MENTAL HOSPITALS OF THE DOMINION. (REPORT ON) FOR 1938.

Appendix to the Journals of the House of Representatives, 1939 Session I, H-07

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1939. NEW ZEALAND.

MENTAL HOSPITALS OF THE DOMINION. (REPORT ON) FOR 1938.

Presented to both Houses of the General Assembly ■pursuant to Section 78 of the Mental Defectives Act, 1911.

The Director-General to the Hon. P. Fraser, Minister in Charge of the Department of Mental Hospitals. g IR Wellington, Ist June, 1939. I have the honour to present my annual report upon the work of the Department of Mental Hospitals for the year ended 31st December, 1938. Statistical. There were 8,149 names of persons upon the registers at the end of the year, including 44 patients and boarders at Ashburn Hall Private Licensed Institution, and 637 patients and boarders who were absent on probation in the care of friends and relatives. In actual residence in State hospitals on 31st December there were 7,472 persons, a decrease of 80 compared with the previous year, and of this number, 7,151 were subject to a reception order, whilst 321 were voluntary boarders. There was a slight increase of 26 in the number admitted for the first time, the relative figures being 1,149 for this year and 1,123 for last year, and 282 former patients and boarders returned to the hospitals. Of all classes of admissions we were able to discharge 924, or 64-50 per cent., calculated upon the admissions, but not more than 517, or 36-12 per cent., could be regarded as fully recovered. These figures refer to all classes of admissions, including voluntary boarders, but most countries in compiling their mental hygiene statistics now differentiate between cases of acquired mental disorder and those of congenital origin, including idiots, imbeciles, and the feeble-minded. In New Zealand, partly because it is only within recent years that we have established separate institutions for the congenitally deficient, this practice has not hitherto been followed, with the result that erroneous conclusions have tended to be drawn as to the incidence of mental disease by those unfamiliar with the system followed. Not only does the grouping of these classes under one heading lead to fallacious comparison of our statistics with other countries, but it tends to mislead in other directions. For example, the establishment of the children's clinics at Auckland and Wellington has considerably increased the " ascertainment " of mental deficiency, and the provision of Templeton Farm Colony and Nelson Hospital as separate institutions for children has greatly increased the number of congenital cases coming under our care. This is shown by the rise in the proportion of congenital cases in our certified institution population from 18-2 per cent, in 1927 to 26-6 per cent, in 1938. The percentage of congenital cases admitted rose in the same period from 11*8 per cent, to 17-5 per cent., and as our " recovery rate " has been based upon the total number admitted any comparisons as to'the results of treatment in the intervening years must be fallacious unless account is taken of the factors recited above. The true position is disclosed in the subjoined tables, in which cases of acquired mental disorders are separated from cases of congenital mental deficiency.

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(1) Mental Disorders.

2. Mentally Deficient.

Prom Table No. 1 it will be seen that of those who were admitted under a reception order as suffering from mental disorders 60-07 per cent, were discharged, and of these, 40-6 per cent, had recovered. In the same class the ratio to population of the admissions, including Maoris, was 5-66 (males 5-03, females 6-31) per 10,000 mean population, and of first admissions 4-71 (males 4-15, females 5-25) so that 1,778 persons in the general population contributed one patient and 2,135 contributed a patient admitted for the first time.

Voluntary Boarders.

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Male. Female. Total. Male. Female. Total. In mental hospitals, 1st Januarjr, 1938 .. 3,104 2,708 5,812 Admitted for first time .. .. .. .. 339 419 758 Readmitted .. .. .. .. 71 80 151 — 410 499 909 Total under care during year .. .. .. 3,514 3,207 6,721 Discharged—Recovered .. .. .. .. .. 162 207 369 Not recovered .. .. .. .. 90 87 177 Died .. .. .. .. .. 220 238 458 472 532 1,004 Remaining in mental hospitals 31st December, 1938 .. 3,042 2,675 5,717

Male. I-Female. Total. Male. Female. Total. In mental hospitals, 1st January, 1938 .. . 1,248 837 2,085 Admitted for first time .. .. .. .. 106 69 175 Readmitted .. .. .. .. . . 11 7 18 117 76 193 Total under care during year .. .. .. 1,365 913 2,278 Discharged .. .. .. .. 58 51 109 Died .. .. .. .. .. 53 36 89 HI 8 7 i9 8 Remaining in mental hospitals 31st December, 1938 .. 1,254 826 2,080

