MENTAL HOSPITALS.

Dominion, Volume 6, Issue 1857, 17 September 1913, Page 5

MENTAL HOSPITALS.

DEPARTMENT'S REPORT.

THE INSTITUTIONS LARGELY SELF-SUPPORTING.

The report of the Mental Hospitals Department, prepared by the InspectorGeneral (Dr. Hay) was laid oil the table of tlio Legislative Council yesterday by the Hon. H. D. Bell, Minister for Internal Affairs. It stated that the number of patients under control of the Department at the beginning of the 3 ear was 375(3 (males, 2220; females, 1336), and at the end of the year 3913 (males, 2273; females, 1640), an increase of 157. (males, 53; females, 104). The average increaso for the previous fivo years was 110. The number of patients in the various hospitals was: Auckland, 845; Christchurch, 717; Dunedin (Seacliff and Waitati), 91o; Hokitika, 231; Nelson, 188; l'orirua, 908; Tokenui, 64; Ashburn Hall (private), 45. Thp proportion of mentally defective persons to the whole population of the Dominion was 35.49 per 10,000, or one in 282. Comparing these figures with those in the last report, and taking the ratios therein as a standard, there were, exclusive of Maoris, on the register at the end of tho year, 55 more patients than would be justified by the natural | increase of population. Curiously enough, the increaso was limited to women patients, who were 60- in excess of'the proportional increaso in population, while tho men were 5 fewer than anticipated. In England and Wales the number of notified insane porsons on January 1, 1911, stood to the estimated population in the proportion of 1 to 275, or 36.4 per 10,000. ) Tho ratio of admissions to the population was one to every 1264, and of first admissions, one to every 1535. As a means of comparison, the averages for various quinquennial periods are hero given, the numbers' being those of persons in tlie pppulation contributing admissions and first admissions: —1902-06j 1459 and: 1788; 1907-11, 1364 and 1688. Tho averages for tho ten years, 1902-11, were 1407 and 1733. The ratio of admissions last year was therefore well below tlio average. In England and Wales, during 1910, every 10,000 of the general population contributed five first admissions and 6.04 total admissions. The number of cases discharged from tho mental hospitals during the year was 402 (males, 212; females, 190), and the deaths 280 (males, 193; females, 87). Tlie figures for the previous year were 376 and 303 respectively. Of those discharged, 325 (males, 184; females, 141) wore classed t as recovered.

Accommodation Question. With regard to accommodation, the report says (inter alia):

