MENTAL HOSPITALS OF THE DOMINION (REPORT ON) FOR 1928.

Appendix to the Journals of the House of Representatives, 1929 Session I, H-07

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1929. NEW ZEALAND.

MENTAL HOSPITALS OF THE DOMINION (REPORT ON) FOR 1928.

Presented to both Houses of the General Assembly by Command of His Excellency.

The Hon. the Minister in Charge op Department of Mental Hospitals to His Excellency the Governor-General. Sir,- — Wellington, 10th July, 1929. I have the honour to submit to Your Excellency the report for the year 1928 of the DirectorGeneral of Mental Hospitals. I have, &c., A. J. Stallworthy, Minister in Charge of Department of Mental Hospitals.

The Director-General to the Hon. A. J. Stallworthy, Minister in Charge of the Department of Mental Hospitals. Sir, — Wellington, 10th July, 1929. I have the honour to present my annual report upon the mental hospitals of the Dominion for the year ended 31st December, 1928. At the conclusion of the year, 6,160 persons were under care and treatment in the institutions, of whom 5,902 were detained under a Magistrate's reception order, and 258 had been admitted as voluntary boarders upon their own application. The number of voluntary boarders admitted during the year was 290, as compared with 197 last year, which represents 21 per cent, of the total admissions. The manifest advantages of securing early treatment in the pre-certifiable stage of mental disorder have been sufficiently stressed in previous annual reports, and it is not necessary to again enlarge upon the matter, but it is gratifying to find that public recognition of this is being reflected in the rapidly increasing number of these who come to us as voluntary boarders, and thus avoid drifting into a condition which necessitates formal certification and committal by a Magistrate. In New Zealand the percentage of voluntary admissions upon the total has risen from 8 to 21 per cent, during the last decade, but we are still far behind the record established at the Royal Mental Hospital, Edinburgh, last year, where no less than half the admissions were on a voluntary basis. It is only fair to state, however, that in New Zealand we restrict such admissions very strictly to those who are able to fully appreciate the nature of a request for admission and consequences of signing it. Our test in this respect is higher than that in vogue at the institution I have quoted. Those whom we judge to be unfit to sign the request for admission can be admitted only under a Magistrate's reception order after certification by two medical men. During the year 439 patients and boarders were discharged as recovered, which is 35*9 per cent, calculated on the admissions. Ido not wish to attach undue importance to these so-called " recovery rates," which are liable to serious error, but it is significant that while only 26-04 per cent, of the committed patients became fit for discharge as " recovered," the corresponding figure for the voluntary boarders was 68-6 per cent. The statistics published in these reports showing the number of patients in mental hospitals have sometimes been quoted as indicating an unusually high incidence of mental disorder in this as compared with other countries; but, as there is no international uniformity in

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the methods employed in handling the problems connected with mental disabilities, such comparisons do not bear analysis. In America, and to an increasing extent in England, for example, the feebleminded and congenitally defective of all classes are cared for in institutions quite apart from mental hospitals, and as we had on our registers 1,145 such inmates at the end of the year, it will be realized how fallacious must be any conclusions arrived at without a knowledge of the facts. Psychopathic Wards in General Hospitals. The clinics for nervous and mental affections conducted by our Medical Superintendents at the genera] hospitals in the main centres continue to carry out a useful function, and the number of those who seek advice and treatment is rapidly increasing, so much so that the time is approaching when the number of weekly sessions will have to be increased. The usefulness of the clinics would be greatly enhanced by the setting-apart of a ward in each hospital for cases which require a more exhaustive examination than is possible in an out-patient department. Some of these cases come to us as voluntary boarders for this purpose, which could often be better served at the hospital, where the services of the various specialists could be readily available. As a matter of general policy Tam not in favour of treating cases of acute mental illness in general hospitals, but the provision of a few beds to be used in association with the clinic would mark an advance in our methods of treatment. In the course of a letter to me on this subject, Dr. William White, head of the St. Elizabeth's Hospital in Washington, author of a standard textbook, and a leading authority on psychiatry, wrote : " I am inclined to think that the best solution would be the system at the Buffalo City Hospital—namely, the setting-aside of one or two wards, not in a separate building but right in the body of the hospital, and having, as you suggest, the interns and nurses rotate in their duty in this service . . . Then I think that with enlightened hospital management it would not only solve the problem of taking care of emergency cases as they developed in the city and previous to their transfer to the State (mental) hospital, but, it could also be used to bring general medicine and mental medicine into closer and more understanding relations." I understand that this question is likely to be considered by the Wellington Hospital Board in the near future, and I have assured the Medical Superintendent that he can depend upon the hearty co-operation of this Department. An early opportunity will be taken of initiating a similar policy in the other main centres. Alterations, Improvements, and Additions. Our capital expenditure for the year amounted to £96,782, and was incurred as shown in the following summary:— Auckland (£561). Although the replacement of this institution by Kingseat is a settled matter of policy, and no new buildings are being erected, some renovations will always be necessary, so long as the present buildings are in occupation, to maintain a reasonable standard of comfort. A good many sanitary alterations have been carried out, as well as certain improvements in the kitchen and laundry. It is proposed during the current year to transform the Medical Superintendent's residence into an additional neuropathic unit for female patients, on the lines of the Wolfe Home. This house, which contains fifteen rooms, is too large for its present purpose, and will provide good accommodation for at least twenty patients. A new Superintendent's residence can be built with a view to its saleability when the evacuation of the institution becomes possible. Kingseat (£11,900). Good progress has been made in the development of this new institution for the Auckland Province. All the farm buildings and outside workers' quarters have been completed, and the watersupply—sufficient for one thousand patients —has been brought on to the estate. The pioneer working patients went into occupation in March, and have assisted in carrying out very material improvements on the land. Plans for the first two residential villas are now in course of preparation, and it is hoped to make a commencement with these buildings at an early date. Tokanui (£19,887). The principal expenditure has been in connection with the three new villas -which were commenced last August, and which we hope to occupy by next October. Their completion will enable us to relieve the overcrowding at Porirua by the transfer of 150 male patients. The new quarters for outside staff are now in occupation. This has given us more room for our nurses ; but with the rapidly increasing population at this institution a. Nurses' Home has become essential, and plans are now in course of preparation. An efficient fire-alarm system, which is most necessary in all mental hospitals, has been installed. Porirua (£27,315). The most important work of the year has been the completion and occupation of a Nurses' Home, with accommodation for eighty-six members of the female staff. This has released certain rooms, which are now being redecorated for the use of patients,

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The population of this institution has increased far beyond the limit which is recognized to make for the highest efficiency, and 110 additions to patients' accommodation are contemplated. There are, however, certain amenities which should be provided, such as an entirely detached hospital block, and I intend to submit proposals in this connection during the current year. It has for long been obvious that the administrative buildings —including kitchen, laundry, and boiler-house —have lagged behind the increase in population, and proposals for a complete rearrangement of these sections are under consideration. I hope something may be done in this direction during next year. Nelson and Stoke Farms (£956). Early in the year a contract was let for the erection of three villas at Stoke Farm, but these will not be available for occupation before June, 1930. A contract has also been let for the erection of a bakehouse, which will serve the needs of Nelson and Stoke. The acquisition of a contiguous estate opens the way for the further development of the villa system, for which the land is admirably suited. A survey has been made in anticipation of securing adequate water-supply. Hokitika (£401). Expenditure has been upon general renovations and maintenance. A contract was let for the erection of a concrete water-tower, and the erection of a laundry is now proceeding. It is proposed during the coming year to erect a villa, the first of a series, in which transfers from other institutions can be housed. Christchurch (£7,777). Additions completed during the year at this institution include an auxilliary sewage system and a new boiler-house and stock. The accommodation for low-grade defectives at B Block is no longer suitable for occupation, and is overdue for replacement. Templeton Farm will shortly be devoted exclusively to the care and training of higher-grade defectives, and a second villa is already in course of erection. Seacliff (£27,132). The bulk of the expenditure at Seacliff has been for the new administrative buildings, comprising kitchen, laundry, and stores. These are almost completed, and will add very much to the smooth running of the institution. Extensive additions have been made to G- Ward. Sixteen rooms were added to the Nurses' Home, which is still too small for an institution of this size. A new Home should be built, and the present one made use of for patients. New day-room accommodation is wanted for several of the wards at Seacliff. Waitati (£853). A small laundry has been erected, and additional sanitary conveniences constructed at one of the villas. Plans have been prepared for a new villa for fifty women patients. Overcrowding. In my last annual report I gave a detailed statement as to the gravely overcrowded state of our institutions, and as you, sir, have recently taken the opportunity of becoming personally acquainted with the resultant conditions, I need not repeat the plea I then made for increased financial appropriations. It will be sufficient for me to point out that buildings now in course of erection and likely to be occupied by the end of the year will barely provide accommodation for our estimated annual increase of patients. During recent years a very great deal has been done to provide proper classification and adequate treatment for recent and recoverable cases, and it was imperatively necessary that this should have been a first consideration ; but unless a considerable speeding-up can be effected in the provision of accommodation for the chronic patients we shall become progressively less able to maintain the institutions at that pitch of efficiency which merits public confidence. Cases op Senile Decay. On the 31st December there were in our mental hospitals 462 patients who were seventy years or upwards in age, and of these ninety-two had been admitted during the year. Senility took second place amongst the assigned causes of insanity. The mild restlessness and excitement which finally cause the admission of these old folk into our institutions is nearly always very transient in character, and could often, with patience and sympathetic understanding, be controlled in a private house. It is fundamentally wrong, and a reproach 011 our reputation for sound social legislation, to allow them to spend the evening of life amongst the insane, and special institutions or homes should be established for this purpose. Not only would this be of benefit to the senile patients concerned, but an appreciable amount of infirmary space occupied by them would be freed for more legitimate purposes. If any legislation in this direction is contemplated, I think that our Medical Superintendents should be empowered to discharge suitable senile patients to the new institutions.

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Insane Aliens and other Immigrants. An unfair tax upon our accommodation and upon the finances of this country is imposed by reason of the large number of patients of non-British races who are permanently mentally defective and likely to remain in our institutions for the rest of their lives. On the 31st December last we had 211 such persons, whose average length of residence in the institutions was thirteen years. The amount expended up to date upon those 211 aliens has been approximately £188,612, and they cost the country £14,509 annually for maintenance. It does not appear possible to take any action in regard to those people already here, but it would be desirable that steps should be taken to prevent any increase in their numbers. I suggest that the Immigration Restriction Act should be amended to allow the deportation of aliens who become insane within five years of the time of their arrival in New Zealand. The existing law as to the immigration of mentally defective persons to NeWjZealand is so imperfect as to be practically a dead-letter. It is provided in section 14 of the Immigration Restriction Act, 1908, that a person shall be prevented from landing if he is an idiot or insane. As an idiot is incapable of travelling alone, and as section 16 exempts him from the provisions of section 14 if he is accompanied by his parents, the position is a reductio ad absurdum.. The position in regard to the insane is in little better case. It is extremely unlikely that a patient suffering from delusional insanity will have an opportunity of communicating his false ideas to the Port Medical Officer during the brief period available for the inspection of each individual passenger, and the detection of other psychoses must in these circumstances be largely a matter of chance. Once such cases as these have landed in New Zealand, as the law stands at present, the country is liable to be faced with an addition to the large expenditure above mentioned. The Nursing Staff. It is due to the nursing staffs of our institutions that I should express my appreciation of the manner in which they carry out their duties. It is all the more fitting that I should do so because the work of our nurses and attendants seldom comes under public notice except by reason of regrettable incidents such as the recent assault case, when the Department had to prosecute an attendant. Our nursing staff comprises 958 nurses and attendants, and it would indeed be surprising if amongst the many probationers engaged there were none found to be temperamentally unsuited for this work, which calls for qualities of a high order. When consideration is given to the various types of patients to be dealt with, the natural discontent engendered by loss of liberty, and the conditions attendant upon overcrowding, it is not to be wondered at that complaints as to treatment are received from time to time. A few of these have some justification, but the majority are due to delusions or some other form of mental unbalance. The letters of appreciation which the Medical Superintendents and I receive from ex-patients and their relatives far outnumber the complaints, and I know that many members of the staff take patients for outings and perform other acts of disinterested kindness which are quite outside the scope of their official duties. The Department is well served by the nursing staff, to whose loyalty and devotion the smooth running of the institutions is largely due. Medical Staff. Consequent upon the increasing amount of time devoted to the clinics, and in order to render more fully effective the provisions now made for the reception and treatment of recent cases, it has been found necessary to augment ojnr medical staff by the appointment of four additional physicians. A selection committee consisting of Sir Hubert Bond, of the English Board of Control, Dr. H. de M. Alexander, Medical Superintendent of Kingseat Villa Mental Hospital, and Dr. J. D. Hunter, one of our medical officers who was in Britain on study leave, chose for us the following gentlemen, who have now joined the Department : Frederick Robertson Martin, M.D., Ch.B., D.P.M. ; Gilbert Mortimer Tothill, M.R.C.S., L.R.C.P., D.P.M.; Gilbert Marshall, M.8., Ch.B., 8.A.0., D.P.H. ; Malcolm Brown, M.8., Ch.B. All these appointees come tc us with excellent credentials, and a record of good work done in positions previously held, and I consider that the Department is to be congratulated upon securing an accession of strength to its medical staff. Dr. J. D. Hunter has resumed duty at Seacliff after eighteen months' study leave in Britain. In addition to taking the diploma in Psychological Medicine, Dr. Hunter paid particular attention to recent developments in the villa system, and held a temporary position at Kingseat Mental Hospital. Dr. R. T. Hay, Assistant Medical Officer at Nelson, has been granted study leave for one year, and is at the Maudsley Hospital, London, studying for the diploma in Psychological Medicine. I desire, in conclusion, to acknowledge my indebtedness to my colleague, Dr. John Russell, Deputy Director-General, and to the Medical Superintendents, for their unfailing loyalty and help at all times. I have also to thank Mr. Holder and the staff at the Head Office for good work done throughout the year. I have, &c., Theo. G. Gray.