I " | " ""i | r * v „„ r First 1 Not First Total ?„ ra Si'S e i ,v .> . Bemaining " ' Admission, i Admission. Admissions. ? iDied. Discharged. on of Patients. 31st December. M. If. T. M. F. T. M. F. T. M. F. T. M. F. T. M. F. T M F T 1312 .. .. 6 17 23 0 0 0 6 17 23 1 3 4 0 0 0 4 3 7 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 24 36 58 94 3 3 6 0 2 2 26 42 68 26 43 69 1920 .. .. 26 38 64 16 12 28 42 50 92 3 4 7 1 2 3 33 33 66 31 54 85 1921 .. .. 39 39 78 U 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 J20 73 97 170 1927 .. ..70 70 140 25 32 57 95 102 197 8 6 14 5 12 17 75 58 133 80 123 203 1928 .. ..120 94 214 37 39 76 157 133 290 8 10 18 10 8 18 102 97 199 117 141958 1929 .. ..102 63 165 50 43 93 152 106 258 11 3 14 9 9 18 119 110 229 130 125 255 1930 .152 84 236 41 35 76 193 119 312 15 9 24 8 6 14 130 79 209 170 150 320 1931 .. 166 98 264 43 36 79 209 134 343 11 14 25 11 7 18 159 102 261 19S 16] 359 1932 .. ..150 85 235 50 40 90 200 125 325 24 32 56 14 5 19 190 108 298 170 141 311 1933 .. . . 112 100 221 53 32 85 165 141 306 11 14 25 5 4 9 121 107 228 198 157 355 1934 .. .. 132 90 221 56 33 89 188 123 311 7 11 18 10 6 16 152 99 251 217 164 381 1935 .. .. 130 87 217 40 55 95 170 142 312 18 20 38 19 10 29 151 116 267 199 160 359 1936 .. 98 99 197 62 44 106 160 143 303 21 20 41 7 10 17 137 111 248 194 162 356 1937 .. .. 103 91 194 64 45 109 167 136 303 14 7 21 6 10 16 163 122 285 178 159 337 1938 .. .. 111 105 216 60 53 113 171 158 329 II 15 26 II ,8 19 144 125 269 183 169 352

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If we omit cases of congenital mental deficiency, who are not eligible for admission under this category, voluntary boarders now form slightly over 25 per cent, of our admissions During 1938 there were 329 voluntary admissions, of whom 269 or 81-7 per cent, were mthm tvrelve months. In the case of 26 boarders whose mental disorder became m degree sufficiently pronou and sustained as to render it improper for them to remain on a voluntary basis, a reception order was granted. Alterations, Additions, and Improvements. Capital expenditure incurred upon new buildings, additions, and improvements during the year amounted to £128,816, and the following summary shows the ma]or items making up the to . Auckland (£907). Water-supply has been improved for fiie-fighting purposes. The new kitchen at M. 3 Ward has been completed. King seat (£71,149). The hospital block is now complete and will be occupied at an early date. hntoherv The boiler-house and laundry machinery has been installed and is now in operation. he butche y and bakery will be in use at an early date. Two male villas and a Nurses' Home are in course of erection. The workshops block and garages for departmental vehicles are neanng completion. Residences for the Medical Superintendent and Engineer have been completed. Necessary roading, water-supply, and telephone services have been extended. Tokanui (£6,903). The provision of separate kitchens in wards has been of great advantage. The water-supply to the institution has been improved. A new villa for male patients should be ready for occupation during the coming year. Porirua (£23,948). The new boiler-house and workshops block will be ready for occupation at an early date. The new bakehouse and butcher's shop is in course of erection. A cottage has been provided for an additional Assistant Medical Officer. The general roading has been improved during the year. Nelson and Ngawhatu (£15,458). The Nurses' Home is nearing completion and will be occupied at an early date. Three new villas are in course of erection. Ilokitika (£1,140). A commencement has been made with the erection of two additional villas. A bicycle-shed has been erected for the use of staff. Ohristchurch (£5,974). Templeton Farm Colony (£810). The equipment for the new laundry has been installed and will be in operation at an early date. Seacliff (£2,527). A new sick-bay with surgery has been erected in F. 4 Ward At Waitati a new kitchen and bathroom have been added to 1.1 Ward. Programme for Current Year. i 1,1 j a TIPW entrance porch will be constructed at No. 7 female ward, which is the admission 1 reatW improve the arrangements for visitors to recently admitted patients. centre. With certain fairly inexpensive alterations, this building will be very and should be ready for occupation by the end S It is hoped to proceed with the elect™ of quarter, for angle male staff, and two • ™ tsSsSKSOTT sSS&R&ftSSr * r 4 1 lbe ** • and SSrofTh.t~t«. "henre include lament of the »a.n hall which is very necessary.

