The 1960s brought new challenges to psychiatric nurses. As concepts of the care and treatment of the mentally ill continued to change, the SPNA focussed most of its energy on the curriculum used to train psychiatric nurses to meet these changes. By the early 1970s, the SPNA could look back at a decade of changes both in mental health and their role within it. Their role had changed; their institutional training schools had been closed and they were still questioning their own viability as a profession.

Prior to 1930 one of the largest areas of the Saskatchewan government's expenditure in regard to health matters fell under the jurisdiction of the Department of Public Works ' the province's mental hospitals.¹⁰ Saskatchewan's first mental hospital was opened in North Battleford in February, 1914. By May the Saskatchewan Hospital, North Battleford, 'one of the most modern on the American Continent,' ¹¹ had 325 patients. The Saskatchewan government had originally intended to limit the accommodation to 800 patients, but by 1919 the hospital had become so overcrowded that a decision was made to open a second institution in Weyburn. The Saskatchewan Hospital, Weyburn opened in December, 1921.¹²

By 1929, with approximately 1,000 patients in each institution, the overcrowding became deplorable. Each hospital had a superintendent and two additional medical officers, a ward staff of about 110 untrained personnel and one registered nurse. There was no formal training program.¹³ This prompted the Saskatchewan government to appoint a special commission to study its psychiatric services with a view to receiving recommendations to resolve the many problems.

The Commission, headed by Dr. C. M. Hincks, submitted its findings in 1930. One of the recommendations was that a training school be started for personnel at each of the mental hospitals with instruction in the areas of psychology, psychiatry, mental hygiene and medicine.¹⁴ This proposal led to the establishment of two-year training programs for ward attendants at North Battleford in 1930 and in Weyburn the following year under the direction of the medical superintendents.¹⁵

In the meantime, psychiatric nurses continued to work under very difficult conditions. Mrs. Minnie Milne, who began her training at the North Battleford hospital in 1940, also reflected on conditions at the time:

On a 12-hour day there were about 71 patients on 3A, at the most there would be three of us to look after them. They call these patients 'continued treatment' now (1973), but in those days we found them the most deteriorated and unclean. The only clothing they wore were strong dresses made of canvas. They slept on beds sometimes two to a bed, sometimes the odd one under a bed. The patients slept on straw mattresses. The hospital had 2,000 patients, but the staff did not realize they were having difficulties. We worked a 12-hour day, from 7 AM to 7PM and on Mondays we worked overtime at a dance, and on Wednesdays we worked overtime at the show. Nobody was paid overtime, of course, it was part of our duties.¹⁶

T. C. Douglas' correspondence files include a newspaper article written by Miss Small who described her job as a psychiatric nurse in the early years at Saskatchewan Hospital, Weyburn.

My chief duty was to guard the door to the day room, allowing no patient entry into the hall or other rooms on the ward. I recall 1A ward particularly well, gray cement floors, gray walls, wooden benches, and huddled on the benches naked, wretched, unclean people.¹⁷

The history of formal staff training for psychiatric services in Saskatchewan began in 1947 with the new ward attendant training course. By this time, it was evident that greater numbers of more adequately trained ward staff were required. Three alternative solutions were considered. The first included the creation, in the two institutions, of basic schools for nursing students proceeding to the Registered Nurse (RN) designation. The second alternative called for placing RNs in all supervisory posts including ward charge positions, the remaining staff to be composed of a mixture of attendants and undergraduate nursing students from general hospitals serving a period of three-months affiliation. The third was the creation of a professional group of psychiatric nursing personnel by the establishment of a greatly expanded training program.

The first option was discarded because of the failure of this policy in several states and provinces. The second was impossible because of the shortage of graduate registered nurses and the unavailability of affiliating nursing students. The third appeared to offer the best prospects for success, and so in the fall of 1947 a 500-hour training program began.¹⁸

In January, 1947 Dr. D. G. McKerracher, Director of Psychiatric Services, made the decision to establish an expanded training program for psychiatric nurses. Two months later, he set up a committee under the chairmanship of Dr. S. Laycock, a member of the 1929 Hincks Commission, to draft a curriculum and propose methods for its implementation.¹⁹

The new program became operational in October, 1947 and immediately encountered a number of problems and setbacks. To begin with, there was no comprehensive term to adequately describe this new type of mental hospital worker. Suggested designations included psychiatric aide, psychiatric technician, and psychiatric nurse. The term 'nurse' was ultimately chosen, but it was to cause problems both within the association and with outside groups.

Registered nurses viewed the training program as a threat to their professional status. They concluded that psychiatric nurses were another group of 'nurses' with inferior training, whose members would force the registered nurse out of the mental hospital field. There were also jealousies and hostilities existing in varying degrees between ward attendants and the newly trained staff.²⁰

The objective of the program at its inception in 1947 was to create a highly trained professional staff. The 500-hour course was organized so as to be spread over a period of three years, with lectures given for one to two hours per day during academic terms extending from October to May.²¹ The rest of the students' time was service-oriented. It was a long, difficult three year training period, but the students were paid a salary and this, no doubt, was instrumental in attracting students.²²

The government obtained the services of Dr. W. Bates, Dr. Lester Bates and Fred McKinnon as Directors of Training in Weyburn, the training school in Moose Jaw and in North Battleford respectively. In the fall of 1947, they began training the first class. By 1951, there was evidence that the training program in psychiatric nursing had greatly improved staff morale, had improved relations between mental hospitals and their communities, and had demonstrated the feasibility of in-service training of ward staff. Consequently, the Saskatchewan Health Survey, in its 1951 report stated:

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