Little is known about social work at psychiatric institutions in Canada. This research looks at patient records at Selkirk Mental Health Centre (SMHC) from 1947-1979 at Selkirk, Manitoba. Qualitative descriptive methods are employed to examine patient records (N=132) for the function and form of social work. A random selection of patient records at SMHC was performed where qualitative themes of social work related activities were identified and collected. Additional data included archival records of provincial and federal reports to provide context for the findings. Social work emerged from practice, becoming increasingly sophisticated as SMHC evolved and degreed social workers entered the field. Findings show that social work was an essential profession for SMHC to address a rising patient census as well as manage the transition to community located mental health care. While some social work related activities are performed by other staff, there is a qualitative difference when a social worker performs these. Findings also showed that social work has a relationship with severe and persistent mental illness as a population served at SMHC. Future historical research can benefit from this study as it includes a developed method for future patient record research. Future research could be in various professional disciplines as well as contribute to the growing knowledge around social work practice in Canada. Findings show that social work is a relevant and important role that has a historic connection in the field of mental health. This study contributes to the growing literature on the history of social work in Canada.