This thesis is a study of the care of the mentally ill in British Columbia from the early days of the pioneers to the present time. It is hoped that this study will be of value to those charged with the care of the unfortunate persons among us who suffer from some form of mental illness. It is also hoped that this work will help to clear up some of the misconceptions surrounding the whole topic of mental hygiene. The study begins in the early years of the nineteenth century. The so-called insane were at first sent to an asylum in California but later were placed in the gaol in Victoria. Later the Royal Hospital in that city was used to house them up until the first asylum was built in New Westminster. After the turn of the century many new ideas regarding the care of the mentally ill began to spread throughout the civilized world, and had a profound affect on the administration of the mental hospitals in British Columbia. After World War I psychiatry developed very rapidly and scientific treatment began to replace simple custodial care in the mental hospitals. The findings of a survey made by the Canadian National committee for Mental Hygiene in 1919 and the recommendations of a Royal Commission in 1927 greatly influenced the government in providing better facilities throughout the province. The first social worker came to hospital at Essondale in 1932, and later that year the Child Guidance Clinic was opened. It has done excellent work but it has been successful in helping only the children who need urgent attention. Shock therapy is used extensively at Essondale and the results have been very encouraging. Other modern forms of therapy are used including organized recreation, handicrafts, and cosmetherapy. Neither psychoanalysis nor group psychotherapy is practised at the hospital. There has been a gradual development in British Columbia from simple custodial care to modern treatment procedures. In spite of present day knowledge, however, the mentally ill in this province are not getting the full benefit of all the techniques for curing them. Overcrowding has always been, and still is, a major problem. Lack of trained personnel, of adequate methods of after-care, of satisfactory preventive services are all problems which need more attention.