MENTAL DISEASE IN THE DOMINION.

Manawatu Herald, Volume XXXII, Issue 887, 3 September 1910, Page 4

MENTAL DISEASE IN THE DOMINION.

DR. HAY’S ANNUAL REPORT. There is one insane person to every 290 of New Zealand’s population. Thetotal number of insane in the various institutions is 3549 'S3 males and 1466 females'), an increase fo r the year of 135 (86 males ami 49 females). Commenting upon these figures in his animal report, Dr Hay (Inspector of Mental Hospitals), suggests that as the quality, and not the number of admissions, is rhe important factor, one year must not be too strongly contrasted with another. Taking quin queuuial periods as better showing the general tendency, Dr Hay shows that the average yearly excess of admissions over discharges and deaths has gone up from 88 for the period 1894-981091 for the period just ended. Comparing last year with 1908, there was an improvement in the ratio of insanity to the general population, and especially in the proportion of first admissions. The percentage of recoveries calculated upon admissions last year was 48.74. There is no panacea in the treatment ot insanity, says Dr Hay, but a state of physical well-being must be established as soon as possible, lest the highly complex braintissue undergo changes which no after-effect can undo. The best hope, therefore, lies in early treatment, and skilled treatment treatment directed with all the understanding which the present state of science gives. This may not be much, but it is all. Do or say what oue may, there are a number of people who will not seud relatives to mental hospitals in the early stages of insanity. They shrink from the required legal procedure, from acknowledging the nature of the malady to themselves. Strenuous efforts are being made in England to place the value of early treatment in a proper light, and Dr Hay notes that as a means of providing this invaluable promptness in treatment, provision will be made, in a measure about to be introduced, which will give effect to the general hospital treatment of mental defectives without undue legal harassments. Through the generosity of Drs. Alexander and Gavin, New Zealand will in due course be able to contribute its share in neuro-pathological investigations, Dr Alexander having undertaken to build and equip a laboratory, and Dr Gavin to do the work required by Government institutions so long as the department bears the annual expenses, estimated at ,£2OO. This offer has been accepted. Dealing with the causes of insanity, Dr. Hay states that many forms of stress operate at the same time, till the searcher after causes often finds himself in a labyrinth. Heredity, the principal factor when the two sexes are grouped, gives way to alcohol in the male sex. The inherent tendency to insanity, states Dr. Hay, may be derived not only from insane ancestry, but persons labouring under allied nueroses, the epileptic, hysterical, neurasthenic, transmit an inheritance which, given the requisite stress, produces insanity. Alcohol and some other toxins operating upon parents lower the ratio of stress necessary to produce unsoundness of mind in the offspring. “To effectually prevent the transmission of such heredity by State interference save by exteudthe definition of persons who may be brought under oversight, care or control, is, in the meantime,” he continues, “ outside practical politics, and must wait that growth of public opinion which develops into reform. When the public is really alive to the value of ettgencies, perhaps legislative interference will not be necessary. As to the factor ot stress, one has to aim at modifying inherited weaknesses in order to raise the ratio which can be borne without untoward result—a matter not so much of tempering the wind but of hardening the shorn iamb.” The causes ot insanity are thus defined :

Much anxiety has been given to the department to find accommodation for patients, and some overcrowding has been necessitated pending the outlet to the overflow which will be provided by the proposed .mental hospital at Tokanui. “It was expected that by this time we should have been busy there with building operations,” adds the report, “but to the taking of the native portion of the land objections have been lodged, and these have still to be heard before we can get to work. In the meantime, preliminary buildings are designed, and, once the objections have been disposed of, there will be no delay in making a start. The mission of the Tokanui Hospital for some years to come will be the absorbing of the yearly increment, leaving the other hospitals much the same size as they are at present, by providing for the reception by transfer of

numbers of patients who as a class can be managed in less expensive institutions than the ordinary mental hospital. This class comprises for the most part patients who keep very fairly well under skilled supervision, but are quite unable to adjust themselves to the larger environment of the world outside the institution. Their transfer will supply workmen to assist in developing the new estate, and accommodation in the hospital they have left for patients requiring stricter supervision and more active treatment/’ There has been a general decrease in the net expenditure per head (allowing for receipts), making an average of 93 gd less per patient. The total cost 1 averages 13s per patient. The asylum estates were profitably managed, raising produce valued at for use in the institutions, while the surplus realised in the market. In regard to the hospital staffs and other works, Dr Hay acknowledges their faithful services, and points out the hardships they suffer with respect to the superannuation allowance when compared with employees in other departments of the public service. Their salary is obviously the money paid plus the emoluments of board, lodging, washing, etc. “If we required them to live out,” adds Dr Hay, “we should have to pay a higher salary, and on this the superannuation allowance would be calculated as a matter of course ; but we require them to live on the premises, and the value of the emoluments (by which sum in effect their salary is reduced) should benefit them when they come to retire.”

Male Female Tl. Heredity 14-32 14.63 14.46 Congenital deficiency 8-95 8.51 8-75 Previous attacks 7-38 11.17 9.11 Critical periods 13.42 15.16 14.22 Child-bearing... 6.92 3-16 Mental stress ... 8.28 it.17 9.60 Physiolo g i c a 1 defects and errors 4-47 1.60 3-16 Toxic — Alcohol 17.90 4.26 11.66 Other toxins 5-37 3-45 4-49 Traumatic ... 2.46 0-53 1-38 Diseases of the nervous sys’m 5-82 5-05 5-47 Other bodily diseases 1-34 3-45 2.31 Unknown 10.29 14.10 12.03 100.00 100.00 100.00