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MEDICAL SUPERINTENDENTS' REPORTS. AUCKLAND MENTAL HOSPITAL. Dr. Prins reports : — I have the honour to submit to you my annual report for the year ended 31st December, 1928. The total number of cases under care has been 1,391, with a weekly average of 1,134. The admissions have numbered 212 (males 106, females 106), a decrease of 15 on last year's total. Of these 162 were admitted for the first time. The general health of the Hospital has been good, the only unusual feature being an outbreak of scarlet fever on the female side, there being 3 nurses and 10 patients at present in isolation. There was also 1 case of enteric fever. The deaths have numbered 77 (45 males and 32 females), 40 being over sixty years of age. Senile decay and heart-disease were the principal causes. Probation has been again largely made use of, there being at present 77 patients on leave in the care of their people. There has been a gratifying increase in the number of voluntary boarders —59 males and 68 females being under care during the year. Of these 52 were new cases and 24 were readmitted. The discharges numbered no less than 47 (25 males and 22 females), which shows the great help it is when people realize they are ill and enter the Hospital voluntarily for treatment. The discharges apart from these have numbered 100, 57 of which left the Hospital " recovered." The most important improvement during the year has been the alterations to Park House. The large day-room has been divided into two, one part being used as a dining-room. The new quarters for the Matrons have been completed. A new coal-bunker has been built, which allows greatly increased space by the store and engine-room. The veranda at the Nervous Unit has been partly enclosed, and a new lawn laid out. The grounds at the Nurses' Home have been finished, and the lawn at the Wolf Home relaid. There has been a large increase in the number of doors left open, further removal of shutters and stops from the windows, allowing the patients much increased liberty, and a great improvement in ventilation generally. The Male Hospital Ward continues to be used as much as possible for the new cases, and there has been very little abuse of the freedon allowed. The Wolf Home receives every possible female and suitable male case. The kitchen has been reorganized, and the meals are now wholly cooked and prepared in the Home, an innovation that is much appreciated. The veranda added to the Female Infirmary Ward is a great improvement. The main kitchen has had a number of repairs carried out —new boilers, a steamer, canopies, &c., being installed —and a further rearrangement will be effected shortly. The laundry has a new electric motor in lieu of the old steam-engine, and electric irons have been installed. A new ironing-machine will, it is hoped, arrive shortly. The painting gang has been busily employed. Lectures have been given to the nurses and attendants by the medical staff for the first and final examinations, six nurses and thirteen attendants sitting for the certificate. The general recreation of the hospital has been looked after. The annual picnic to Henderson was held in February, a total of over 450 being conveyed by train and bus, the latter taking some of the crippled and infirm, who would otherwise have been unable to go. During the winter the usual fortnightly dances and entertainments were held. The Salvation Army and Avondale bands have given concerts on Sunday mornings. The usual picnics have been held, and parties have gone to the pictures and football matches, seats being kindly provided by the managements. The bowlers have played their usual tournaments, and home and away matches. Tennis, croquet, and golf have all been largely played. The annual Christmas tree was a great success, the concert being provided by members of the Optimists Club. We are once more indebted to many friends for suitable gifts and donations. The Auckland Clinical Society again held one of their meetings at the Hospital, and had cases demonstrated to them by the medical staff. Visits have been paid by Mr. Blomfield (District Inspector), Mr. Alexander, Mrs. Yon Sturmer, Mrs. Armitage, Official Visitors, and by Sister Hanna and Miss Jackson. Services have been held every Sunday. The Archbishop, as usual, came at Christmas-time. The Rev. Mr. Budd and Father Holbrook visited frequently. The Hospital has received as gifts a wireless set and six loud-speakers from Mrs. Wilson, Mr. Alexander donating the wire necessary to connect up the various day-rooms and parks ; also a set and loud-speaker for the Male Hospital from Mrs. Hardie Neil. Crystal sets have been given and installed by Mr. Hayden in the Wolf Home, Nervous Unit, and in some wards of the main building. Mr. Hayden has also obtained for us pictures and books. A gramophone was donated by the Rotary Club. Mr. Lang, Head Attendant, retired after forty years' service, being the first in the Department to do so. He will be much missed, and carries the good wishes of everybody in his well-earned retirement. He has been succeeded by Mr. McKenzie. Mr. White has been appointed Resident Engineer, and has been instrumental in carrying out a large number of improvements in the hot-water service, and in minor things, which have contributed largely to the comfort of the patients and staff. Drs. Hart and Tothill have joined the staff. Dr. Jary resigned, and has the good wishes of all on her approaching marriage. During my absence on sick-leave Dr. J. Russell was in charge of the Hospital. In conclusion, I have to thank all my officers, nurses, and attendants for their help and co-operation at all times in the work of the Hospital.

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TOKANUI MENTAL HOSPITAL. Dr. CJhilds reports — I have the honour to submit my report for the year ended December, 1928. On the Ist January there were 345 patients in the Hospital (221 males and 124 females), the number under care during the year being 432 (280 males and 152 females), while the average resident number was 367 (238 males and 129 females). The cases admitted number 87 (59 males and 28 females), and of these 55 (28 males and 27 females) were admitted for the first time. Four males were readmitted, and 28 (27 males and 1 female) were transfers from other hospitals. Eighteen patients were discharged, 15 being males and 3 females ; 10 of these (9 males and 1 female) were transfers to other hospitals. The deaths numbered 16 (9 males and 7 females) there being no special contributing factor. At the beginning of the year there were 10 voluntary boarders in hospital (2 males and 8 females), and during the year 5 males and 9 females have been admitted : 13 of these were admitted for the first time. Four males and 6 females have been discharged, while I died. During the year 13 male and 10 female patients were granted probation. One Maori woman gave birth to a full-time male child, with no subsequent improvement in her mental condition. The general health of the patients during the year has been good. There was a mild outbreak of influenza, * but no deaths. The system of parole has gradually been extended, and, as the Hospital is some distance from any town, the majority of the male patients enjoy parole of some sort. Various minor improvements have been made to the Hospital, and this adds to the general welfare of the patients. The work of beautifying the grounds and the making of lawns lias been proceeded with, and, although there is still much to be done, a distinct improvement has been noted. A new dormitory has been added to No. 1 Camp, the old dormitory has been renovated and made into a living-room, while extra accommodation has been provided for the staff. It now houses fourteen chronic working-patients, and for that type of patient conditions could hardly be improved. The work of excavating the sites for the new villas now in process of erection was performed by the patients, a number of whom had been looked upon as unsuitable for work. Most of them were found capable of doing work of some kind and since the excavations have been completed they have been employed in levelling the new playing-field. The new villas cannot be ready too soon, as extra accommodation is urgently required. Recreation has formed a considerable part of the Hospital life, fortnightly dances in the winter, occasional concerts, and weekly pictures being held. The Australasian Films (N.Z.), Ltd., supply a good class of film for the latter free of charge. Outdoor games such as bowls, croquet, and cricketwere indulged in, while swimming and picnic parties were held when the weather allowed. The patients also attend any outside entertainment that is suitable. A fancy-dress ball was held during the year, and proved very popular, while the annual picnic was also a success. Lectures and demonstrations have been given to the nursing staff during the year ; five candidates entered for the senior examination, all gaining certificates, two gaining a first-class one. A canteen was opened during the year for the benefit of staff and patients, the proceeds to go to the patients' recreation fund. It has served a useful purpose, and has been a success. The work on the farm has proceeded steadily, and since a large part of the estate has been transferred to the Prisons Department a great improvement has been noted. Water has been laid on to several paddocks, new buildings have been added, and new machinery installed ; while, in addition to the usual routine, fencing, draining, and roadmaking have been proceeded with. The Official Visitors, Mr. Batson and Mrs. Wood, have been most attentive in their duties, Mrs. Wood in particular sparing no amount of time and trouble in her efforts to provide gifts and promote the welfare of the patients generally. All sections of the staff have shown zeal in the way they have performed their duties, and I wish to thank them for the way they have endeavoured to make the interest of the patients and the Hospital their chief concern. This particularly applies to the heads of the various branches, who are always ready to work for the Hospital as a whole. PORIRUA MENTAL HOSPITAL. Dr. Hayes reports I have the honour to present my report for the year 1928. On the Ist January there were 1,408 patients (762 males and 646 females) ; at the end of the year there were 1,508 patients (820 males and 688 females). The total admissions for the year were 332 (192 males and 140 females). The number discharged was 94, of whom 81 were recovered. The total under care was 1,740, and the number of deaths was 108. The principal causes of death were senile decay, circulatory disease, and general paralysis of the insane. At the beginning of the year there were 67 voluntary boarders, and at the end of the year 75. The total number of voluntary boarders was 63 (36 males and 27 females) ; readmitted 15, and discharged 68. One was committed, and 2 died. During the year track has been kept of the admissions in relation to the section of the Hospital into which they were originally received, and their subsequent disposal. The total number of admissions during the year was 410. The following shows the disposal of the cases : Admissions—To main institution, 163; to neuropathic (curative) division, 247 ; Discharge or probation —From main institution, 14 ; from neuropathic division, 93. Transferred —From institution, 5 ; from neuropathic division to main institution, 66. These figures, of course, do not illustrate the full possibilities of the discharges, as towards the latter end of the year many of the cases would not have had timeto improve.

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Although a good percentage of the yearly admissions can be admitted through the neuropathic divisions, a proportion have had to be transferred to the institution, as their noise and refractory conduct militated against the recovery of other cases. Some of these cases might have been recoverable themselves, and their own recovery might be retarded or inhibited by transference to the environment of the chronic cases. With regard to this point I would like to urge the provision of an annexe at Rauta for this particular type of case. The Clinic. —During the year 122 new cases were interviewed at the Public Hospital either in the clinic or in the wards. The following is the source of these patients. Education Department, 3 ; Public Hospital, 30 ; general practitioners, 19 ; Pensions Department, 22 ; Prisons Department, 3 ; social organizations, 5 ; spontaneous, 40. The following were the types of cases met with : Anxiety states, 12 ; neurasthenia, 6 ; war neuroses, 20 ; hysteria, 9 ; obsessional neuroses, 4 ; schizoid states, 10 ; paranoid states, 6 ; organic states, 23 ; manio-depress. ins., 6 ; involution melanchol., 11 ; congenital defects, 15. The following is the disposal of these cases : Report given or referred to source, 29. Taken as — Out-patients, 40; voluntary boarders, 24. Committed, 22. Advice not followed — Voluntary boarders, 5 ; committed, 2. Of those who continued as out-patients the following was their disposal : Discharged recovered, 5 ; discharged relieved, 13; discharged unrelieved, 3. Advised voluntary boarder, 1. Continuing as out-patients, 18. The treatment centre at Rauta has been in use for about one year, and the usual methods of physical therapy are employed—Massage, exercises, electrical and ultra-violet radiation. The cases treated are selected as likely to recover, and. so the results are not controlled. Males —Treated, 75 ; discharged or on probation, 48 ; remaining, 27 : total, 75. Females— Treated, 82 ; discharged or on probation, 46 : remaining, 36 : total, 82. The question ot overcrowding is becoming very acute, and is seriously affecting the comfort of the patients. In the event of any infectious disease catching hold in the more crowded parts, a serious epidemic would easily ensue. The overcrowding is more serious in the chronic wards, particularly the female wards F and D. The numbers in excess for the female and male sides respectively are 190 and 70. The former figure will be somewhat relieved by the vacation of eighty rooms when the new Nurses' Home is opened ; but with the increasing hospital population this relief can be only temporary. During the year renovations and painting have been carried out in wards F, D, B, Rauta. Vailima, and H Cottage ; also in Male 7, lower building, kitchen, and to the exterior of the main building. The provision of a new main kitchen and the extension of the stores remains a very pressing need, for the growth of the establishment has long since overtaken the existing ones. The removal of the piggeries to a more distant site still remains a necessity. Sister Widdowson was appointed sister-tutor during the year, and has assisted in the training of nurses on both sides. The usual weekly entertainments have been given, and in addition to these, concerts have been provided by amateur and professional artists interested in the Hospital. I would like to offer special thanks to the Women's National Reserve for the interest continually displayed in a very practical manner —giving many comforts, including a wireless installation for the female hall. The Red Cross Society and the Victoria. College Social Service Club have paid regular visits to the patients in whom they are interested, and their services have been a great help. Special thanks are also due to the Rev. Mr. Harding, who has organized entertainments and distributed many gifts amongst the patients of both sides. The commercial travellers also deserve thanks for providing orchestral concerts for all the patients, for gifts to the children, including the gift of a wireless set. My thanks are due to the ministers of religion for their services. I would like to thank the Official Visitors (Mrs. Eraser, Mrs. McVicar, Mr. Bothamley, and Mr. Bradey) for their regular visits and interest displayed in the welfare of the patients. lam grateful to my colleagues, Drs. Williams, Macky, and Anderson for their help. 1 also wish to thank the Matrons, Head Attendants, and the staff generally for their loyal support and work throughout the year. NELSON MENTAL HOSPITAL. Dr. Jeffreys reports :— I have the honour to forward my report for the year 1928. At the beginning of the year there were upon the register 418 patients (283 males and 135 females), and on the ,31st December there were 426. The total number under care during the year was 465, while the weekly average number resident was 413. Including 7 transfers from other institutions, there were 47 admissions, and of these 36 (20 males and 16 females) were admitted for the first time. Of the 23 voluntary boarders who were under treatment during the year, 8 were discharged 2 were committed as ordinary patients, and 1 was transferred, leaving 14 remaining at the end of the year. Thirteen patients were discharged recovered, and 4as " relieved " or " not improved." Twenty-one patients died during the year, and 8 of these were old people between seventy and ninety years of age, while 3 patients died from broncho-pneumonia following measles. On the whole the general health of the patients has been very satisfactory. Towards the end of the year there was an outbreak of sickness among the boys at El Nido. Seven boys were stricken down within a few days of each other, and the symptoms were at first suggestive of typhoid fever, but very soon definite pneumonic signs became apparent, and we were able to diagnose the condition as that of epidemic influenza of a virulent type. In spite of the severity of the symptoms all the patients recovered, although three of them were very dangerously ill for a time.