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The new boiler-house workshop block is practically completed, and this paves the way for radical alterations near the entrance to the building, including the provision of adequate office space and visitors' rooms. The old workshop will serve admirably as an occupation centre. Nelson.—Three new male closed villas are in course of erection ; these will house the patients presently in the main building, and their completion will enable us to proceed with the erection of villas for senile cases and administrative offices. Hokitika.—lt is hoped to erect a Nurses' Home during the year and to utilize space now occupied by staff for increase of the store. The butcher's shop and bakery will be commenced, and also two additional villas. Christchurch. —The workshops which were burnt down during the year are being re-erected. In the meantime the artisans are using the occupational block, which will soon become available for its proper purpose. Seacliff. —The old boiler-house is in process of alteration to provide an occupation centre and hairdressing saloon. Attention will be given to modernization of the telephone and fire-alarm systems. Abolition of Maintenance Charges. Under section 94 of the Social Security Act, 1938, maintenance in mental hospitals is to become free of all cost to the patients and their relatives, and, consequently, the Receiver's Branch of this Department will disappear. Prior to 1910, when the office of Receiver was established and the collection of maintenance became a function of the Head Office, this work was carried out by the Chief Clerks at the several institutions. In his annual report for 1904 Dr. MacGregor, the Inspector-General, made the following comment: — "On account of payment for patients, £6 2s. 3fd. was received per head. This amount speaks well for the painstaking work done by the Chief Clerks, who act as receivers. The difficulty they have in collecting the payments is incredible. The statements made by persons liable to support an insane relative under the Destitute Persons Act frequently bear the imprint of evasion." Last year the total amount collected for maintenance was £162,135, or an average per patient of £21 os. Bd., and I must say that our experience of the way in which relatives have met their obligations has been much happier than that described above by Dr. MacGregor. For almost twenty-five years the office of Receiver was held by Mr. A. T. Wells, and it was almost entirely due to that officer's well-balanced judgment, sound common-sense, and sympathetic contacts with relatives that the average payments per head rose from £9 10s. 2d. in 1911 when he assumed office, to £18 6s. 2d. in 1935 when he retired, and to £21 os. Bd. in 1938 when maintenancecollection ceased. During the twenty-nine years in which the collection of maintenance has been a function of Head Office no less than £2,719,113 has been collected, and that with a remarkable freedom from friction or complaint. A great deal of credit in this connection is due to the Head and District Officers of the Public Trust Department, who have always been most co-operative and understanding. During recent years payments have been made in respect of approximately 40 per cent, of the patients resident. Increase in Medical Staff. During recent years we have had the greatest difficulty in obtaining the services of suitable medical men who desired to find a permanent career in mental hospital work. From time to time we have kept vacancies filled by recent graduates without experience or by more mature practitioners who were temporarily available, but we have felt gravely handicapped by the inability to build up an adequate trained medical staff. I am happy to report that, following upon improvements in the salaries allotted to Medical Superintendents and Assistant Medical Officers, the position has altered, and we are better off in this respect than we have been for many years. Twelve additional medical officers joined the service at the end of the year, and there is every indication that the Department has been very fortunate in its selection. We are now fully staffed and the Medical Superintendents will be free to give their attention to certain improvements which we have had in contemplation for some time but have been unable to inaugurate. Honour. During the year Miss Martin, Matron at Christchurch, received the decoration of M.8.E., an award which was regarded by all the officers of the Department with great satisfaction and pleasure, in view of Miss Martin's long and faithful service to the Department. Appreciation. I deeply regretted that Mr. Gavin Menzies found it necessary to relinquish the position of Receiver on account of ill health. The Department has lost a valuable officer, and the Head Office staff a much respected colleague, and we extend to Mr. Menzies our wishes for a speedy recovery. I desire to thank Dr. John Russell, the Deputy Director-General, and all the Medical Superintendents for their loyal support at all times. lam grateful to Mr. Sinclair, Chief Clerk, and the officers at Head Office for their excellent work during the year. I have, &c., Theo. G. Gray.

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AUCKLAND MENTAL HOSPITAL. 1)k. Buchanan reports : — I have the honour to present my annual report for the year ended 31st December, 1938. The total number of oases under care during the year was 1,769, with a weekly average of 1,2/3. The admissions numbered 356 —under certification 133 males, 152 females ; by transfer 9 males , and as voluntary boarders, 30 males, 32 females. During the year 144 patients and 58 voluntary boarders were discharged. Transfers to other hospitals numbered 14 (6 males and 8 females). Deaths totalled 131. At the end of the year 196 patients were on probation, 135 on full parole, and 202 on limited parole. . I append figures relative to the Psychiatric Clinic held by Drs. Hunter, Macky, and myself at the Auckland Public Hospital: — Total. (1) Number of separate persons seen .. M. 266 79 345 v F. 22 10 32 288 89 377 (2) Number of — (a) First visits . . • ■ ■ ■ ■ ..212 89 301 (b) Subsequent consultations .. • • • • 404 243 647 616 332 948 (3) Sources of reference — _ Pensions Department .. ■ ■ 220 65 285 Medical practitioners • • ■ • • • . . 26 15 4-1 Voluntary calls .. •• ' '4 Prisons Department ■■ ..15 .. 15 Police Department . . .. ■ • . . 2 . . 2 Salvation Army .. • ■ • • • • . . 4 .. 4 City Missioner .. • ■ ■ ■ • ■ • • 2 Public Trustee .. • • • ■ ' • • * Institute for the care of Backward Children . . • ■ 2 Crown Law Office . • • • • • ■ • 1 Director-General, Mental Hospitals Department 1 ■ • 1 District Inspector .. • • • ■ ■ ■ 2 .. 2 Nelson Mental Hospital . . .. • ■ ■ • 2 Public Hospital 288 89 377 1 was away on leave of absence for the greater part of the year under review. I desire to take this opportunity of expressing my gratitude to the Minister of Mental Hospitals and yourself for making this possible. Part of my leave was spent in visiting mental hospitals and homes lor congenital mental detects in England. My most intense interest was in the great strides certain hospitals have made in occupational therapy. To see this work, which in many places permeates a whole hospital, is a great experience. Later I hope to give you separately a report on what I have seen. Here, on a smaller scale, we have done occupational therapy for many years, and I have now every intention of expanding this to a scale similar to that which I have seen overseas. The introduction of a hairdresser for the female patients has proved a most excellent innovation. She has helped many a patient to regain some personal pride, and, in consequence, a sedative effect in behaviour has resulted. , No major work has been carried out during the year, but all the same there has been consistent effort to maintain things at a good level. Besides the usual painting programme, the other important works were the installation of machinery in the laundry and the alterations of the water service to bring our fire-lighting apparatus up to date. This latter work is not as yet fully completed. We were unfortunate in having ail outbreak of typhoid in May and June. This necessitated the procedure of blood-testing and inoculation of all patients and the members of the staff. This imposed an additional burden on our staff, already weakened in numbers. The members, however, rose well to the occasion. In parentheses, I may state that the staff-shortage problem is almost as acute m some parts of England as it is here. , , Tl , A most successful bazaar and sale of work of patients handicrafts was held on the 2nd December, 1938 The most gratifying sum of £143 was made. This money will be devoted to the patients recreation and providing materials for occupational work. _ The Auckland Hospital Auxiliary continues to be our very good and much appreciated friend They are constant in their help in person, kind, and cash. Performances by the Waterside Workers' Band were much appreciated, as also concerts given by Miss Ward and her pupils. In concluding I must express my gratitude to the Medical Officers, Matron, Head Attendant, Chief Clerk, and all other members of the staff for the help and encouragement given me.

