future (town; community; work)? a. How do you cope? b. Plans for the future? (housing, investment, retirement, relocation) c. Do you feel that others have similar plans? d. What do you expect to see in the future, for Kitimat?
Health and Health Services 6. In general, do you feel Kitimat has adequate health services? (Has this changed?) a. Have you heard of anyone seeking health service outside of town? b. Do you feel you have a good relationship with your doctor?
7. If you had a mental health problem, what would you do? a. Who might you talk to, and could they meet your needs? i. What influences this decision? (availability; relationship) ii. Have you heard of anyone seeking help outside of town? iii. Is there anything else that you would like to tell me?
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Appendix J
Figure J A Provincial Government advertisement on the industrial and commercial opportunities in British Columbia focusing mostly on the natural resources such as forestry, mining, agriculture, fisheries and power, ca. 1954.
© Kitimat Centennial Museum 2013
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Appendix K
Figure K Kitimat General Hospital’s Location relative to the Town Site *Current KGH +Former KGH
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© Google Maps 2013
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Appendix L
Figure L An aerial view of smelter operation in Kitimat, ca. 1965
© Kitimat Centennial Museum 2013, photo credit to Max Patzelt
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Appendix M
Figure M An aerial view of Albatross and Cormorant streets, green space, walkways and Cormorant School, ca. 1954
© Kitimat Centennial Museum 2013, photo credit to Max Patzelt
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Appendix N
Figure N Town planner Julian Whittlesey surveys a construction site, August 1954
©Kitimat Centennial Museum 2013
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Appendix O
Figure O An aerial view of Kitimat showing land cleared for Neighbourhood “D,” the Whitesail Neighbourhood under construction (right foreground), and the Alcan smelter and Douglas are shown in the background, 1962
© Kitimat Centennial Museum 2013, photo credit to Max Patzelt
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Appendix P
Figure P Image of the Kitimat Master Plan Topography Model (ca. 1952) overlaid onto a current Aerial View of the townsite, showing how closely the Master Plan was followed
© Google Earth 2013 and Kitimat Centennial Museum 2013
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Appendix Q
Figure Q Northern Health Authority in British Columbia, Divided by Health Service Delivery Areas
© Northern Health Authority 2013*
!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!! * Northern Health, “North West Contacts,” accessed June 3, 2013 from http://www.northernhealth.ca/FindUs/ContactUs/LocalContactsFacilities/NorthWest.aspx.
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Appendix R
Table R List of current and ongoing industrial projects in Kitimat, as of 2013
Project Investment Description Stage Rio Tinto Alcan – Kitimat $3.5 billion Increase aluminum capacity Under way Modernization Project and reduce emissions by 50% Kitimat LNG – Natural $4.5 billion Liquefaction and marine Clearing and grading ongoing Gas Liquefaction and terminal; Produce 5 million Export Terminal tonnes LNG annually Pacific Trial Pipeline – $1.3 billion Connect Summit Lake to First Nations support; front-end natural Gas Pipeline Kitimat LNG and export engineering and design stages LNG to Asian Markets Douglas Channel Energy N/A Small-scale LNG plant for Proposed Partnership export of 900, 000 tonnes annually Sandhill Materials $25-30 million Aggregate processing and Agreements underway export terminal LNG Canada $12 billion Natural gas treatment, Scheduled for 2020 startup liquefaction and storage, marine terminal, LNG pipeline, support facilities Coastal GasLink – natural $4 billion LNG pipeline from Dawson Proposed Gas pipeline Creek to Kitimat Enbridge Northern $6 billion Marine terminal, bitumen Awaiting Joint Review Panel Gateway – Marine and condensate pipelines decision, late 2013 Terminal and Pipeline Kitamaat Renewable $150 Million Hydroelectric project; tie-in Environmental review initiated 2007 Energy Corp Rio Tinto Alcan transmission Kitimat Clean $13 billion Oil refinery financed by the Memorandum of understanding with Bank of China, crude oil Bank of China; environmental pipeline assessment underway; construction scheduled to begin 2014
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Appendix S
Table S Residential Facilities of Mental Health in British Columbia post-WWII*
Institution Name Location Established Closed Distance from Kitimat (km) Riverview Hospital Coquitlam 1872 2012 1, 395 (i.e. Essondale) Tranquille Kamloops 1959 1985 1, 164 Woodlands New Westminister 1950 1996 1, 395 Valleyview Coquitlam 1959 1986 1, 395 Geriatric Hospital Terrace Late 1940s N/A 56 Geriatric Hospital Vernon Late 1940s N/A 1, 267
!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!! * This table is adapted from information provided in Boschma, “Deinstitutionalization Reconsidered,” and BC Mental Health & Addiction Services, “BC Mental Health Timeline,” 2013, accessed June 3, 2013 from www.bcmhas.ca/AboutUs/History.htm, and Google Maps, Directions.