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The value of immediate, complete isolation was strikingly demonstrated during this outbreak. The infected boys were at once isolated in one of the large dormitories, and were in sole charge of three nurses, who were put on eight-hour shifts. The result was most gratifying, for in spite of the overcrowding in this ward no other patients were infected. In July there was a fairly severe outbreak of influenza. No fewer than 160 of the patients and staff at Nelson and Stoke were laid up, and, owing to the sudden onset and the number infected, it was quite impossible to isolate them without a special isolation ward, and the necessity for such a ward, which has long been recognized, was very apparent. It is to be hoped that the necessary funds will be forthcoming to build one in the near future. It is a relief to know that the contract has been let for the erection of three villas at Stoke, for the overcrowding has become a very acute problem. Most of the excavation for the site of the first villa was done by patients, the majority of whom are mentally deficient boys, who are being trained to become useful members of our little community. At the time of writing the contractors have made a start on the excavation for the second villa, and by this time next year the erection of the villas should be well on the way to completion. At present there are seventy-nine boys at El Nido, and until the villas at Stoke are ready for occupation it will be quite impossible for us to find accommodation for any more boys. In spite of the many disadvantages we still labour under at Stoke, conditions there are. very satisfactory. A large percentage of the patients are on full parole, and many of the remainder are on limited parole. Although there are no fenced-in parks or airing-courts, it is rarely a patientattempts to escape. The freedom from unnecessary restraint is greatly appreciated, and what was regarded by many as a rather doubtful experiment has proved to be an unqualified success. The people of the Nelson District take a practical interest in the institution, and have been most generous in their donations towards the recreation funds, and in helping in other ways to provide entertainment for the inmates. I deeply regret that ill health has rendered necessary the resignation of Mrs. Scantlebury, who has been Official Visitor for many years. She has always taken the keenest interest in the welfare of the patients, and has aroused the interest of others. My sincerest thanks are due to her for her selfdenying work. I am indebted to Archdeacon Dart and other members of the Nelson Ministers' Association for regular Sunday services and visits to the patients. I must also express my appreciation of the valued assistance given me by Dr. Sadlier and the other officers and staff throughout the year. HOKITIKA MENTAL HOSPITAL. Dr. Buchanan reports : — I have the honour to submit my report for the year ended 31st December, 1928. At the beginning of the year there were 216 patients on the register and 1 voluntary boarder; at the end of the year there remained 144 males and 61 females, making a total of 205 patients. Admissions numbered 12 ordinary patients. No voluntary boarders were admitted during the year. Discharges were 7, deaths 15, and 1 transfer. One voluntary boarder was discharged. It will be noted that the total number of patients is slowly diminishing year by year. The general health of the patients continues to be good. On the 17th August the hay-shed was destroyed by fire. We have since erected a larger one on a new site away from the institution. This new site will ultimately be the position of the farmsteading when the present old and unsatisfactory buildings are replaced by new ones. The old pigsties have been broken up, and a series of discrete movable ones have been erected at a suitable distance away from the main buildings. Towards the end of the year a greenhouse was added to the garden. By utilizing old iron and available glass this was built cheaply. It is in use for growing tomatoes and raising pot-plant.s for the wards. I had hopes that commencement would be made before the end of the year on the projected water-tower and laundry. The delay in these two items has been a great disappointment to me. Over 5 acres of virgin ground has been stumped, drained, and sown down into pasturage. By reason of similar work carried out last year we are beginning to show an increase in our milk-supply. Thirty-nine chains of new road was formed and linked up with the old bush-track, thus completing a circular walking route for the patients. Tree-plantingl|was|continued, and we have now 17 acres afforested. We raised most of the trees from seed in our own nursery ; the balance was kindly donated to us by the local Conservator of Forests. The bowling-green is now completed, and we expect to play on it in January, 1929. Besides providing additional recreation for the patients, this work also serves the purpose of beautifying a hitherto ugly spot at the entrance of the grounds. The annual picnic was held in February, and, as usual, was a great source of pleasure to the patients. Mr. Clifton and Miss Reynolds have visited us regularly, and taken an interest in the welfare of the patients. My thanks are due to the staff for their loyal assistance throughout the year.

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CHRISTCHURCH MENTAL HOSPITAL. Dr. McKillop reports : — I have the honour to forward my report for the year ended 31st December, 1928. On the Ist January, 1928, there were 886 patients on the register. During the year we had 175 admissions (90 men, 85 women), 66 patients were discharged, and 9 transferred to other institutions. The total number of committed patients under care was 1,061, and 918 remained on the 31st December (inclusive of 59 absent on probation). Ninety-two voluntary boarders received treatment, 50 men and 42 women. The marked increase in the number of voluntary boarders is particularly pleasing : each year an increasing number take advantage of the provision in the Act sanctioning admission as voluntary boarders. Many have come through the clinics at the General Hospital, which have been remarkably well attended. The general health of the patients has been good. During 1928 there were 68 deaths (27 men, 41 women), the chief cause being senile decay. I am deeply gratified at the consideration our many wants have received at your hands and at the hands of the Public Works Department. Many important additions and renovations have been carried out: the chief addition being a forty-eight-unit building at Templeton, which has been in occupation for some months. This is in the nature of a farm colony, and the patients in residence there are very happy and contented. Tenders have been called for another forty-eight-unit building at Templeton to accommodate feeble-minded patients. This should be in use before the end of the year, and will mark a great advance in the treatment of the feeble-minded, as well as affording increased accommodation at the main institution, thus allowing better classification. The farm buildings at Templeton have been rebuilt, and the water-tower completed. Extensive renovations are in progress at Sunnyside : during the past four years the institution has been painted and renovated throughout, and the alterations have given it a bright and airy appearance. It is intended to apply for a grant to build an extra day-room at North House, a building situated some distance from the main building : there should then be accommodation for a hundred patients there, and I propose to use this entirely for senile women patients, thus keeping patients suffering from the general physiological changes of old age apart from the others. The farm returns have been very satisfactory : work on the farm and in the gardens continues to provide agreeable and healthy employment. The patients' recreation has been arranged on the usual lines : the new cinematograph machine is greatly appreciated by patients and staff. I have to tender my thanks to the Deputy Inspector (Mr. Acland), the. Official Visitors, Mrs. Williams and Mr. Hanna, and to the clergy of all denominations, for their regular visits and the interest they have taken. I regret to have to record the death of our Patients' Friend, Mr. Souter. He is greatly missed by every one, and the memory of good deeds and kindly interest will last for many days. I am glad to take the opportunity of recording my thanks to Drs. Russell and Hart for their assistance and co-operation; their promotion to more important positions is very pleasing. They have been succeeded by Drs. Brown, Lewis, and Bellringer, who are taking a live interest in the progress of the institution. I have also to thank Mr. Thomas and the office staff, the Matron, Head Attendants, and other heads of departments for the assistance they have given me in carrying on the work of the Hospital. lam very fortunate in having a very good staff of senior nurses and attendants, who have entered whole-heartedly in carrying out any improvements suggested. To the staff as a whole I tender my thanks for their good work during the year. SEACLIFF MENTAL HOSPITAL. Dr. Gribben reports : — I beg to submit my report for the year ended 31st December, 1928. At the beginning of the year there were 1,176 patients on the register (643 males and 533 females), and at the end of the year 1,188 (649 males and 539 females). The admissions numbered 144 (79 males and 65 females). Seventy-two patients were discharged, comprising 39 males and 33 females. Of voluntary boarders 40 remained from the previous year and 22 were admitted. Seventeen voluntary boarders were discharged, 1 committed as ordinary patient, and 1 died. Sixty patients died during the year (34 males and 26 females). The average weekly number of patients resident during the year was 1,161 (638 males and 523 females). The health of the.patients has generally been good. Of the 60 deaths which took place, 19 were due to senile decay. An extensive building programme has been in progress. Work on the new kitchen and laundry block has proceeded satisfactorily, and these buildings are now well forward. A considerable amount of excavation has been carried out round them in preparation for the roadway. The new oil-store and petrol-storage tank are nearing completion. The new coal-bunker was completed, and has facilitated the handling of coal. The Neuropathic Hospital at Puketeraki was occupied in August. The water-supply at this unit has not been satisfactory, and I would urge the installation of an additional source of supply. An addition of sixteen bedrooms and a sitting-room, together with a bathroom, boiler-house, and hot-water system, was made at the Nurses' Home, and the resulting room in the wards has helped in a measure to relieve congestion. Additions to G Ward in progress include bathrooms, extra store accommodation, a hot-water system, and sanitary conveniences. The fire appliances throughout the institution were brought up to the requirements of the Fire Inspector. A new Medical Officer's residence was erected, and is now occupied. The new electrification scheme is in progress. Unfortunately it has necessitated the cutting-down of a large number of trees along Russell's Road and in other parts of the grounds. At Waitati a new bathroom for Female Ward No. 2 is in course of erection, and an addition is being made to ihe present laundry.

2—H. 7.

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10

Repairs and renovations include a renewal of the main sewer for a length of 5 chains, renovations to sanitary conveniences in several of the wards, and a new floor in the general dining-hall. In Female Ward No. 4 smaller tables and chairs were installed, and this will be carried out in other wards as opportunity arises. The floor in the day-room of E Ward was renewed in jarrah. A considerable amount of painting has been carried out in the main building and outside units. Operations in connection with the farm have been carried out in accordance with the policy laid down. The top-dressing of pastures has produced beneficial results. An increased area, has been sown in root crops during the spring, and at present the prospects appear good. It is also proposed to cut a larger acreage of grass for hay and ensilage, and given favourable weather conditions there should be an abundance of winter fodder. A plentiful supply of vegetables has been available, and the upkeep of the gardens generally has been creditably maintained. The weekly clinic at Dunedin Hospital is being increasingly availed of, and is, I am convinced, appreciated by those desiring advice in connection with mental and nervous troubles. As in previous years, regular picture-shows have been held for the patients, as well as dances during the winter months. When the weather has been favourable there have been picnics for different groups of patients, and a number visited the Summer and Winter Shows in Dunedin. Entertainments have been given by the Ancient Order of Buffaloes, the Commercial Travellers' Association, the Dunedin Male Choir, the Dunedin Pipe Band, and the band of the First Battalion, Otago Regiment. The annual sports meeting, which was favoured by good weather, was again a pronounced success. I have to express my thanks to Mr. Slater (Official Visitor) and to Mr. Cumming (Patients' Friend). Mr. Cumming, in addition to his other work, has been a great help in obtaining employment for patients on their discharge, and helping them after they have left the Hospital. I desire also to acknowledge my indebtedness to members of the staff for their co-operation in the work of the institution.

STATISTICAL. The patients on the register at the end of the year numbered 5,902 (m. 3,274, f. 2,628), or 229 (m. 127, f. 102) more than at the beginning ; and the daily average under treatment during the year was 5,579 (m. 3,120, f. 2,459), or 184 (m. 98, f. 86) more than in the previous year, while the total under care was 6,696. Patients belonging to the Native race numbered 83 (m. 46, f. 37) at the end of the year. The admissions numbered 956 (m. 506, f. 450), or 11 more (m. 25 less and f. 36 more) than in the previous year. Of these, 149 had been previously under care, making the proportion of readmissions 15-58 per cent., and 807 patients were admitted for the first time. The ratio to population of all admissions (exclusive of Maoris) was 6-76 (m. 6-99, f. 6-51) to 10,000, and of first admissions 5-73 (m. 6-03, f 5-43), so that 1,479 persons in the general population contributed one patient, and 1,742 contributed a patient admitted for the first time. The discharges (excluding transfers) numbered 359, or 31 less than in 1927. 110 (or 5 less) harmless unrecovered persons were returned to the care of friends, and 249 (m. 115, f. 134) recovered —36 less than last year, representing a percentage of 26-04 (m. 22-72, f. 29-77) on the total admitted. With voluntary boarders added the percentage rises to 35-95. Altogether, 44-78 per cent, of the inmates admitted were able'to leave institutional care. Of a total of 6,696 patients under care, 368 (m. 207, f. 161) died, or 6-59 per cent, on the average number resident. An inquest is held in the case of every death, whatever the cause. The causes are detailed in Table XII, and the following is the percentage of causes mainly contributing : Senile decay, 27-17 ; disease of the brain and nervous system group, 30-43 ; heart-disease, 17-39 ; tuberculosis, 6-00. In Table XIII the principal causes assigned for the mental breakdown in the admissions are stated ; but as a matter of fact they are merely approximations, and these, with the small numbers with which we have to deal, show such divergencies from year to year that the proportion assigned to any one cause in any one year cannot be assumed to be our average incidence. Causation is always complex, and the most potent factor is the individual. Hereunder the assigned causations in the table referred to are grouped and shown in their relative proportions :— Males. Females. Total. Heredity .. .. .. .. .. 19-36 20-00 19-66 Congenital .. .. .. .. .. 9-68 10-44 |10-04 Predisposed by previous attack .. .. .. 11-06 9-55 10-41 Critical periods .. .. .. .. .. 18-77 30-22 24-16 Child-bearing (puerperal, non-septic, and lactation) .. .. 4-88 2-30 Mental stress .. .. .. .. .. 14-62 11-11 12-97 Physiological defect and error .. .. .. 0-40 1-55 0-84 Toxic, including M. f. Sf :: :: :: ™ 5™} IMI »•» 10 - M Traumatic .. .. .. .. .. 0-98 0-44 0-72 Disorder of nervous system, including — m. f. Epilepsy .. .. .. 4-34 3-77 6-91 5-33 6-17 Other bodily affections .. .. .. .. 0-98 1-55 1-25 No definite cause assigned .. .. . • 1-43 1-38 1-44 100-00 100-00 100-00

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Voluntary Boarders.

It will be noted that there were 290 voluntary admissions in the year under review, that 199 were discharged, and that 18 boarders, representing 6-2 per cent, of the admissions, had to be transferred to the register of patients (having shown mental disorder in degree sufficiently pronounced and sustained to render it improper for them to be continued as voluntary boarders), while the proportion of deaths on average number resident was 7-79 per cent. The column devoted to " Not First Admissions " records readmissions on a return of illness in those previously treated to recovery as voluntary boarders. The average daily number of voluntary boarders in 1928 was 231 (m. 103, f. 128).