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KINGSEAT MENTAL HOSPITAL. Dr. Hunter reports : — I have the honour to submit my annual report for the year ending 31st December, 1938. The total number of patients under care during the year was 596 (307 males and 289 females), with a weekly average of 577. Patients admitted for the first time numbered 2 (males), and 1 male patient was readmitted during the year. Patients admitted by transfer were 9(7 males and 2 females). Transfers to other hospitals numbered 3, all of whom were males. There were 5 patients (4 males and 1 female) discharged, and there were 13 deaths (9 males and 4 females). The weekly average of voluntary boarders resident during the year was 6 (3 males and 3 females). One male was discharged and committed, while there .were no admissions or deaths. The general health of the patients and staff has been excellent, on the whole, although the measles epidemic affected a large proportion of the nursing staff. I also regret to have to report the death of one of the members of our nursing staff, Nurse Mavis Evelyn Nicholson, who passed away on 20th July, 1938, following an operation. To her relatives we tender our deepest sympathy. The building programme continues, and this year the following buildings have been completed or are in the course of construction : Medical Superintendent's house, Engineer's house, hospital and treatment centre, Villas 7 and 8 for male patients, oil-store, mortuary, workshops block. Tenders have been called for the erection of a Nurses' Home. Renovations have been carried out to the cow-byres, and this part of the farm buildings is now in first-class order. The installation of equipment for the laundry, engineer's block, bakehouse, and butchery has been proceeded with, and this block should be in operation early in the new year. The main thing which is causing delay is the non-arrival of the boilers, which are expected early in February, 1939. The furnishing and equipment of the hospital and treatment centre is nearly completed, and this fine addition to the hospital, situated on a slight rise overlooking the recreation ground, has a bright and sunny outlook. The amenities provided in this block should do much towards the successful treatment of our nervous and mentally ill. The automatic-telephone system mentioned in last year's report has been installed, and is proving of great benefit in the administration of the hospital. With the increasing number of patients and staff the question of suitable entertainment is becoming somewhat of a problem. The use of three rooms in a villa for the weekly dances is not satisfactory, while concerts require the transportation of seating-accommodation from villa to villa, so that a recreation hall with cinema facilities is now essential for further development of the villa system. The staff-housing problem is acute, and will be more so when the service blocks are fully staffed. We are short of single-male-staff accommodation, and there is difficulty in securing houses in the vicinity of the hospital for married staff. Auother problem that is arising is the fact that our distance from Auckland, and the difficulty of transport has resulted in many of our staff acquiring motor-cars, and the question of staff garages has arisen. I think that this matter will be required to be dealt with in the near future. The patients, on the whole, are happy and contented, and appreciative of the parole privileges, to which they are reacting satisfactorily. They are fully occupied in constructional work on the farm, in the grounds, gardening, laundry, and sewing-room. Their amusements have not been neglected, and they are all eligible to play in the various sports, teams, and clubs which the hospital has. Our sports clubs have had a successful and enjoyable year. Mrs. Waugh, working under the auspices of the Auckland Hospital Auxiliary, Mental Hospitals Branch, conducts a weekly handicraft class, and this year this class has been extended to the more restless and unstable types of patients, and the results are encouraging. These patients are better behaved, and look forward eagerly to the weekly visit. I feel that this result would be enhanced if it were possible to have the handicraft class daily instead of weekly. Mr. McFarlane, of the Public Works Department, has taken his usual active interest in the progress of the hospital, and for his many useful and practical suggestions I am very grateful. A weekly clinic is conducted at the Auckland Public Hospital, where 89 new cases were treated, whilst there were 332 attendances. New cases were referred by Pensions Department, 65 ; Hospital, 5 ; medical practitioners, 15 ; voluntary, 4. I am most grateful to those who have helped to provide entertainment and for the gifts of reading-material; to the several local branches of the Returned Soldiers Association lor their interest in ex-soldier patients ; the women's division of the Farmers' Union and the Women's Institute for their interest in the activities of the hospital; the Auckland Women's Auxiliary for regular donations for the benefit of the patients ; and the members of the clergy who have conducted Church services throughout the year. Finally, I wish to thank the Chief Clerk and his staff, the Matron, Head Attendant, and all members of the staff for their very helpful and encouraging services for the benefit of the patiehts and in forwarding the interests of the hospital.