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Appendix T
Table T Population Estimates and Census counts for Kitimat, 1953-2012*
Population Source Year Population (DoK = District of Kitimat Estimate) 1953 2,500 DoK 1954 4,000 DoK
1955 8,000 DoK 1956 9,679 Census 1957 13,800 DoK 1958 11,300 DoK 1959 8,781 DoK 1960 9,336 DoK 1961 8,217 Census 1962 7,703 DoK 1963 8,497 DoK 1964 9,000 DoK 1965 9,500 DoK 1966 9,735 Census 1967 10,000 DoK 1968 10,500 DoK 1969 12,090 DoK 1970 12,500 DoK 1971 11,803 Census 1972 13,272 DoK 1973 13,755 DoK 1974 13,563 DoK 1975 13,500 DoK 1976 13,000 DoK (Census: 11,956) 1977 13,200 DoK 1978 13,000 DoK 1979 13,500 DoK 1980 13,650 DoK 1981 14,500 DoK (Census: 12,814)
!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!! * Data compiled by the District of Kitimat, Community Planning and Development Department. *Indicates estimates generated through BCStats by the researcher (BCStats.gov.bc.ca)
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Population Source Year Population (DoK = District of Kitimat Estimate) 1982 14,000 DoK† 1983 13,500 DoK 1984 13,500 DoK 1985 13,000 DoK 1986 12,500 DoK 11,196 Census 11,633 BCStats 1987 12,000 DoK (BCStats: 11,544) 1988 11,196 Census for 1986 (BCStats: 11,287) 1989 11,200 DoK (BCStats: 11,327) 1990 11,535 DoK ( BCStats: 11,428) 1991 11,305 Census 1991 ( BCStats: 11,618) 1992 11,305 DoK ( BCStats: 11,547) 1993 11,305 DoK (BCStats: 11,480) 1994 11,504 BCStats estimate 11,725 DoK 1995 11,382 BCStats 1996 11,136 Census 11,587 BCStats 1997 11,636 BCStats (1 July 1997), later revised to 1998 11,725 BCStatsest 11,742 (1 July 1998), later revised to 1999 11,672 BCStatsest 11,692 (1 and July 11,365 1999), later revised to 2000 11,533 BCStatsest 11,195 (1 July 2000), later revised 2001 10,295 Censusto est 10,919 10,771 BCStats(Eurocan had 40 layoffs) (Alcan had 2002 10,851 BCStats25 exempt (1 staffJuly severances;2002), later revisedmore to than 170 unionized employees offered BCStatsest 10,430 (1 July 2003), later revised to 2003 10,432 voluntary packages) 2004 10,449 BCStatsest 10,116 (1 July 2004), later revised to 2005 10,587 BCStatsest 10,014 2006 8,987 Censusrevised to 9,633 9,328 BCStats 2007 9,044 BCStats 2008 9,182 BCStats 2009* 10,309 BCStats (10 June 2013) 2010* * 10,234 BCStats (10 June 2013) 2011* 9,104 BCStats (10 June 2013) 2012* 9,009 BC Stats (10 June 2013)
!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!! † Population estimates from “Population Estimates and Census Counts: 1953 to Date,” District of Kitimat, Department of Community Planning and Development, accessed May 2013, http://www.kitimat.ca/assets/Residents/PDFs/population-table.pdf.
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