MENTAL NURSES. In December the usual examination was held for the registration of mental nurses, when the following passed : — Auckland : Second Grade—Beaty Beswick, George Campbell, Mary Collins, Hugh Samuel Conn, Charles Francis Cooper, William Hugh Crees, John King Grant, Margaret Ross McClure, Robert McCready, Ina McKay, Murdoch McKenzie, Florence Norton, Charles Fryer Pritchett, Edmund Greig Sim, Thomas Westwater Whyte, Annie Elizabeth Woods. Tokanui: First Grade —Marie Patricia Healy, Robert Pinniger Robinson; Second Grade— Eliza Margaret Borrell, Caroline Ellen Maud Healy, Thomas McComb, William Henry Smith. Porirua : First Grade —Lucy Mary Bramwell; Second Grade —Alexander Eraser Anderson, Catherine Broderick, Daniel Bernard McGuckian, Robert Ernest Smith, Harold Spencer, Alma Rhoda Wright. Nelson: Second Grade—Alfred Keith Bradcock, Annie Brough, Rubina Pearly Brown, William Dickinson, Clifton Albert Exton, John Kissock, David McFarlane McKenzie, Dorice Irene McMurray, Margaret Emily Morgan, Eunice Elizabeth Nock. Hokitika : Second Grade—James Arnold Doyle, Daniel Francis Errol Freitas, Eileen Mary Groufsky, William James Lennane, Louisa Johanna Clarisy Rowe, Miriam Alice Sharplin. Christchurch : First Grade —Evelyn Dorothy Bagge, James Edgar Jackson ; Second Grade — Ellen Kathleen Clark, Hannah Fahey, Irene Winifred Holland, Donald Mcßae, William George Robson, Mabel Ivy Woodgate, Margaret Frances Wylie, Catherine Mary Wylie, Andrina Stark Young. SeacliS: First Grade —Margaret Ellen Wells; Second Grade—Greta Alice Bright, James Ralph Clark, Archie Ellwood, Findlay Alexander Fraser, Alexander Francis Leckie, Rita Jane Sime, Ann Skinner.

f "Pirat Tnfal Transferred | Remaining Year. , : - Not lust . „ to Register Died. I Discharged. on Admission. Admission. Admissions. oJ p a( j ents 31 s t December. ! ] : ! M. F. T. M. F. T. M. F. T. M. F. T. M. F. T. M. F. T. M. F. T. 1912 .. .. 6 17 23 000 6 17 23 134 000 437 1 11 12 1913 .. .. 18 19 37 0 2 2 18 21 39 2 5 7 0 1 1 12 12 24 5 14 19 1914 .. .. 17 19 36 3 2 5 20 21 41 7 5 12 1 1 2 11 15 26 6 14 20 1915 . . .. 15 17 32 1 2 3 16 19 35 3 4 7 0 1 1 8 14 22 11 14 25 1916 .. .. 13 23 36 5 8 13 18 31 49 4 4 8 1 2 3 14 14 28 10 15 25 1917 . . .. 14 21 35 1 13 14 15 34 49 6 6 12 0 1 1 10 23 33 9 19 28 1918 .. . . 23 38 61 5 11 16 28 49 77 1 4 5 2 2 4 15 30 45 19 32 51 1919 .. .. 31 39 70 5 19 34 36 58 94 3 3 6 0 2 2 26 42 68 26 43 69 1920 . . . . 26 38 (54 16 12 28 42 50 92 3 4 7 1 2 3 33 33 66 31 54 85 1921 .. .. 39 39 78 11 15 26 50 54 104 2 3 5 5 1 6 38 41 79 36 63 99 1922 .. .. 47 38 85 10 16 26 57 54 111 6 5 11 4 4 8 40 48 88 43 60 103 1923 .. .. 44 50 94 15 21 36 59 71 130 3 6 9 3 3 6 47 47 94 49 75 124 1924 .. .. 38 44 82 16 20 36 54 64 118 4 8 12 6 3 9 39 48 87 54 80 134 1925 .. .. 64 59 123 15 34 49 79 93 172 10 15 25 6 3 9 60 63 123 57 92 149 1926 .. .. 71 60 131 11 29 40 82 89 171 10 11 21 7 2 9 49 71 120 73 97 170 1927 .. .. 70 70 140 25 32 57 95 102 197 8 6 14 5 12 17 75 58 133 i 80 123 203 1928 .. ..120 94 214 37 39 76 157 133 290 8 10 18 10 8 18 102 97 199 117 141 258

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APPENDIX.

Table I.—Showing the Admissions, Readmissions, Discharges, and Deaths in Mental Hospitals during the Year 1928.

Table II.—Admissions, Discharges, and Deaths, with the Mean Annual Mortality and Proportion of Recoveries, etc., per Cent, on the Admissions, etc., during the Year 1928.

M. F. T. M. Jf. T. In mental hospitals, 1st January, 1928 .. .. .. .. 3,147 2,526 5,673 Admitted for the first time .. . . . . .. 435 372 807 ~\ Readmitted 71 78 149 / 506 460 956 Total under care during the year .. .. .. 3,653 2,976 6,629 Discharged and died— Recovered .. .. .. .. 115 134 249 Relieved .. . . . . . . . . .. 40 40 80 Not improved . . . . . . 17 13 30 Died .. .. . . 207 161 368 (Not including transfers—Males 57, females 10.) 379 348 727 Remaining in mental hospitals, 31st December, 1928 .. .. 3,274 2,628 5,902 Increase over 31st December, 1927 . . .. . . .. 127 102 229 Average number resident during the year .. .. .. .. 3,120 2,459 5,579

In Mental Hos- Admissions in 1928. Total Number Mental Hospitals. pitals on j — 9* , 1st January, 1928. Admitted for the Not First Jratients First Time. ' Admission. Transfers. under Care. M. P. T. M. F. T. M. F. T. M. F. T. M. F T Auckland .. .. 655 524 1,179 82 80 162 15 22 37 (9 4 13) 761 630 1 391 Christchureh .. 415 471 886 71 70 141 13 15 28 (6 0 6) 505 556l'o61 Dunedin (Seacliff) .. 643 533 1,176 68 49 117 8 13 21 (3 3 6) 722 598 1,320 Hokitika . . .. 152 64 216 5 5 10 2 0 2 .. 159 69 '228 Nelson .. .. 283 135 418 20 16 36 1 3 4 (6 1 7) 310 155 465 Porirua .. .. 762 646 1,408 159 116 275 28 23 51 (5 1 6) 954 786 1 740 Tokanui .. .. 221 124 345 28 27 55 4 0 4 (27 1 28) 280 152 '432 Ashburn Hall (private 16 29 45 2 9 11 0 2 2 (1 0 1) 19 40 59 mental hospital) ! Totals .. 3,147 2,526 5,673 435 372 807 71 78 149 (57 10 67) 3,710 2,986 6,696 Patients discharged, transferred, and died. T ,, In Mental HosMental Hospitals. i | I _ . , Pitals on niqphflrppd DiRpharffed ' Total discharged, 31st December, Recovered ! not i eco'fred. Transferred. | Died. transferred, l 928 . and died. M. F. T. M. F. T. M. F. T. M. F. T. M. F. T. M. F T Auckland .. .. 31 26 57 15 16 31 (10 2 12, 45 32 77 101 76 177 660 554 1 214 Christchurch 22 23 45 7 14 21 (7 2 9) 27 41 68 63 80 143 442 476 '9I8 Dunedin (Seacliff) .. 17 20 37 21 13 34 (1 0 1) 34 26 60 73 59 132 649 539 l 188 Hokitika .. ..1 5 6 1 0 1 (1 0 1) 12 3 15 15 8 23 144 61 205 Nelson .. 4 9 13 2 2 4 (1 0 1) 14 7 21 21 18 39 289 137 426 Porirua .. .. 37 44 81 5 8 13 (27 3 30) 65 43 108 134 98 232 820 688 1 508 Tokanui .. .. 2 2 4 4 0 4 (9 1 10) 9 7 16 24 10 34 256 142 398 Ashburn Hall (private 1 5 6 202 (1 2 3) 123 5 9 14 14 31 45 mental hospital) _____ Totals .. 115 134 249 57 53 110 (57 10 67) 207 161 36S 436 358 794 3,274 2,628 5.902 Average Number . Percentage Percentage of Mental Hospitals. resident during ltecoveries on Deaths on Average the Year. Admissions Number resident during the Year. during the Year. M. V. T. M. 1?. T. M. P. 1 Auckland .. .. .. .. .. 630 504 1,134 32-00 25-49 28-64 7-14 6-34 6-79 Christchurch .. .. . . .... 410 456 866 26-19 27-06 26-62 6-58 8-99 7-55 Dunedin (Seacliff) .. .. .. .. 638 523 1,161 22-36 32-25 26-81 5-33 4-97 5-17 Hokitika .. .. .. .. 148 62 210 14-28 100-00 50-00 8-10 4-83 2-38 Nelson .. .. . . . . .. 283 130 413 19-04 47-37 32-50 4-94 5-38 5-08 Porirua .. .. .. .. .. 758 625 1,383 19-66 31-66 24-85 8-57 6-88 7-83 Tokanui .. .. . . .. .. 238 129 367 6-25 7-40 7-27 3-78 5-42 4-36 Ashburn Hall (private mental hospital) .. .. 15 30 45 50-00 45-45 46-15 6-66 6-66 6-66 Totals .. .. .. .. 3,120 2,459 5,579 22-72 29-77 26-04 6-63 6-55 6^59

13

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Table IV.-Duration of Disorder on Admission.

Table III.-Ages of Admissions.

n ,. Ashburn Hall Ages. Auckland. Christchurch .q"" 8 , 1 ?! 1 ? Hokitika. Nelson. Porirua. Tokanui. (Private Mental Total. (beacliH). Hospital). . , . , _____ j j M. F. T. M. F. T. M. F. T. M. F. T. M. F. T. M. F. T. M. F. X. M. F. T. M. F. T. Under 5 years .. .. .. .. 2 0 2 101 123 .. 202 .. .. .. 62 8 From '5 to 10 years .. .. .. 101 213 1 2 3 .. 606 134 213 .. 13 7 20 „ 10 „ 15 • • . • ■ • 1 3 4 3 1 4 2 0 2 .. 3 0 3 2 1 3 1 0 1 .. 12 5 17 „ 15 „ 20 .. .. .. .. 6 3 9 6 8 14 5 5 10 1. 0 1 0 1 1 6 9 15 3 4 7 .. 27 30 57 „ 20 „ 30 .. .. .. 5 18 23 18 14 32 16 7 23 1 0 1 0 3 3 31 21 52 3 5 8 0 4 4 74 72 146 „ 30 „ 40 „ .. .. .. 20 18 38 15 18 33 8 6 14 0 1 1 2 0 2 31 24 55 5 6 11 0 2 2 81 75 156 „ 40 „ 50 „ .. • .. 16 25 41 13 11 24 11 16 27 1 2 3 1 6 7 44 40 84 2 8 10 2 5 7 90 113 203 „ 50 „ 60 „ .. .. . . 23 15 38 13 16 29 10 5 15 2 1 3 3 4 7 30 16 46 7 2 9 .. 88 59 147 „ 60 „ 70 „ .. • ■ ■ - 8 8 16 6 9 15 10 12 22 1 1 2 2 1 3 27 9 36 5 ! 6 .. 59 41 100 „ 70 „ 80 „ .. .. .. 7 7 14 6 5 11 6 5 11 1 0 1 2 3 5 8 12 20 2 0 2 .. 32 32 64 „ 80 „ 90 „ .. .. .. 2 2 4 1 2 3 6 2 8 .. 0 1 1 6 4 10 .1 0 1 .. 16 11 27 „ 90 „ 100 „ . .. .. .. .. .. .. ■ • •• • ■ 10 1 . . 10 1 Unknown .. .. .. .. 639 .. .. .. .. 101 .. 73 10 Transfers .. •• •- 94 13 606 3 3 6 .. 617 516 27 1 28 1 0 1 5; 10 67 Totals .. .. .. .. j 106 106 212 90 85 175 79 65 144 7 5 12 27 20 47 192 140 332 59 28 87 3 11 14 563 460 1,023 - ■ I J if 1 ' .. : ! ; __1

! I ] Ashbui-n Hall Auckland. Christcliurch. ,o Hokitika. Nelson. Porirua. Tokanui. {Private Mental Total. I iheacnrr;. Hospital). M. F. T. M. F. T. M. F. T. M. F. T. M. F. T. M. F. T. M. F. T. M. F. T. M. F. T. First class (first attack and within 3 months 27 36 63 31 19 50 27 16 43 3 2 5 2 5 7 127 68 195 14 15 29 1 5 6 232 166 398 on admission) Second class (first attack above 3 months and 11 8 19 13 12 25 3 4 7 0 3 3 1 1 2 9 13 22 3 1 4 .. 40 42 82 within 12 months on admission) Third class (not first attack, and within 12 I 18 21 39 19 33 52 7 13 20 2 0 2- 1 6 7 21 17 38 1 0 1 1 4 5 70 94 164 months on admission) Fourth class (first attack or not, but of more i 19 30 49 21 21 42 39 29 68 2 0 2 17 7 24 30 41 7] 14 11 25 0 2 2 142 141 283 than 12 months on admission) .. Unknown .. - • • .. .. j 22 7 29 .. .. • • •. • • • • • • 22 7 29 Transfers •• ..9 4 13 606 336 .. 617 516 27 1 28 101 57 10 67 Totals .. .. . . 106 106 212 90 85 175 79 65 144 7 5 12 27 20 47 192 140 332 59 28 87 3 11 14 ! 563 460 1,023

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Table V.-Ages of Patients Discharged "Recovered" and "Not Recovered" during the Year 1928.

Table VI.-Ages of Patients who died.