"The question of providing accommodation for tho yearly increment of patients, tho excess of admissions over discharges and deaths, is a very serious one, by no means confined to this country, and it has to bo answered by expenditure. In this, country the Government undertakes the oversight, care, and control of the mentally defective, and tlie responsibility is great, one which cannot in the nature of things be ovsded, and cannot be carried out without great cost to tho taxpayer. There has been somo discussion recently on the burden of tho general hospitals. What would that burden bo if the patients who did not recover were not discharged? So regarded, tho full significance of tho accumulation of the mentally defcctivo and tho necessity to house and maintain them impresses itself upon the imagination. It is a grievous burden in a developing country, but one I venture to believe a humanitarian peoplo will willingly bear. Nothing is wanted in tho way of extravagance, but we do want sufficient floor-space per individual, and sufficient sunlight and fresh air—given those, comfort can bo added at a negligible' cost. Our older buildings did not look ahead sufficiently, and their design may bo described as a band marked out at intervals into wards like a foot rule in inches. In course of time these buildings became filled, sometimes ono ward more than another. They could not conveniently bo added to, there was 110 elasticity in the size of the wards, and the characteristics of patients varied from time to time. The inadequacy of the original designs had to be met by adding separate buildings, some connected to the main building, some quite disconnected. One naturally prefers solid structures, ■ but rather than wait for funds that the additional first cost would entail, and for the time taken in building, it would be better to build a proportion ■ of the requirements as above in detached blocks., We should aim at beinr; a year ahead of requirements, or at the very least six months, plus a margin for classification. The distributing of the patients at the closing of Mount View was equal to nearly a two-year surplus, and then the abandoning of the 'reef site' buildings, ■ when everything was prepared to ho gone on with, was another set-back, diverting energies to trying to catch up to mere accommodation when one's anxiety was to get surplus accommodation for a proper classification. I sincerely trust that tho building programme will be proceeded with without hindrance, and that one may look forward to carrying out in the near future the classification and treatment of patients on approved lines, and I am glad to know that* tho Department has your entire sympathy in this matter." Tho report goes on to detail-tho work of enlargement already carried out at various hospitals, and that which yet requires to bo done. Farming Operations. "It is always satisfactory," the report continues, "to have our farms assisting to maintain the patients; but still more satisfactory is the knowledge of the large number employed in this primitive and best of occupations." Produce to the value of £6713 Os. Bd. had been sold; and £14,071 lis. lOd. worth consumed in tho hospitals. Tho balance in favour of the farms was £10,517 os. 7d.,' a very considerable saving to the country. Compared with the previous year, the sales were £728 18s. lid. better, and tho value of tho produce consumed increased by £1,869, 14s. lid., a total increase of £2593 13s. lOd. The net profit on the working of each of the farms was as follows Auckland, £2951 10s.; Christchurch, £3232 13s. lOd.; Seacliff, £2318 16s. 3d.; I-lokitika, £135 35.; Nelson, £810 9s. lid.; Porirua, £1068 7s. lid. The Staff. Tho report deals at some length with the staff, tho opinion being expressed that tho largo majority aro of a class that any Department may well bo proud of, loyal, conscientious, humane, cleanliving, and performing their duties to tho best of their ability. "We employ nearly six hundred people, and it is obvious that in that number tliero will be, from time to time, persons who manage to pass muster but are unsuitcd for the occupation. In past years when tho control was local the discipline was consequently hotter. Now and again a mistako may have been mado in dispensing with tho services of an omployco upon evidonco which perhaps justified little more than gravo suspicion; but an officer in cliargo of any institution very soon estimates tho calibre of his staff, and it may be taken for granted that ho will do all ho can to rotain the services of those ho finds trustworthy, and, if any error occurred, such as stated abovo hypothotically, it would not have been in a case of a person who was otherwise ontirely satisfactory. I do not say that such mistakes were mado, but they were alleged, and I w.ould therefore poip^out

that any hardship inflicted would have been almost nominal, as tho labour marJket would soon absorb any such individual. But what Ido say is that it is far better to make an occasional mistake in tho interests of tho patients than to retain on the staff members in whom implicit confidence cannot bo placed." Miscellaneous. The report deals also with the results of tho visits of inspection paid to *fce various institutions by officers of the Department and others. "It is intended to appoint persons in tho capacity of patients' friends, at any rate in the larger institutions, whoso duty it will bo to spend the day in the wards, help tho patients with advice in their troubles, to read to them, assist them when necessary with their correspondence, join them in their r&ireations, and encourage them iu tlieir occupations, while taking no part in their oversight or control. The office will need to bo a stipendiary one, as it will occupy _ tho working-day of tho persons appointed, but 1 venture to believe, given persons of tho necessary education and special capacity, that the expenditure will be insignificant when compared with the manifest advantages." Tlio total number of voluntary boarders admitted during tho year was (males 7, females 16). Of these, three were discharged as recovered, ono as relieved, and two as not improved, and fivo were transferred to the register of patients, leaving at the end of tho year 12 (males 1, females 11) in residence. The provision for single patients under the Act was taken advantage of in one case. The provision for minors was employed in two cases. When our buildings are what they should bo one maj- expect a largo number of voluntary admissions. Tho report concludes: —"I can but repeat what I said last year —that is, emphasise tlie necessity for building in advance, as 150, more or Less, will be added to, our patients yearly, and this increment will, of course, grow with the growth of population."