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TOKANUI MENTAL HOSPITAL. Dk. Tothill reports : — I have the honour to present my annual report for the year ending 31st December, 1938. The total number of cases under care during the year was 788, which includes 29 voluntary boarders. Admissions numbered 108, of whom 7 were transfers from other institutions and 12 voluntary boarders. The discharges were 50 patients under certificate, 7 voluntary boarders, and 6 transferred. There were 48 deaths, senile decay and heart-disease being the predominant causes. At the end of the year 674 patients, including 33 on probation and 18 voluntary boarders, remained on the register. Reports have been made for the Justice Department on inmates at Waikeria and on children under the care of the Child Welfare Department, Hamilton. The general health of the patients has been good, though a number of cases of measles occurred among the patients and staff. For some months we have been conducting an interesting experiment in trying to rehabilitate male schizophrenics by intensive directional treatment. In various forms this is used as a concomitant of insulin therapy, but here we have omitted the insulin. This work is still in its infancy, and though no miraculous cures can be claimed a definite improvement in conduct and personal hygiene has been noted to the extent that patients taken out of a refractory ward are now well enough to be nursed in the admission ward. Good progress has been made in modernizing the older parts of the hospital and interior, and exterior renovation continues to be actively pursued. The detachment of Ward P. 2. is now complete, the kitchen addition is ready for use, a dining-room has been provided, and the new bath-room and improved lavatory accommodation are nearing completion. Wards F. 1 and P. 7 are in the process of being detached, and alterations will provide cooking facilities and improved bathing and lavatory arrangements. When the work has been executed Wards P. 1, P. 2, and P. 7 will be self-contained, independent units. Part of the long corridor on the female side has already been demolished, and eventually it will be completely removed. By the separation of the wards and elimination of this corridor serious fire risk will be abolished. A veranda has been built on to P. 7 and will be particularly useful in wet weather. The double-storied veranda addition to the female admission ward is now completed, the upstairs providing extra bed accommodation and the ground floor a sun room and facilities for the treatment of recent patients who are receiving bed. treatment. The roofs of Wards F. 1 and F. 7 have been painted, and those of F. 2 and the main kitchen are to receive attention in the near future. Stainless-steel sinks were installed in the sculleries of Wards A, C, H, and the male staff, benches renewed, and the backs tiled. Ward A has been completely repainted, and additional furniture increases its comfort. Fire-places throughout the hospital were repaired. The male-staff quarters have been renovated, the mess-room papered, and staff sitting-room furnished. The Assistant Medical Officer's new residence is now in occupation. Various improvements and repairs were carried out on the staff houses on the hospital estate. The pipes on the water-main from Te Awamutu are being replaced by spiral steel pipes, and will result in considerable economy by eliminating water leakage. An additional Public Works store was erected, and accommodation for Public Works staff is being built. The new mortuary, in which a post-mortem table was constructed, is in use. An all-weather road to-the hospital cemetery has been made, and a small shelter for the Ministers is being provided. Lights over the fire escapes at the Nurses' Home have been installed. Works due to begin include the erection of a new slaughter-house, skin-room, and boiling down works, exterior painting of Ward H, Villas 4, 5, 6, and the Nurses' Home, installation of foot-baths for farm-workers in A and C Wards, and alterations to the administration block to provide quarters for five officers. It is hoped to build an ample storage shed and a glass-house in the near future. The vegetable garden has been extended, lawns laid down round the male villas, and flowering shrubs planted. I shall be glad to see work commenced on the new laundry, engine-room, butcher's shop, and bakery as soon as possible. The laundry has been outgrown, and the butchery and bakery are out of date. A large number of patients are continuously employed on the farm, and further swamp land has been drained. We joined the herd-testing association, and our cows are now regularly tested. During the year some of our stock were affected with facial eczema, but, fortunately, not to any serious extent. It has been suggested that the cow-byres bo moved to the centre of the farm. This would be an advantage to both farm and hospital, as the cows will have a shorter distance to travel and valuable building-sites for new male villas be placed at our disposal. Visits were made by the Hon. P. Fraser, Minister in Charge of Mental Hospitals, and Mr. Simpson, Public Service Commissioner for Western Australia. Mr. S. A. Empson, who for many years has been associated with this hospital as Coroner, retired, Mr. W. Jeffery being appointed as his successor.

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The usual entertainments and games were provided throughout the year. Mr. Dunlop, Superintendent of Waikeria, arranged for performances by the Waikeria Concert Party, and the excellent programmes were greatly appreciated by all. I am deeply indebted to the members of the clergy who have conducted the devotional services, the Te Awamutu Library Committee for donation of books, various returned soldiers' associations for gifts of money and extra comforts, branches of women's institutes, and all those openhearted individuals who by their generosity and interest in the hospital have materially contributed to the happiness of our patients. Mr. Findlay, our Official Visitor, has again given every assistance in promoting the welfare of the hospital. In conclusion, I desire to thank all members of the staff who by their efforts and co-operation have helped me in the care of the patients and administration.