Auckland. Ohriatchurch. Dunedin (Seacliff). Hokitika. « Nelson. Porirua. Tokanui. (Private Total. Ee- Notre- Be- ; Notre- j Ee- Notre- Be- Notre- Be- Notre- Ee- Notre- Ee- Notre- Ee- Notre- Recovered Not , covered, covered. covered. I covered, covered, covered, j covered, covered, covered. covered, covered, covered, covered, covered, covered, covered. • recovered. : I ! : 1 _ : : : I ■ I 1 ' M. F. T. M. P. T. M. F. T. M. F. T. M. F. T. M. F. T.j M. F. T.| M. F. T. M. F. T. M. F. T. M. F. T.I M. F. T. M. F. T. M. F. T. M. F. T. M. F. T. M. F. T. M. F. T. Under 5 years .. .. .. •• 10 1.. .. ' ■ .. .. •• j •• •• • • •• •• 101 From 5 to 10 years .. .. .. .. 101 .. .. .. .. .. .. .. •• •• •• • • •• - • 101 „ 10 „ 16 „ .. .... .. 112.. 101.. .. .. . • • • •■ • ■ ■ • •• • • • • 213 „ 15 „ 20 „ .. 7 8 15 4 3 71 3 4 .. 0 1 1 0 1 1 .. .. 0 2 2 .. 2 1 3 .. .. .. • ■ •. 10 15 25 4 4 8 „ 20 „ 30 .. .. 38 11 2 4 6 7 5 12 1 4 5j 4 3 7 5 1 6 1 01 .. 2 1 3 .. 4 7 11 2 2 4 .. 1 0 1 .. .. 21 24 45 11 11 22 „ 30 ., 40' .. 7 7 14 2 2 4 4 4 8 0 2 2] 5 3 8 4 5 9 0 1 1 .. 1 2 3 1 0 1 7 12 19 .. 0 1 1 1 0 1 0 2 2 .. 24 32 56 8 9 17 „ 40 , 50 .. 9 1 10 1 4 5 7 7 14 1 4 5 5 10 15 2 2 4 0 2 2 1 0 1 0 111 0 111 15 26 0 6 61 12 1 0 11 3 42 0 2; 34 40 75 9 15 24 „ 50 „ 60 „ .. 1 1 2 1 1 2 3 3 6 0 2 2 3 3 6 3 1 4 .. .. 1 2 3 0 1 1 8 S 16 3 0 3 1 0 1 1 0 1 .. .. 17 17 34 8 5 13 60 „ 70 „ .. .. 101011112' .. 314022 .. .. .. 415 .. . - .. .. .. 437538 70 „ 80 .. .. 10 1.. 213.. .. 011011.. .. . . • • ■ • ..011325 „ 80 „ 90 „ .. .. .. .. . . .. 112;.. .. .. .. 101 .. .. .. . . ..|101112 „ 90 „ 100 „ .. .. .. .. .. I .. .. .. .. .. • • • ■ •• • • • - •• ! Unknown .. ..415426 .. .. .. .. .. .. .. .. •• ■■ •• •• •• 415426 Transfers .. .. .. 10 2 12 .. 7 2 9 .. 1 0 1 .. 1 0 1 .. 1 0 1 .. 2" 3 30 .. 9 1 10 .. 1 2 3 .. 57 10 67 Totals .. 31 26 57 25 18 43 22 23 4514 16 3017 20 37 22 13 35 1 5 6 2 0 2 4 9 13 *3 2 5 37 44 SI 32 11 43 2 2 413 1 14 1 5 6 3 2 5 115 134 249114 63 177 •

Ages. Auckland. Christchurch. Dunedin (Seaolifli, j Hokttika. Nelson. Porirua. Tokanni. T >tal. . - . | i j M. F. T. M. V. T. M. F. T. M. *. T. M. F. T. M. F. T. M. F. T. M. F. T. M. F. T. Under 5 years From 5 to 10 years .. .. .. .. 0 I I .. .. 4 0 4 .. .. .. 415 10 „ 15 „ .. .. .. .. 10 1 .. .. 112 .. .. .. 2 13 „ 15 „ 20 „ .. .. 10 1 .. I • .. 1 0 1 0 2 2 1 0 1 .. 3 2 5 „ 20 „ 30 „ .. .. 4 1 5 2 1 3 2 1 3 ... .. 5 2 7 0 1 1 .. 13 6 19 „ 30 „ 40 .. .. 2 5 7 2 4 6 4 1 5 .. 1 0 1 8 0 8 .. .. 17 10 27 „ 40 „ 50 .. o 7 7 i 4 6 10 2 5 7 2 1 3 0 1 1 8 6 14 2 2 4 .. 18 28 46 50 „ 60 „ . 11 6 17 5 9 14 3 7 10 5 1 6 2 1 3 14 14 28 0 2 2 1 1 2 41 41 82 „ 60 „ 70 „ .. 17 4 21 | 5 8 13 4 2 6 2 0 2 0 1 1 15 5 20 2. 2 4 .. 45 22 67 „ 70 80 „ .. 7 6 13 j 3 10 13 13 7 20 1 0 1 4 2 6 7 8 15 1 0 1 .. 36 33 69 „ 80 „ 90 „ .. .. .. 3 3 6 4 2 6 5 3 8 1 1 2 1 1 2 7 6 13 2 0 2 0 1 1 23 17 40 „ 90 „ 100 „ .. .. .. .. 10 1 10 1 10 1 •. 10 1 10 1 .. 5 0 5 Unknown Totals .. . . 45 32 77 ! 27 41 68 34 26 60 12 3 15 14 7 21 65 43 108 9 7 16 1 2 3 207 161 368 i

15

H.—7

Table VII. —Condition as to Marriage.

; Admissions. Discharges. Deaths. I I 1 Auckland— ' m. f. t. : m. f. t. m. f. t. Single .. .. .. .. .. .. 32 39 71 24 16 40 20 12 32 Married .. .. .. .. .. j 42 41 83 20 19 39 17 11 28 Widowed .. .. .. .. .. 7 22 29 1 6 7 5 9 14 Unknown .. .. . . .. .. 16 0 16 1 I 2 3 0 3 Transfers .. .. .. .. . • 9 4 13 1 10 2 12 ; 1 Totals .. .. .. .. .. 106 106 212 56 44 100 45 32 77 Ohristchuroh — Single.. .. .. .. .. .. 47 44 91 13 14 J; 27 16 15 31 Married . . .. .. .. .. 35 30 65 16 16 i.j 32 10 17 27 Widowed .. .. .. .. ■ • 1 2 11 13 I 0 9 10 Unknown .. .. .. .. .. '' Transfers .. .. .. .. 606 729 Totals .. .. .. .. .. 90 85 175 36 39 75 27 41 68 Dunedin (Seaoliff) — Single .. .. .. .. .. .. 44 23 67 24 13 37 22 18 40 Married .. .. .. .. .. 26 29 55 13 18 31 6 3 9 Widowed .. .. 6 10 16 12 3 6 5 11 Unknown Transfers .. .. .. .T .. 336 101 Totals .. .. .. .. .. 79 65 144 39 33 72 34 26 60 Hokitika— Single 325 2 1 3 9 2 11 Married .. .. .. .. •• 235 044 20 >2 Widowed .. .. .. .. .. 2 0 2 i .. 011 Unknown .. .. .. .. .. .. •• 101 Transfers .. .. .. .. .. .. 101 Totals .. . . . . .. .. 7 5 12 | 3 5 8 12 3 15 Nklson— Single.. .. .. .. .. .. 14 9 23 I 5 2 7 11 4 15 Married 5 6 11 1 8 9 12 3 Widowed .. .. .. .. ■■ 246 0 1 1 2 1 3 Unknown Transfers .. .. .. .. .. 6 1 7 j 1 0 1 Totals .. .. .. .. .. 27 20 47 | 7 11 18 14 7 21 PORIRTJA — Single .. .. .. .. .. - • 105 58 163 j 21 16 37 33 16 49 Married . . . . .. .. 69 62 131 i 20 29 49 29 17 46 Widowed .. .. .. .. .. 13 19 32 1 6 7 3 10 13 Unknown .. .. .. .. .. .. 0 11 Transfers .. .. .. .. .. 5 1 6 j 27 3 30 Totals . . .. .. .. . . 192 140 339 69 55 124 65 43 108 Tokanui — Single .. .. .. .. .. .. 19 10 29 1 0 1 5 2 7 Married .. .. .. .. •• 11 12 23 5 2 7 3 4 7 Widowed . . .. .. . • ■ ■ 2 5 7 .. 1 1 2 Unknown Transfers .. .. . . .. .. 27 1 28 9 1 10 Totals .. .. .. .. .. 59 28 87 15 3 18 ' 9 7 16 Ashburn Hall— Single .. .. .. •• -• 1 6 7 1 3 4 | 1 0 1 Married .. .. .. .. •• 156 2 2 4 j 0 2 2 Widowed .. .. .. .. .. .. ■. j Unknown .. .. .. .. .. .. .. Transfers .. .. .. .. .. 101 123 Totals .. .. .. .. .. 3 11 14 4 7 11 1 2 3 Totals — Single.. .. .. .. 265 191 456 91 65 156 117 69 186 Married .. .. .. .. .. 191 188 379 77 98 175 68 56 124 Widowed .. .. .. .. .. 34 71 105 3 22 25 18 36 54 Unknown .. .. .. .. .. 16 0 16 123 4 04 Transfers .. .. .. .. .. 57 10 67 57 10 67 Totals .. .. .. .. .. 563 4601,023 229 197 426 207 161 368

H.—7.

Table IX.-Ages of Patients on 31st December, 1928.

Table VIII.-Native Countries.

16

Countries. ! Auckland. Ckristchureh. (SeacHfO Hokitika. Nelson. Porirua. | Tokanui. ; Total. v - • I ■1 1 |___ ! I . M. F. T. M. F. T. M. F. T. M. F. T. M. F. T. M. F. T. M. F. T. M. F. T. M. F- T. England and Wales .. .. 116 91 207 69 77 146 88 58 146 29 7 36 21 17 38 153 109 262 54 17 71 4 4 8 534 380 914 Scotland .. .. . . .. ] 28 23 51 19 13 32 66 59 125 6 2 8 17 3 20 44 28 72 17 5 22 2 1 3 199 134 333 Ireland .. .. . . .. 1 48 33 81 22 29 51 42 42 84 17 8 25 12 3 15 52 58 110 14 14 28 1 0 1 208 187 395 New Zealand .. .. .. ] 327 332 659: 306 326 632 417 345 762 66 41 107; 219 105 324 456 416 872 129 96 225 7 24 31 1,927 1,685 3,612 Australian States .. .. .. 36 25 61 13 16 29 19 29 48 11 3 14 9 6 15 31 25 56 13 3 16 0 2 2 132 109 241 France .. .. .. .. 011224 .. 101 .. 011 202 .. 5 4 9 Germany .. .. .. .. 516 022 303 .. 101 459 314 .. 16 9 25 Austria .. .. .. .. 27 4 31 .. 101 .. 202 011 505 .. 35 5 40 Norway .. .. .. .. 404 303 10 1 101 .. 415 101 .. 14 1 15 Sweden .. .. .. .. 314 213 303 303 101 415 .. .. 16 3 19 Denmark .. .. .. .. 2 0 2 .. 213 .. 101 628 202 .. 13 3 16 Italy .. .. .. .. 213 .. 101 404 .. 527 202 .. 14 3 17 China .. .. .. .. .. .. 202 101 .. 325 .. .. 628 Maoris .. . . .. .. 21 17 38 .. .. 1 0 1 5 2 7 16 13 29 3 5 8 .. 46 37 83 Other countries .. .. .. 22 10 32 6 10 16 4 5 9 4 0 4 1 1 2 24 II 35 11 1 12 .. 72 38 110 Unknown .. .. .. . . 19 15 34 .. .. .. .. 18 13 31 .. . . 37 28 65 Totals .. .. .. 660 554 1,214 442 476 918 649 539 1,188 144 61 205 289 137 426! 820 688 1,508 256 142 398 14 31 35 3,274 2,628 5,902

Ages. Auckland. Christchuroh. (Seacliff) Hokitika. Nelson. Porirua. Tokanui. ipSrate^H 1 ) Total. J U I . I • I i M. F. T. M. F. T. M. F. T. M. F. T. M. F. F. M. F. T. M. F. T. M. F. T. M. F T. From 1 to 5 years .. ..101 .. 325 .. 5 0 5 .. .. .. 9 2 11 5 „ 10' „ .. .. 0 1 1 1 6 7 2 3 5 .. 28 0 28 0 9 9 2 2 4 .. 33 21 54 „ 10 „ 15 „ .. .. 5 8 13 4 11 15 4 4 8 0 1 1 52 2 54 2 15 17 1 1 2 .. 68 42 110 15 „ 20 „ .. .. 14 15 29 15 15 30 23 11 34 1 0 1 37 6 43 17 28 45 7 4 11 .. 114 79 193 ». 20 „ 30 „ .. .. 64 66 130 67 40 107 89 39 128 5 2 7 28 18 46 106 79 185 18 10 28 0 1 1 377 255 632 „ 30 „ 40 „ .. .. 117 92 209 84 70 154 92 87 179 13 7 20 29 14 43 157 123 280 31 21 52 2 2 4 525 416 941 „ 40 „ 50 „ .. .. 160 127 287 105 118 223 165 132 297 45 15 60 28 28 56 210 162 372 65 39 104 2 9 11 780 630 1,410 „ 50 „ 60 „ .. .. 137 115 252 80 112 192 124 116 240 36 19 55 33 25 58 171 133 304 78 32 110 1 4 5 660 556 1,216 „ 60 „ 70 „ .. .. 87 69 156 45 71 116 83 100 183 30 10 40 32 27 59 99 83 182 35 2) 56 6 8 14 417 389 806 » 70 „ 80 „ .. .. 45 37 82 36 24 60 49 36 85 5 3 8 12 9 21 46 39 85 10 11 21 3 6 9 206 165 371 „ 80 „ 90 „ .. .. 10 9 19 4 8 12 9 8 17 3 2 5 3 5 8 10 15 25 3 1 4 0 1 1 42 49 91 Upwards of 90 .. .. .. .. 112 .. 011 10 1 2 2 4 .. .. 4 4 8 Unknown .. .. .. 20 15 35 .. 6 1 7 6 1 7 1 3 4 .. 6 0 6 .. 39 20 59 • Totals .. .. .. 660 554 1,214! 442 476 918 649 539 1,188 144 61205 289 137 426 820 688 1,508 256 142 398 14 31 45 3,274 2,628 5,902 J ! .

3—H. 7

H.—7

Table XI.-Length of Residence of Patients Discharged "Recovered" during 1928.

Table X.-Length of Residence of Patients who died during 1928.

17

Length of Kesidence. Auckland. Christchureh. (SeacTif/)' Hokitika. Nelson. Porirua. Tokanui. (Pri'vatc^AI^ H) Total. M. F. T. M. F. T. M. F. T. M. F. T. M. F. T. M. F. T. M. F. T. M. F. T. M. F. T. Under 1 month .. .. .. .. 516 7 3 !0 044 112 101 8191224 .. 24 12 36 From 1 to 3 months .. .. . . 7 3 10 1 3 4 5 3 8 1 0 1 1 1 2 13 . 2 15 .. .. 28 12 40 3 „ 6 „ .. .. .. 2 4 6 1 0 1 .. .. 1 0 1 7 4 11 1 0 1 .. 12 8 20 „ • 6 9 ,, .. .. .. 314 437 112 .. 022 639 011 .. 14 11 25 9 „ 12 „ .. .. .. 1 3 4 1 0 1 5 0 5 .. .. 3 2 5 1 0 1 .. 11 5 16 1 „ 2 years .. .. .. 426 224 628 213 112 82 10 .. .. 23 10 33 „ 2 ,, 3 „ .. .. .. 202 246 213 .. .. 336 101 .. 10 8 18 „ 3 „ 5 „ .. .. 3 5.8 0 6 6 2 3 5 .. 4 0 4 6 6 12 .. .. 15 20 35 „ 5 „ 7 „ .. .. . . 1 3 4 1 1 2 .. .. 2 0 2 1 1 2 .. .. 5 5 10 „ 7 „ 10 „ .. .. .. 2-1 3 1 3 4 1 1 2 1 0 1 .. 2 5 7 0 1 1 .. 7 11 18 „ 10 „ 12 „ .. .. .. 202 011 022 .. .. 213 .. 011 459 „ 12 „ 15 „ .. .. .. 314 033 314 202 .. j 0 11 101 .. 96 15 Over 15 years .. .. .. .. 8 3 11 7 11 18 9 8 17 5 1 6 4 3 7 , 5 8 13 2 3 5 1 1 2 41 38 79 Died while absent ou trial .. .. 257 011 .. .. 145 101 .. 4 10 14 T-.tils .. .. .. 45 32 77 27 41 68 34 26 60 12 3 15 14 7 21 65 43 108 9 7 16 1 2 3 207 161 368 ! I

Length of Kesidenee. Auckland. Christehurch. (SeaclST Hokitika. Nelson. Porirua. Tokanui. (PrKatelFH) Total. I " | | I I M. F. T. ; M. F. T. ' M. F. T. M. F. T. M. F. T. M. F. T. M. F. T. M. F. T. M. F. T. Under 1 month .. .. .. .. 0 1 1 1 0 1 101 .. .. .. .. 0 2 2 235 From 1 to 3 months .. .. .. H 5 16 5 3 8 314 .. 123 628 .. 123 27 15 42 3 „ 6 .. .. .. 4 5 9 7 6 13 7 6 13 .. 1 1 2 2 7 9 2 0 2 0 1 1 23 26 49 6 „ 9 .. .. .. 5 7 12 5 6 11 0 3 3 0 1 1 0 4 4 6 8 14 0 1 1 .. 16 30 46 9 „ 12 .. .. ..6 2 8 2 3 5 1 3 4 1 0 1 .. 7 8 15 .. .. 17 16 33 1 „ 2 years .. .. .. 5 4 9 2 3 5 3 5 8 0 1 1 1 2 3 10 12 22 0 1 1 .. 21 28 49 2 „ 3 „ .. .. .. .. 0 1 1 .. 0 1 1 .. 3 4 7 .. .. 3 6 9 » 3 „ 5 „ .. .. .. Oil .. 011 .. 101 202 .. .. 325 5 „ 7 „ .. .. ..011 .. 101 .. .. .. .. .. 112 7 „ 10 „ .. .. .. .. .. 0 11 .. 0 3 3 .. .. 0 4 4 ,, 10 „ 12 „ .. .. .. .. Oil 112 .. .. 101 .. .. 224 „ 12 „ 15 m Over 15 years .. .. .. .. ,, .. Oil .. .. .. .. O il Tota ls •• .. 31 26 57 | 22 23 45 17 20 37 1 5 6 4 9 13 37 44 81 2 2 4 1 5 6 115 134 249

H.—7.

Table XII. —Causes of Death.

18

■ I i ■ I f Hi CaU3e? - I I : il I = 4 I III 3 I ' T" a J I I 115 I % , I 1 I £ 2 S *2 _ . j . I. General Diseases. Tuberculosis . . . . M. F. M. F. M. F. M. F. M. F. M. F. M. F. M. F. M. F. General .. .. .. .. .. 2 2 .. .. .... .. 22 Of bone .. .. ..10 .. .. .. .. .. j .. .. 10 Of lungs .. .. ..11 1 0 2 0 0 1 1 0 4 6.. .. 98 Diabetes .. .. ..10 .. .. .. .. .. .. .. 10 Typhoid fever .. ..10 .. .. .. .. .. .. .. 10 Dysentery .. .. ..10 .. .. .. .. .. .. .. 10 Cancer ' . . .. ..1011 . . 10 .. 0101 .. 33 Influenza .. .. .. .. 02 .. .. .. 01 .. 0104 Toxaemia .. .. .. .. 01 .. .. .. .. .. .. 01 Pernicious anaemia .. .. .. 0 1 .. .. .. .. .. .. 0 1 II. Diseases of the Nervous System. Melancholia, exhaustion from ..10 3 2 1 1 .. .. 4010 10 3 Mania, exhaustion from .. .. .. 11 .. ., .. .. ..Ill Cerebral syphilis .. .. .. .. .. .. .. .. 01 .. 01 General paralysis of insane .. 5 1 2 1 3 0 1.0 2 0 21 2 0 1 .. 34 5 Organic brain-disease .. .. .. .. 01 .. 10 .. .. .. 11 Epilepsy .. .. ..35 25 13 .. ;01 1212 .. 8 18 Cerebral haemorrhage .. ..41112311 .. .. .. .. 86 Cerebral thrombosis .. ..3001 .. .. .. .. 10 II III. Diseases of the Respiratory System. Pneumonia .. .. .. 12 1 331 5031 230101 15 12 Bronchitis .. .. .. .. .. 12 .. .. .. .. .. 12 IV. Diseases of the Circulatory System. Heart-disease .. 7 3 2 6 1 4 1 0 3 2 10 14 . . .. 24 29 Arterio sclerosis .. ..2 3 1 0 3 0 .. .. .. .. .. 6 3 Embolism .. .. .. .. 10 .. .. .. .. .. .. 10 Myocarditis .. .. .. .. 01 .. .. j ... .. 01 V. Diseases of the Dioestivb I System. Enteritis .. .. .. .. 01 .. .. 01 .. .. .. 02 Gastric ulcer .. ..11 .. .. .. .. .. j 11 Acute obstruction .. .. .. .. .. .. .. 11 .. .. 11 VI. Diseases of the Genitourinary System. Nephritis .. .. .. .. 1. 001 .. .. .. 1 0 2 1 Cystitis .. .. .. .. .. .. ., .. 02 .. .. 02 VII. Old Age. Senile decay .. .. 10 10 10 12 13 6 3 1 3 1 19 7 4 1 62 38 VIII. Ill-defined Causes. Asthenia .. .. .. .. .. 01 .. .. .. I 01 IX. External Causes. Suicide .. .. .. .. 1 0 1 0 | .. 01 .. .. .. 21 Decapitation .. .. .. .. .. . . .. .. 10 .. 10 Asphyxia .. .. .. .. .. .. .. .. 10 .. .. 10 Shock following burns .. .. 0 2 .. .. .. .. .. .. 0 2 Shockfollowingformalinpoisoning .. .. .. .. 10 .. .. .. 10 Crushed by fall of earth .. .. .. .. .. .. 10 .. .. 10 X. DIED while on TRIAL .. 2 5 0 1 .. .. .. 1 4 1 0.. 4 10 Totals .. .. 45 32 27 41 34 26 12 3 I 14 7 65 43 i 9 7 1 2 207 161

H.—7.

Table XIII.—Principal Assigned Causes of Insanity.

Table XIV.—Former Occupations of Patients.

19

Causes. Auckland, elliir j(Seaoliffl Hokitika. Nelson. 1'orirua. ToUanui. Hall Total. _ _ ~ m. r. m. f. m. f. m. f. i m. f. m. f. m. f. m. f. m. f. Heredity .. .. .. 10 14 18 21 11 15 1 1 3 4 46 25 9 8 0 2 98 90 Congenital .. .. .. 12 14 10 11 9 3 1 0 j 8 2 6 16 3 1 .. 49 47 Previous attack .. .. 2 1 9 13 13 9 .. | .. 29 19 3 1 .. 56 43 Puberty or adolescence .. 6 5 85 01 .. .. 54 34 01 22 20 Climacteric .. .. .. 0 14 0 12 09 .. 01 0 13 01 03 0 53 Senility .. .. .. 12 13 12 11 16 15 2 0 2 2 20 21 7 0 .. 71 62 Involution .. .. ..20 .. .. .. .. 01 .. .. 21 Puerperal .. .. ..0504 .. .. 0205 .. .. 0 16 Pregnancy .. .. .. 0 1 .. 0 3 .. .. 0 2 .. .. 0 6 Mental stress —Prolonged 20 14 j 10 3 7 4 1 1 0 1 35 18 1 4 0 5 74 50 Alcohol .. .. 53 62 10 1 01 20 11 2 .. 1 0 35 6 Syphilis .. .. .. 10 0 7 1 3 0 1 0 .. 20 3 0 1 1 0 42 5 Post-operative .. .. .. .. .. .. .. 01 .. .. 01 Traumatic .. .. .. 102020 .. .. 02 ..' .. 52 Epilepsy .. .. 2 4 2 2 3 2 .. 21 11 6 22 .. 22 17 Chorea .. .. .. 1 2 I .. .. .. .. .. .. 12 Encephalitis .. .. .. .... 10 .. 102 0 .. .. 40 Influenza .. .. .. .. .. .. .. .. 01 .. .. 01 111 health .. .. ..33 .. .. .. 01 .. 11 .. 45 Toxic .. .. ..20 .. 10 .. .. .. 02 .. 3 2 Arterio-sclerosis .. 6 4 .. .. .. 10 .. .. 74 Hemiplegia .. .. .. .. .. .. .. .. .. 01 .. 01 Organic brain-disease .. ..10 .. .. .. .. .. .. .. 10 Thyroid disease .. ..03 .. .. .. 10 .. .. .. 13 Heart-disease .. .. 0 2 1 ".. .. .. 02 .. .. .. 04 Diabetes .. .. ..10 .. .. .. .. .. . . .. 10 Privation .. .. .. .. .. .. .. . . . . 10 . . 10 Unknown .. .. 1 0 .. 122 3 1021 .. 76 Transfers .. .. ..946033 .. 61 51 27 1 10 57 10 Totals . . _ .. 106 106 90 85 j 79 65 I 7 J5 , 27 20 [192 140 I 59 28 3 11 563 460

« |[ j m . o £t - *3 Occupations. 2 co i3 Occupations. 2 c/2 ~ ; . *5 •« 2 r ■ w 3 -2 • ee '2 %3 9 « -3 • c3 3 a ;^0l o Ea^jS'S^^i S^S03J00» r ° PfO^OoJOO^O -sJOQMzifiiE-i^B Males. Accountants .. .. I j 2 .. .. 2 [Labourers .. .. j 32 29 23 31 2i 65 10 ..164 Agents .. .. 1 1 .. .. 2 | Lithographer .. .. j .. 1 | 1 Apprentice ,. .. 1 1 Machinist .. .. 1 1 Bakers .. .. 2 1 1.. .. 4 Manufacturer 1 .. .. 1 Bank-managers ..j.. .. 1 1 2 Masons .. .. 1 .. 1 2 Barmen .. .. j 1 1 .. .. 2 Mill employee 1 .. .. 1 1 Blacksmiths .. .. 2 1 1.... 1.... 5 Miners .. 1 2.. 3 Bootmakers .. .. .. 1 1.. .. 2 Motor-drivers .. 1 1 .. .. 2 Bricklayer .. 1 1 .. .. 1 Motor mechanics 2 .... 2 .... 4 Bushmen .. .. 2 2 Painters .. .. 2.. 2 4 Butchers .. .. 1 1 1.... 1 .... 4 Pensioners .. .. 1 4 4 1 .. 3 .. .. 13 Canvassers .. 3 .... 3 Plasterer .. .. 1 1 Carpenters .. .. 3 4 2.... 7 .... 16 Plumbers .. .. j .. 1 .. .. 1 1 .. .. 3 Carriers .. .. 1 .. 2 3 Porters . . .. | 1 .. 2 .... 3 Civil engineers 2 .. .. 2 Prisoners .. .. 3 ..[ 8 .... 11 Clergyman .. 1 .. 1 Railway employee .. I .. .. 1. Clerks .. .. .. 4; 1 .. .. 3 1 .. 9 Saddler .. .. 1 ..j 1 Coachbuilder .. .. 1 1 Salesmen .. I 2 .... 2 Company-manager .. 2 .. .. 2 School-teacher I 1 1 Confectioner .. 1 .. .. 1 Seamen ,. .. 1 2 1 4 Contractor .. 1 .. .. 1 Secretary .. .. 1 1 Cooks .. .. 2 4.. .. 6 Shepherds .. .. .. 2 2 Cooper .. 1 1 Shop assistant .. 1 1 Dentist .. .. .. 1 1 Soldier .. 1 .. .. 1 Draper .. 1 .. .. 1 Solicitor .. .. .. 1 .... | 1 Engineers .. 2 .... 2 Stewards .. ..j.. 1 .. .. j .. 3.. .. 4 Engine-drivers .. .. 3 2 5 Storekeeper .. .. I 1 .. .. 1 Farmers .. .. 10 6313731 34 Storemen ,. .. | .. 1 | . 4.. .. 5 Farmhands .. .. .. 2 30 2 .. 34 Surveyor .. .. 1 | .. ..j .. .. 1 Fellmonger .. .. 1 1 Tailor .. .. 1 .. ...... .. I .. .. 1 Firemen .. .. 1 .. j .. .. 1 1 .. .. 3 Telegraphist .. .. j .. 1 .. I .. i .. 1 j .. .. 2 French-polisher ; 1 .. .. 1 Timber-worker .. 1 .... • ■ j 1 Fruiterers .. .. 1 1 .. .. 2 Warehouseman .. j .. 1 .. .. 1 Gardeners .. .. .. 5 2.. .. 7 Wool-classer .. ...... j 1 1 .. j .. 1 .. .. 2 Grocers .. .. 1 3.... 4 No occupation .. j 10 IT 24 2 12 8 12 .. 79 Groom .. 1 1 Unknown .. .. 5 .. I .. .. I 5 Hairdressers .. .. 1.. 1 2 Transfers .. .. 9 6 3 .. 6 5 27 1 57 Hawkers .. .. 1 J .. 2 Horse-trainer .. .. 1 1 Totals .. 106 90 79 7 27 192 59 3 563 Ironmonger .. 1 .... 1 i Females. Artist .. ...... 1 1 .. .. 1 School-teachers .. 1 5 1 ...... 1 1 9 Clerks .. .. 3 .. | .. 1 .. 4 Shop-assistants .. 1.... 1 2 Domestic duties .. 79 68 50 4 12132 24 7 376 Storekeeper .. 1 1 Dressmaker .. 1 1 Tailoresses .. .. 1 1 2 Librarian .. .. .. 1 1 Waitress 1 .. .. 1 | Music-teacher.. .. 1 1 No occupation .. 13 6 8 .. 7 4 1 .. 39 j Nurses .. .. 2 1 1 4 Transfers .. .. 4 .. 3 .. 1 2 1 .. 11 Pensioners .. .. 1 4 2 7 — Prisoners .. .. ..| li .. ■■ 1 Totals .. 106 85 65j 5 20141 28 11461

H.—7

20

Table XV.-Showing the Admissions, Discharges, and Deaths, with the Mean Annual Mortality and Proportion of Recoveries per Cent. of the Admissions, for each Year since 1st January, 1876.