PORIRUA MENTAL HOSPITAL. Dr. Hart reports : — I have the honour to submit my report for the year ending 31st December, 1938. The total number of cases under care during the year was 2,011, of whom 1,774 were committed patients, 228 voluntary boarders, and the remainder of cases were remanded for observation. Admissions numbered 429—under certification, 307 ; as voluntary boarders, 113 ; and on remand, 9. During the year 301 persons (196 committed patients and 105 voluntary boarders) were discharged, whilst a further number were sufficiently recovered mentally to leave the hospital on probation to the care of relatives or friends. Deaths numbered 118, and 30 patients were transferred to other mental hospitals. These figures in comparison with those of the previous year show a deduction in the number of deaths, a slight reduction in total number of cases under care and number of admissions, whilst the number of discharges and the percentage of voluntary boarders on total admissions have both increased. Over 26 per cent, of all admissions for the year entered hospital voluntarily. During the year psychiatric work has been carried out as formerly in the psychiatric wards in the Wellington Public Hospital and at the out-patients' clinic at-Wellington and Palmerston North. In the latter portion of the year, owing to medical staffing difficulties, the clinic at Palmerston North was temporarily discontinued. The number of individual cases dealt with in this extra-mural work was as follows : (1) Cases in psychiatric wards, Wellington Public Hospital, 232 ; (2) out-patients' clinic, Wellington, 189 ; (3) outpatients' clinic, Palmerston North, 64. The major structural work completed during the year was the boiler-house block containing, as it does, engineers', carpenters', painters', and upholsterers' shops. Unfortunately, the non-arrival of the boilers and certain other machinery has prevented the erected building from being brought into full use. This delay has also prevented the reconstruction of the old boiler-house block as an occupational therapy centre. A shearing-shed, with equipment, yards, dip, &c., was erected on the farm. The bakers', butchers' shop, and cool-storage block is nearing completion, whilst an additional residence for an Assistant Medical Officer will be ready for occupation at an early date. An additional washingmachine, a blanket-washer, and three modern electrically driven hydro extractors were added to the laundry equipment. Remodelling of the driers, which is at present in hand, plus an additional vac ironer, should raise the laundry efficiency to the desired standard. It is hoped that the already planned decentralization kitchen scheme for the main building will be commenced at an early date. The completion of this scheme along with certain additional equipment for existing kitchens in other units is complementary to the proposed improved variety in patients' dietary. I also hope that financial provision will be made during the year to arrange for the necessary increase in medical and clerical office accommodation and visiting-rooms in the present administration block. Comprehensive improvements and overhaul of the hospital sewage scheme have been under review for some considerable time, but, apart from the relaying of a portion of the sewage channels about a year ago, very little progress has been made towards completing this urgent and necessary work. Throughout the year the artisan staff have been fully occupied in renovating, repairing, and making minor alterations to existing buildings. Certain other repairs and renovations, such as painting, have been completed by outside contract. Some 71 chains of hospital roads and 21 chains of paths were bitumen-sealed during the year. Apart from occupational work for patients in the artisans' shojxs, sewing-rooms, gardens, farm, &c., there has been during the year a definite expansion in the more specialized occupational work such as spinning, weaving, cane-work, and simple handicrafts. A female and male instructor give tuition in these subjects, and it is hoped in the coming year to increase the types of specialized work undertaken. Activities on the farm, orchard, flower and vegetable gardens have continued much as formerly. Additional acreage has been taken for the growing of vegetables. Apart from minor fluctuations due to variation in seasons, the returns from the vegetable gardens have during the last three or four years shown a steady increase.

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The usual recreations for patients and staff have been provided for during the year. Patients' sports meetings, bowls, tennis, golf, concerts, fortnightly dances, weekly cinema, and picnics to the beach have been organized and enjoyed by various patient groups. lam grateful to Mr. Hooker for continued effort in arranging for the supply of certain magazines and weeklies for the library and reading-room. I have to thank numerous societies and charitable organizations and individuals too numerous to mention who have throughout the year provided various comforts, reading-matter, and donated money towards the patients' recreation. We are also grateful to various people who have given concerts at the hospital from time to time during the year. I regret to have to record the death of the Rev. Mr. Harding, which occurred during the year. Mr. Harding for many years associated himself with the work of the hospital, and was indefatigable in assisting in the arranging of concerts and entertainments for patients. He will be greatly missed by patients and staff. The shortage of medical staff existing in 1937 became more acute last year, and more especially during the latter few months of the year. In this respect I particularly wish to thank my deputy, Dr. R. G. T. Lewis, on whose shoulders fell the greater part of the burden occasioned by the absence of Assistant Medical Officers. As with other mental hospitals, we experienced during the year a difficulty in getting probationer nurses, and this shortage was in part overcome by the female nursing staff working overtime. I should like to express my appreciation to the female nursing staff, who maintained hospital efficiency under these somewhat trying conditions. In conclusion, I wish to thank the staff as a whole for their loyal co-operation in the work of the year.

NELSON MENTAL HOSPITAL. Dr. Williams reports : — I have the honour to present my annual report for the year ending 31st December, 1938. The total number of cases under care during this period was 923, of whom 896 were held under a reception order, 25 were voluntary boarders, and 2 were sent to us on remand for observation. The admissions totalled 74, of whom 12 were voluntary boarders and 62 were certified. Of the latter, 18 were admitted under the provisions of section 8 of the 1928 Amendment to the Act. The discharges, 38 in number, included 11 voluntary boarders. There were 56 deaths during the year, amongst whom were several feeble children, whose poor resistive power could not withstand the whooping-cough, which occurred as an epidemic. As is frequent when whooping-cough is prevalent, there were other epidemics, of minor disorders chiefly. Most notable was measles, and more than 300 of oar patients were affected, some having as many as three attacks. A large proportion of the staff was affected also. The principal item in the building programme has been the erecting of a Nurses' Home at Ngawhatu. This should be completed and ready for occupation about the middle of 1939. The road up Yorks Valley was tar-sealed as far as Villa 3. New piggeries were built at Ngawhatu, but await some additions before they will be ready for occupation. Staff cottages were renovated ; extensions were made to water-supply ; painting of and repairs to butcher's shop were done ; and the developmental work in Yorks Valley continued, though, as noted previously, paucity of good labour has resulted in this progressing rather slowly. At Nelson fire-breaks were put through the pine plantation ; the adjoining hill was cleared, and some thousands of trees planted there. Additions were made to the sewage systems, and the farm buildings, stores block, and artisans' workshop were renovated where required and are being repainted. A good deal of inside painting has been done by the working-party also. Authority has been received for the repainting of Villa No. 1, but scarcity of suitable labour has made it not possible to do this work yet. Similarly, we have been unable to obtain adequate workmen for the fencing of Stoke Farm above Poorman's Valley, although we have the materials on hand. Tenders have been called for the erection of three new male villas. These will be most welcome, and will result in better classification and treatment of patients. A modern admission block with sick-bay and theatre facilities and independently situated is really very desirable and necessary. Miss Soutter, Kitchen Supervisor, has been here for some little time and has offered useful suggestions. She is much in favour of the system in vogue of cooking in the individual villa. Fire drill has been carried out regularly, and appliances inspected by the Public Works Department, and their recommendations adopted. The local fire brigade has visited in order to gain familiarity with the lay-out. The patients have been well catered for in the matter of amusements and recreation, and in this respect my thanks are due to many individuals, business firms, and societies in Nelson for their continued support and for donations of moneys and goods. Miss Cooksey and party have been particularly good in providing outings for the children ; the Sunshine Fund organized by Mrs. Scantlebury for provision also of picnics for the children has been very successful, and the results were much appreciated. To the Official Visitor, to the visiting Ministers of religion, to my colleague Dr. Crawshaw, and to the staff generally, for assistance and co-operation I wish also to express my thanks.