. * ; 7 — — — * I j I I Discharged. Remaining, ' averaffs Numbers Percentage Percentage of Deaths Year. Admitted. I Died. 31st December in rAident of Recoveries on on Average Numbers Recovered. Relieved. Not Improved. each Year. j ' j Admissions. ; resident. I i r . j i\j. K. | T. >1. F. T. M. F. T. M. F. T. H. I F. T. M. F. T. M. F. T. M. F. T. M. F. T. 1875 . ■ ■ • 482 254 736 1876 .. 221 117 338 129 79 208 17 8 25 2 8 10 36 12 48 519 264 783 491 257 748 54-53 66-01 57-56 S-21 3-58 6-70 1877 .. 250 112 362 123 57 180 20 5 25 3 2 5 42 ; 21 63 581 291 872 541 277 818 49-20 50-80 49-72 7 76 7-58 7-70 1878 .. 247 131 378 121 68 189 14 14 28 4 4 8 51 I 17 68 638 319 957: 601 303 904 48-98 51-90 50-00 8-48 5-61 7-52 1879 .. 248 151 399 112 76 188 15 13 28 9 4 13 55 16 71 695 361 .1,056; 666 337 1,003 45-16 50-33 47-11 8-25 4-74 7-07 1880 .. 229 149 378 100 67 167 36 25 61 5 2 7 54 20 74 729 396 1,125; 703, 371 1,074 43-66 44-96 44-17 7-68 5-39 6-89 1881 .. 232 127 359 93 65 158 41 36 77 9 2 11 49 14 63 769 406 1,175 747 388 1,135 40-08 51-10 44-01 6-29 3-60 5-55 1882 .. 267 152 419 95 59 154 49 32 81 5 6 11 60 19 79 S27 442 1,269 796 421 1,217 35-58 38-81 36-75 7-53 4-51 6-49 1883 .. 255 166 421 102 78 180 13 20 33 10 9 19 65 18 83 892 483 1,375 860 475 1,335 40-00 46-98 42-75 7-55 3-78 6-21 1884 .. 238 153 391 89 77 166 17 9 26 18 12 30 68 24 92 938 514 1,452: 911 497 1,408 37-39 50-32 42-45 7-46 4-82 6-53 1885 .. 246 133 379 95 76 171 10 5 15 25 2 27 73 22 95 981 542 1,523 965 528 1,493 38-62 57-14 45-12 7-56 4-16 6-36 1886 .. 207 165 372 99 60 159 11 17 28 12 7 19 57 19 76 1,009 604 1,613 984 559 1,543 47-82 36-36 42-74 5-79 3-39 4-91 1887 .. 255 161 416 103 78 181 34 17 51 74 27 101 1,053 643 1,696 1,034 613 1,647 40-39 48-75 43-61 7-15 4-40 6-13 1888 .. 215 146 361 116 92 208 31 28 59 2 3 5 78 26 104 1,041 640 1,681 1,045 641 1,686 53-95 63-01 57-62 7 56 4-05 6-16 1889 .. 230 161 391 93 53 146 31 30 61 3 1 4 70 30 100 1,074 687 1,761 1,046 660 1,707 40-43 32-92 37-34 6-69 4-54 5-86 1890 .. 230 160 390 98 88 186 23 17 40 12 5 17 76 35 111 1,095 702 1,797 1,078 685 1,763 42-61 55-00 47 69 7-05 5-11 6-29 1891 .. 234 171 405 88 74 162 33 24 57 14 .. 14 79 41 120 1,115 734 1,849 1,089 699 1,789 37-61 43-27 40-00 7-25 5-86 6-71 1892 .. 231 158 389 89 76 165 21 17 38 8 2 10 74 34 108 1,154 763 1,917 1,125 714 1,839 38-53 48-10 42-42 6-58 4-76 5-S7 1893 .. 281 179 460 101 89 190 17 12 29 10 8 18 78 23 101 1,229 810 2,039 1,172 758 1,930 35-94 49-72 41-30 6-66 3-03 5-23 1894 .. 270 176 446 107 76 183 15 11 26 5 4 9 64 35 99 1,308 860 2,168 1,241 812 2,053 39-63 43-13 41-03 5-16 4-31 4-82 1895 .. 252 165 417 105 77 182 24 19 43 1 2 3 101 42 143 1,329 885 2,214 1,313 849 2,162 41-67 46-66 43-64 7-69 4-94 6-61 1896 .. 278 159 437 104 70 174 25 16 41 2 1 3 86 32 118 1,390 925 2,315 1,347 882 2,229 37-41 44-02 39-13 6-38 3-63 5-29 1897 .. 284 193 477 102 73 175 17 12 29 10 .. 10 105 43 148 1,440 990 2,430 1,411 944 2,355 35-92 37-82 36-69 7-44 4-55 6-28 1898 .. 254 212 466 114 110 224 13 23 36 7 1 8 88 60 148 1,472 1,008 2,480 1,438 973 2,411 44-88 51-89 48-07 6-12 6-17 6-14 1899 .. 259 199 458 88 99 187 15 19 34 2 1 3 114 43 157 1,512 1,045 2,557 1,487 1,004 2,491 33-98 49'49 40-83 7-67 4-28 6-30 1900 .. 300 202 502 103 96 199 29 10 39 4 4 99 46 145 1,581 1,091 2,672 1,534 1,049 2,583 34-33 47-54 39-64 6-45 4-38 5-61 1901 .. 320 223 543 125 104 229 20 17 37 2 2 102 72 174 1,654 1,119 2.773 1,622 1,094 2,716 39-06 46-64 42-17 6-29 6-58 6-41 1902 .. 352 192 544 135 99 234 26 15 41 10 9 19 120 55 175 1,715 1,133 2,848 1,671 1,114 2,785 38-35 51-56 43-01 7-18, 4-94 6-28 1903 .. 355 226 581 144 101 245 26 i 24 50 2 2 129 44 173 1,771 1,188 2,959 1,741 1,160 2,901 40-56 44-69 42-17 7-41 3-79 5-96 1904 .. 332 236 568 157 106 263 24 11 35 1 1 120 70 190 1,801 1,237 3,038 1,780 1,198 2,978; 47-59 44-91 46-30 6-74 5 84 6-38 1905 .. 360 251 611 149 121 270 29 24 53 147 67 214 1,836 1,276 3,112 1,796 1,232 41-39 48-21 44-19 8-18 5-44 7-07 1906 .. 395 264 659 157 126 283 28 22 50 1 1 146 85 231 1,900 1,306 3,206 1,823 1,265 3,088 39-75 47-73 42-94 8-01 6-71 7-48 1907 .. 359 241 600 160 139 299 22 13 35 168 64 232 1,909 1,331 3,240 1.851 1,285 3,136 44-29 57-68 49-84 9-08 4-98 7-39 1908 .. 426 318 ! 744 180 146 326 9 12 21 1 1 148 74 222 1,997 1,417 3,414 1,894 1,346 3,240 42-25 45-91 43-82 7-81 5-50 6-85 1909 .. 419 297 716 179 170 349 17 11 28 1 1 136 68 204 2,083 1,465 3,548 1,970 1,404 3.374 42-72 57-24 48-74 6-90 4-84 6-00 1910 .. 474 314 788 182 145 327 29 27 56 186 97 283 2,160 1,510 3,670 2,028 1,445 3,473 38-40 46-18 41-50 9-17 6-71 8-15 1911 .. 448 317 765 163 168 331 23 16 39 4 2 6 198 105 303 2,220 1,536 3,756 2,105 1,496 3,601 36-38 53-00 43-27 9-41 7-02 8-41 1912 .. 458 381 839 184 141 325 17 44 61 11 5 16 193 87 280 2,273 1,640 3,913 2,146 1,551 3,697 40-17 37-01 38-74 8-99 5-61 7-57 1913 .. 466 318 784 175 162 337 35 48 83 1 5 6 196 111 307 2,332 1,632 3,964 2,252 1,597 3,849 37-55 50-94 42-98 8-70 6-96 7-98 1914 .. 509 359 868 207 162 369 27 29 56 6 9 15 193 88 281 2,408 1,703 4,111 2,309 1,64! 3,950 40-67 45-12 42-51 8-36 5-36 7-11 1915 .. 450 361 811 202 157 359 ! 26 32 58 10 11 21 172 112 284 2,448 1,752 4,200 2,391 1,703 4,094 44-89 43-21 44-88 7-19 6-58 6-94 1916 .. 518 361 879 160 171 331 35 34 69 7 8 15 209 80 289 2,555 1,820 4,375 2,483 1,768 4,251 30-89 47-37 37-66 8-42 4-52 6-80 1917 .. 470 374 844 171 152 323 32 20 52 6 5 11 205 113 318 2,611 1,904 4,515 2,54-3 1,825 4,368 36-38 40-64 38-27 8-06 6-19 7-28 1918 .. 437 402 839 142 141 283 i 17 36 53 12 12 24 274 174 44S 2,603 1,943 4,546 2,602 1,899 4,501 32-49 35-07 33-73 10-53 9-16 9-95 1919 .. 512 371 883 190 147 337 : 37 44 81 9 13 22 212 130 342 2,667 1,980 4,647 2,620 1,907 4,527 37-11 39-62 38-17 8-09 6 82 7-55 1920 .. 455 418 873 162 148 310: 27 37 64 6 10 16 210 166 376 2,717 2,037 4,754 2,674 1,980 4,654 35-63 35-32 35-51 7-85 8-40 8-08 1921 .. 479 402 881 178 193 371 30 21 j 51 15 9 24 201 117 318 2,772 2,099 4,871 2,723 2,031 4,754 37-23 47-88 42-11 7-38 5-76 6-69 1922 .. 453 386 839 156 157 313 32 20 52 10 8 18 211 184 395 2,816 2,116 4,932 2,747 2,062 4,809 34-44 40-67 37-31 7-67 8-92 8-21 1923 .. 442 366 808 168 151 319 42 38 80 15 5 20 194 131 325 2,839 2,157 4,996 2,789 2,079 4,86S 38-00 41-25 39-48 6-95 6-30 6-67 1924 .. 446 377 823 152 128 280 30 42 72 9 11 20 221 95 316 2,873 2,258 5,131 2,808 2,146 4,953 34-08 33-95 34-02 7-87 4-42 6-37 1925 .. 445 430 875 144 175 319 29 37 66 23 17 40 201 123 324 2,921 2,336 5,257 2,830 2,203 5,033 32-36 40-69 36-45 7-45 5-57 6-43 1926 .. 508 439 947 136 145 281 27 35 62 15 25 40 207 147 354 3,044 2,423 5,467 2,926 2,287 5,213; 26-18 30-75 29-67 6-16 6-42 6-77 1927 .. 531 414 945 157 128 285 40 42 82 14 9 23 217 132 349 3,147 2,526 5,673 3,022 2,373 5,395 29-56 30-91 30-16 7-17 5-65 6-47 1928 .. 506 450 956 115 134 249 40 40 80 17 13 30 207 161 368 3,274 2,628 5,902 3,120 2,459 5,579 22-72 29-77 26-04 6-63 6-55 6-59 18,538 13,486 32,024 7,099 5,930 ' 13,029 1,347 1,230 2,577 381 281 662 6,919 3,671 ! 10,590 _ .. ■ • .. * ' Excluding transfers between institutions —1,572 males, 1,041 females

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Table XVJ.— Showing the Admissions, Discharges, and Deaths from Ist January, 1876, to 31st December, 1928 (excluding Transfers). M. F. T. [n hospitals, 31st December, 1875 .. .. .. 482 254 736 Admissions .. .. .. . 18,538 13,486 32,024 19,020 13,740 32,760 Discharged— ji. F. T. Recovered .. 7,099 5,930 13,029 Relieved .. 1,347 i >2 3o 2,577 Not improved . 381 281 662 Died •• -- . 6,919 3,671 10,590 : 15,746 11,112 26,858 Remaining on 31st December, 1928 .. .. .. 3,274 2,628 5,902

Table XVII. —Summary of Total Admissions: Percentage of Cases since the Year 1876.

Males. Both Sexes. Recovered .. .. .. .. .. 38-29 43-97 41-93 Relieved .. .. .. .. .. 7-26 9-12 8-04 Not improved .. .. .. .. .. ; 2-05 2-08 2-06 Died .. .. .. .. .. .. | 37-32 27-22 33-06 Remaining .. .. .. .. .. j 15-08 17-61 14-91 100-00 | 100-00 100-00

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Table XVIII.-Debits for the Financial Year 1928-29.

Auckland. Christchurch. Dunedin. Hokitika. Nelson. Porlrua. Tokanui. Head Office. Total. £ s. d. £ s. d. £ s. d. £ s. d. £ s. d. £ s. d. £ s. d. £ s. d. £ s. d. Salaries .. 35,061 14 3 39,512 17 1 50,660 8 0 14,387 4 7 18,302 1 6 47,907 7 6 18,510 1 3 6,020 18 6 230,362 12 8 Official visitors ' . . . • • • • ■ 50 8 0 18 18 0 14 14 0 9 9 0 .. 31 5 0 27 1 8 .. 151 15 8 Advertising, books, &e. .. .. •• •• 2 15 0 8 12 0 7 17 7 799 ® J J ?aiao f 14 111 89 11 Bacteriological research .. • • 0 10 6 9 9 0 0 4 6 .. 0 9 0 19 10 2 3 14 9 .. 33 17 11 Bedding and clothing ■■ •• 5,531 17 0 4,901 6 1 6,240 13 3 1,153 3 10 2,023 1 11 7,328 19 0 2,317 6 8 .. 29,496 7 9 Buildin|s, including additions, &c 1,113 8 5 1,798 7 6 1,468 9 4 382 4 0 451 3 7 1,320 13 9 1,277 1 1 .. 7,811 7 8 Compensation under Workers' Compensation Act .. • ■ • ■ 900 0 0 .. .. .. .. .. 900 0 0 Dental services .. .. . - . • • • 10 4 0 123 5 2 7 5 5 1 15 0 4 2 6 100 15 2 2 4 0 .. 249 11 3 Developmental .. .. •• •• •• •• •• •• •• mo' n a 6/5 89 .. 675 8 9 Fares and expenses of four medical officers' families from 157 7 4 151 3 5 157 7 5 .. .. 168 9 2 .. .. 634 7 4 United Kingdom Farms maintenance of .. .. •• 927 3 11 1,479 0 7 2,165 8 5 208 5 7 1,573 16 11 1,794 14 10 2,778 2 0 .. 10,926 12 3 Fencing, draining, and roading .. ■ - • • 115 10 0 102 6 2 515 10 9 96 15 8 141 7 11 273 9 2 541 15 3 . . 1,786 14 11 Freight, cartage, and transport 18 19 9 131 19 5 456 19 9 44 8 4 183 10 1 307 14 2 95 14 4 .. 1,239 5 10 Fuel! light, water, &c. . •• •• 5,365 4 9 5.562 9 4 5,976 0 3 964 14 6 2,585 111 6,040 6 3 2,099j£7 11 33 19 2 28,627 4 1 Funeral expenses of officer who died as result of injury on . . .. 34 17 0 .. .. .. .. .. 34 17 0 duty Funerals expenses of .. .. • ■ ■ • 84 2 6 36 0 0 41 0 0 10 0 0 53 15 0 107 15 0 49 0 0 .. 381 12 6 Furniture and furnishings .. .. ■■ 381 10 5 515 1 9 475 18 7 55 19 0 260 18 5 694 7 4 569 17 3 799 11 9 3,753 4 6 Gardens and shrubberies, expenses of .. .. 51 6 6 159 13 5 30 18 10 85 14 6 10 16 0 33 17 2 41 8 5 .. 413 14 10 Grants to— Relative of officer (deceased) equivalent of leave due.. .. .. 11 13 4 .. .. .. .. .. 11 13 4 Officer retired medically unfit .. .. .. .. • • - • - • 23 4 6 .. .. .. 23 4 6 Laundry .. .. •• •• •• 216 16 10 363 18 9 2,114 1 7 910 17 7 192 18 5 470 16 6 191 2 7 .. 4,460 12 3 Legal and inquiry costs .. . • ■ • ■ • . ■ ■ ■ • • • • 6 8 6 13 14 0 .. .. 20 2 6 Machinerv, repairs, and stores .. .. .. 154 5 2 172 18 1 331 3 0 13 10 4 92 o 1 155 5 11 1/7 12 5 .. 1,097 0 0 Medical fees for certificates, &c. .. .. .. 471 15 6 401 6 0 315 10 0 17 8 0 54 14 0 705 16 0 12 2 19 6 .. 2,089 9 0 Motor-vehicles, maintenance of .. .. .. 45 3 4 94 11 10 176 8 0 23 18 0 141 1 2 147 3 8 118 15 10 .. 747 1 10 Motor-vehicles, purchase of .. .. .. .. 285 0 0 482 17 3 .. .. 225 17 4 .. .. 993 14 7 Nursing staff — Engagement of . • • • • • • • . ■ 0 17 6 .. .. 0 10 0 11 3 0 0 15 0 .. 13 5 6 Uniforms, purchase of .. .. .. .. 398 1 0 315 4 9 470 14 6 303 13 0 188 3 11 229 3 0 171 17 3 .. 2,076 17 5 Office equipment .. •• •• •• - - 4 16 4 912 25 11: 065 326 389 32 5/ /6 24 131 9 0 Patients' expenses connected with — Gratuities .. .. .. •• ■■ 121 16 8 14 4 8 162 8 10 36 11 4 130 16 4 79 10 0 22 9 9 .. 567 17 7 " Patients' friends" .. • • - • - • ■ • | 16 13 4 100 0 0 .. .. .. .. .. 116 13 4 Recreation •• •• •• 1,203 14 0 1,243 5 7 1,777 10 8 354 15 3 505 3 1 1,332 5 1 709 9 9 .. 7,126 3 5 Transfers • • • • • • 11 3 6 8 17 7 0 10 8 15 8 11 18 19 1 101 10 7 23 3 0 .. 179 13 4 Postages and telegrams .. 58 7 6 90 11 8 108 10 6 9 8 1 35 7 3 142 7 7 47 14 1 190 9 7 682 16 3 Printing and stationery .. .. •• •• 169 2 1 196 2 8 185 1 11 51 8 9 68 14 0 188 10 2 84 11 4 233 6 3 1,176 17 2 Rations •• •• 16,560 19 o! 12,417 11 2 17,484 11 2 4,473 15 11 6,434 12 2 20,203 9 5 4,139 16 2 .. 81,714 15 0 Rents and rates ! 1,999 17 0 103 8 1 .. .. .. .. 604 0 5 2,707 5 6 Stores .. .. .. •• •• •• 620 4 11 j 1,'006 11 11 922 7 11 136 18 0 435 8 6 1,802 19 5 411 7 6 .. 5,335 18 2 Surgery and dispensary — Drugs and instruments .. .. •• •• 210 9 3 i 180 10 1 192 3 10 71 12 5 188 9 10 394 18 3 167 19 3 .. 1,406 2 11 Wines, spirits, ale, and porter .. ■ • • • • . 7 13 9 19 10 10 0 9 2 5 10 0 5 14 0 • • . • 38 17 9 Telephone services .. .. .. ■ • 106 8 7 97 1 5 240 3 6 21 1 0 44 5 8 173 3 0 53 17 5 133 8 7 869 9 2 Transfer and removal expenses .. • • • • 138 16 1 66 10 11 70 1 3 4 8 2 .. 24 16 6 96 8 9 53 19 7 455 1 3 Travelling-allowances .. .. •• 300 10 14 49 4 4 16 10 7 /I 12 3 1 15 8 22 3 11 277 0 1 451 8 2 Travelling-expenses .. .. .. ] 79 11 5 61 6 10 242 9 5 35 2 0 38 6 2 92 0 0 52 13 8 302 5 8 903 15 2 Treatment and maintenance in general hospitalsPatients .. . .. •• 4 12 0 •• 43 1 0 5 6 6 70 16 0 83 16 6 .. .. 207 12 0 Staff .. .. . . .. .. • • 53 19 6 22 2 9 3 13 0 1 1 0 .. 27 7 0 .. .. 108 3 3 Contingencies .. .. . . .. .. 5 17 6 0 10 6 1 2 10 4 2 2 2 16 6 1 12 6 0 0 6 6 12 0 22 14 6 Total expenditure .. .. .. 69,511 2 6 73,593 0 2 94,764 6 5 23,914 16 4 34,349 13 8 92,767 13 6 35,656 12 3 8,746 5 0 433,303 9 10 Credits .. .. .. .. . ■ 21,738 14 5 24,431 16 6 29,339 10 11 2,480 15 9 9,373 11 4 33,361 14 5 9,247 1 0 30 7 8 130,003 12 0 Net expenditure .. .. .. 47,772 8 1 49,161 3 8 65,424 15 6 21,4-34 0 7 24,976 2 4 59,405 19 1 26,409 1.1 3_ 8,715 17 4 303,299 17 10

23

Table XX.-Expenditure, out of Public Works Fund, on Mental Hospital Buildings, etc., during the Financial Year ended 31st March, 1929, and Liabilities at that Date.

Table XVIIIa.-Credits for the Financial Year, 1928-29.

Auckland. Christchurch. Dunedin. Hokitika. Nelson. Porirua. Tokamii. Head; Office. Total: . . - £ s. d. £ s. d. £ s. d. £ s. d. £ s. d. £ s. d. £ s_ d. £ s. d. £ s, d.. Receipts for maintenance .. .. .. .. 20,505 7 7 20,048 7 10 23,719 5 2 1,857 14 9 7,452 0 10 30,660 14 6 ! 7,028 2 1 .. 111,271 12 9 Receipts for farms .. .. .. .. i 526 5 10 3,200 15 2, 1,698 11 9 62 11 6 1,489 19 8j 1,067 9 7 1,645 19 4j .. i 9,68112 10 Miscellaneous .. .. .. .. .. 707 1 0 1,182 13 6 3,921 14 0 560 9 6 431 10 10 i 1,643 10 4 j 572 19 7 , 30 7 8 9,050' 6 5 ' 1 1 ; ; 1 Totals .. .. .. .. . . 21,738 14 5 , 24,431 16 6 29,339 10 11 2,480 15 9 9,373 11 4 j 33,361 14 5 : 9,247 1 0 j 30' 7 8 j 130,003 12 0 Table XIX. —Average Cost of each Patient per Annum. Average ! i I w I Number Bedding Buildings Fuel, Light, Surgery ~ , v] . , ! Total Cost : _~f' i | Other Net Cost I Net Cost Decrease Increase Mental Hospital. I resident Salaries. and and Farm. Water, and Provisions. and P er Main ! Ee " P er 1 Previous in i n '(inclusive of Clothing. Repairs. Cleaning. Dispensary. f I | Patient tenance ! P a y ment9 - Patient, i Year. 1928-29. 1928 29 Boarders). i ' £ s. d. £ s. d. j £ s. d. £ s. d. 1 £ s. d. £ s. d. £ s. d. £ s. d. £ s. d. £ s. d. £ s. d. £ s. d. £ s. d. ; £ s. d. £ s. d. : £ s. d. Auckland .. 1,205 29 2 9} 4 11 9}i 0 18 1 If 0 15 4} 4 9 0J 13 14 10| 0 3 6 .. 3 17 4 57 13 8-1 17 0 4 1 0 5| 39 12 11 39 13 7.J 0 0 8| Christchurch .. 903 43 15 11J 5 8 6} ] 19 10 1 12 9 6 3 2} 13 15 0J 0 4 0 , 0 0 2 8 10 6 81 9 11+ 22 4 0J 4 17 1 54 8 10 52 10 0J .. 1 18 9£ Dunedin (Seaoliff) .. 1,206 42 2 0 5 3 6 ' 1 4 4J ] 15 11 4 19 l|-14 10 0 0 3 2} 0 0 4 8 13 1J 78 11 6 19 13 U 4 13 2| 54 4 11 53 7 5J .. 17 5£ Hokitika .. .. 205 70 6 8 5 12 6 1 17 3J 1 0 4 4 14 1J 21 16 6 0 7 0 0 0 0110 18 8016 13 lfj 9 1 3 3 0 9J104 11 1-J-I88 7 4 .. 16 3 9| Nelson .. .. 426 42 19 3 4 15 0 ! 1 1 2 3 13 10f 6 1 4J 15 2 1 0 8 10 0 0 3 6 10 9| 80 12 8 17 9 10J 4 10 2| 58 12 7 157 5 10 .. 1 6 9 Porirua .. .. 1,4:64 32 14 10} 5 0 li! 0 18 0J 1 4 6J 4 2 6J 13 16 0 0 5 4| 0 0 1 5 5 8J 63 7 3} 20 18 10 J 1 16 10J 40 11 6f!37 2 11 .. 3 8 7} Tokanui .. .. 391 47 8 2} 5 18 6J 3 5 4 8 16 lb 5 7 4} 10 11 9 0 8 7 .. 9 7 ,U 91 3 10$ 17 19 6 5 13 6 67 10 10|-!50 10 9£! .. 17 0 1 Head Office (Welling- .. 1 0 9} .. .. .. .. .. .. -• 0 9 4} 1 10 2 .. 0 0 1} 1 10 Oft 1 10 1 ton) : ; 1 — — Totals .. 5,800 39 15 3J 5 1 8f 1 6 11| 2 0 0 4 18 8f 14 1 9|| 0 5 10J 0 0 1| 7 3 8| 74 14 1J 19 3 8J 3 4 7 52 5 10jl49 6 9J| 1 2. 19 1J

Date. . J . • •: I . " j -it *■ i tt •+■ i ' Expenditure for Year i Liabilities Mental Hospitals. ! ended 31st March, 1929. | on 31st March, 1929. £ £ Auckland .. .. .. .. . • 12,461 5,860 Christchurch (Sunnyside) .. .. .. .. •• 7,777 715 Hokitika.. .. .. .. .. .. •• 401 214 Nelson and Stoke.. .. .. . • • • ♦ • 956 493 Porirua .. .. .. .. •• •• *• 27,315 566 Seacliff .. .. .. .. .. •• •• 27,132 310 Tokanui .. .. .. .. .. •• •• 19,887 2,635 Waitati .. .. .. .. .. • • - • i 853 otal .. .. .. •• •• 96,782 10,793

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24

Table XXI.-Total Expenditure, out of Public Works Fund, for Buildings and Equipment at each Mental Hospital from 1st July, 1877. to 31st March, 1929.

By Authority : W. A. G. Skinner, Government Printer, Wellington.— 1929.

Approximate Cost of Paper.—Preparation, not given ; printing (625 copies), £37 10s.

Price 9d .]

j Total _ Mental Hospitals. 1877-1920. 1920-21. ' 1921-22. 1922-23. 1923-24. 1924-25. 1925-26. 1926-27. 1927-28. 1928-29. jSfy llOT* 6 ' to 31st March, 1929. £ £ £ £££££££ £ Auckland .. .. .. .. 152,245 8,040 9,013 777 5,188 2,393 2,073 19,988 12,213 12,461 224,391 Ohristchurch (Sunnyside) .. .. 185,334 5,139 3,494 2,245 1,497 6,272 2,901 7,229 10,164 7,777 232,252 Dunedin (The Camp) .. .. .. 4,891 .. .. .. .. .. .. .. .. .. 4,891 Hokitika .. .. .. .. 3,727 .. 984 4,789 10,216 16,013 8,034 1,745 141 401 46,050 Hornby .. .. .. .. 7,370 928 2,682 122 .. .. .. .. .. .. 11,102 Motuihi Island .. .. .. 561 .. .. .. .. .. .. .. .. .. 561 Napier .. .. .. .. 147 .. .. .. .. .. .. .. .. .. 147 Nelson .. .. .. .. 26,253 3,496 3,316 1,929 1,429 2,389 1,182 805 .. 956 41,755 Richmond .. .. .. .. 1,097 .. .. .. .. .. .. .. .. .. 1,097 Seacliff .. .. .. .. 183,699 40 3,389 1,602 1,246 3.016 4,767 17,888 9,408 27,132 252,187 Stoke .. .. .. .. .. .. 337 1,450 3,095 12,568 2,691 753 .. 21,704 Tokanui .. .. .. .. 80,340 5,381 9,774 515 2,743 16,076 8,097 1,658 2,124 19,887 146,595 Waitati .. .. .. .. 9,783 3,620 3,217 848 194 .. .. 637 .. 853 19,152 Wellington .. .. .. .. 29,641 .. .. .. .. .. .. .. .. ,. 29,641 Wellington (Porirua) .. .. .. 206,437 724 5,969 688 2,578 18,374 38,213 16,004 16,315 27,315 332,617 Totals .. .. .. 891,525 27,368 41,838 j 13,852 26,541 68,438 77,835 68,635 51,118 96,782 1,363,932