2 —H. 7.

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HOKITIKA MENTAL HOSPITAL. Dk. Childs reports :— I have the honour to submit my report for the year ending 1938. At the commencement of the year the patients on the register numbered 462. The admissions proper were 20, while 5 males and 6 females were received on transfer. The discharges numbered 13, transfers to other institutions 4, and deaths 24. The total number under treatment was 493, and the number remaining on the register at the end of the year 452. There were 3 voluntary boarders on the register at the beginning of the year ; 9 were admitted and 4 discharged. The general health of the patients has been satisfactory. A new model piggery and a cycle-shed have been erected during the course of the year. Arrangements are almost completed for the building of a new Nurses' Home and for the erection of two closed villas, one on the male and one on the female side. With the Nurses' Home completed it will then be possible to enlarge the existing store accommodation, which, owing to the continued growth of the institution, has become inadequate, while the additional two closed villas will allow of a better classification of the patients than is possible at present. The usual routine of farming and gardening operations have been carried out during the year, 8 acres of swamp land have been cleared, drained, and left fallow, and 5 acres of fallow land sown down in grass. The painting gang has been active during the year, and the usual maintenance-work carried out. The Hokitika Band has, as usual, visited the hospital frequently and supplied most of the music for the patients' dances. A monthly clinic has been held at Greymouth Hospital, and the Westland Hospital visited when required. The playing-field has been enlarged and improved, and games and recreation are playing an important part in the life of the institution, but the want of a recreation hall is becoming increasingly urgent. Picnic, swimming, theatre, and shopping parties are arranged when possible, and suitable patients are given the opportunity of attending outside entertainments, such as the local race meetings, sports gatherings, &c. Thanks are due to those who have provided entertainment during the year and to those who have been responsible for Christmas gifts and cheer. The clergy have made frequent visits, and regular services have been held. Mrs. Pane, who has a considerable knowledge of social work, has been appointed Official Visitor on the female side, and the Official Visitor for the male side has shown his usual interest in the welfare of the patients. I wish to thank the staff for the generous support they have given me during the year.

CHRISTCHURCH MENTAL HOSPITAL. Dr. McKillop reports : — I have the honour to forward my report for the year ending 31st December, 1938. On Ist January, 1938, there were 1,394 patients (773 males, 621 females) on the register. During the year 227 persons (107 males, 120 females) were admitted and 20 patients were transferred from other institutions. Discharges totalled 141 (61 males, 80 females), and there were 1,641 persons under care during the year. Out of 11 cases sent for observation, 6 were committed and 5 were discharged. Voluntary boarders numbered 66 (males 34, females 32), and of this number, 22 males and 17 females improved sufficiently to return to their former duties. There were 95 deaths during the year, the cause in most cases being senile decay. Much has been done during the past few years to make the conditions of the patients more comfortable, and overcrowding is not now in evidence. Personally, I should like to see separate institutions for the senile cases. At the present time many aged persons are sent to a mental hospital on the appearance of slight aberration ; such cases seldom give us any trouble. The provision of two new villas, one for female patients and one for males to accommodate senile patients, and of a hospital block would make this mental hospital quite up to date. The pumping machinery has been installed, and the water-supply is now of excellent quality and quite adequate. The old system has been retained and connected up for fire purposes. The laundry at Templeton, although completed at the time of my last report, is not yet functioning, and the delay is causing very great inconvenience. Present indications are that it is unlikely to be in use for some months, though I understand tenders have been called for the erection of the machinery. The new bakehouse at Sunnyside is in use, and extensive alterations are now being carried out in the kitchen.

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The occupational therapy building has been completed and will be occupied very soon ; the extension of this class of treatment is likely to prove of great value. The results have been very gratifying. The new poultry-houses are now in use. The latest form of equipment has been installed, and the prospects of making this branch of farm-work a success are very good. Several experienced poultrymen have inspected the plant and have unanimously considered the layout an excellent one The farm generally has had a good year. Patients' recreation has been carried out on the usual lines. I have to thank the concert parties who have come to Sunnyside and to Templeton. The concerts and picture programmes have proved of great enjoyment to the patients. Miss Jackson and the staff of the winter gardens provided the Christmas tree and a party for the children, and I have to thank them for their efforts. The numbers attending the clinic at the Christchurch Hospital have increased considerably, and many new cases have come of their own accord apart from the cases sent by general practitioners. I have visited Timaru Hospital monthly ; there the clinic is also functioning well. Mr. H. D. Acland, K.C., and the Official Visitors (Mrs. Williams, Mr. Hanna, and the Rev. Mr. R. Martin) have paid regular visits to the hospital. They are keenly interested in the patients and the work of the institution. We were fortunate to get the services of Dr. Cameron during the latter part of the year, and it is very pleasing to know that Drs. Heath and O'Reilly have been appointed to the Sunnvside staff. I have to record my thanks to Dr. Bellringer for his valued assistance during a most trying year. I regret exceedingly that the services of Mr. Thomas have been lost to the Department. This most efficient Chief Clerk has retired after almost forty years of service. I have to thank him and his office staff, the Matrons, Head Attendants, and the staff as a whole for their assistance.

SEACLIFF MENTAL HOSPITAL. Dr. Brown reports :— I have the honour to present my report for the year ending 31st December, 1938. On the Ist January, 1938, there were 1,133 patients on the register. During the year 142 patients were admitted, 75 were discharged, and 10 were transferred to other institutions. The total number of patients under care during the year was 1,275. During the year 80 voluntary boarders were under care, and 40 still remain. There were 74 deaths, the chief causes being senile decay and cardio-vascular disease. At the end of the year there were 1,071 patients and 37 boarders resident. There has been a decrease in the total population, but the overcrowding has only been relieved to that extent so that the male side is overcrowded to the extent of 82 and the female side to 67. 1 would, again emphasize the need for new admission units. The general maintenance of the hospital has involved much work. Various bathrooms and lavatories have been repaired and remodelled, and much painting, both external and internal, has been done. A new bathroom has been built in F. 1 Ward at Waitati, and a kitchen for that ward will soon be completed. A sick bay with a surgery is almost finished in F. 4 Ward at Seacliff. The conversion of the old boiler-house into a unit for occupational therapy is well in hand. The water mains from Double Hill continue to give trouble from time to time due to the slipping ground, and many repairs have been effected on them. The gardens and the grounds have been well looked after, and the farm has had a satisfactory year. Miss Miller, of the Red Cross Society, has continued her teaching of handicrafts to the patients with satisfactory results. The building which is being converted to an occupational centre will be ready for use shortly, and it will allow this form of treatment to be extended to patients who cannot receive it under existing conditions. The members of the Dunedin Branch of the Womens' National Council continued to visit and to teach sewing and fancy work to the female patients. My thanks are due to these ladies for their kindly interest. Included in the occupational block will be a fully-equipped hairdressing-room, and this, with the appointment of a full-time hairdresser, will provide a service which should be greatly appreciated, especially by the female patients. Further alterations to the main kitchen, including a hot-plate, have helped to improve the service of meals to the wards. In the early hours of the morning of 20th July the wooden dining-room of F. 1 Ward was destroyed by fire. When the outbreak was discovered the wooden building was beyond saving, and the attendants and artisans did excellent work in controlling the blaze and preventing its spread to the adjacent buildings. The nurses evacuated the patients from F. I Ward with a total absence of fuss or panic, and the conduct of the whole staff was most praiseworthy.

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in December, during heavy rains, a creek overflowed its banks and did extensive damage to the kitchen garden, as well as flooding the kitchen, store, and workshops. Despite the loss of a portion of our main crop of vegetables, the gardener has contrived to keep the kitchen well supplied with fresh vegetables. The treatment of cases of schizophrenia with insulin was commenced in June. One series of cases has completed the treatment, and a second series is at present undergoing and will shortly complete it. The technique of this work is intricate and exacting, and unremitting medical and nursing attention is necessary for its success. At this stage figures relating to our results would be fallacious, but the results have been most encouraging, in some cases quite startling. The treatment has its undoubted dangers, but, despite them, it is a marked advance in the treatment of these unfortunate people, and my opinion is that it is well worth pursuing. lam much indebted to the Otago Medical School and to Professor D'Ath in particular for a great deal of help in the investigation of these cases. For the entertainment of the patients I am. indebted to various organizations. Concerts have been provided by the Dunedin Male Voice Choir, the Justices of the Peace Association, the Orphans Club, the Dunedin Choral Society, and the United Congregational Choir. The Salvation Army, the West Harbour Band, and the St. Kilda Band have provided enjoyable band entertainments. The staff Sports Club has entertained the patients at various times. Many of these concerts have been given through the agency of Mr. Stevens, of the Patients' and Prisoners' Aid Society, and I am grateful to him and his society which has provided the transport for these concert parties. The Otago Agricultural and Pastoral Association and the Waikouaiti Racing Club granted free admission to the show and race meeting. To them and to the companies who provide the weekly picture programmes I wish to express my thanks. The Returned Soldiers' Association have provided tobacco and other comforts for the soldier patients, and I am in their debt also. I have to acknowledge the gift of more wireless sets from the Patients' and Prisoners' Aid Society. Every ward in the hospital is now equipped with a set, and the entertainment so provided is greatly enjoyed by the patients. lam on the honorary staff of the Dunedin Public Hospital and visit there twice a week. During the year 189 new cases were seen either in the wards or in the outpatients' clinic. I saw 27 cases on my monthly visits to the Oamaru Public Hospital. Dr. Hay has conducted a monthly clinic in the Invercargill Public Hospital, and 34 new cases were seen by him. The Hon. P. Fraser, Minister in Charge of Mental Hospitals, visited the hospital on the 28th October. He spent the whole day with us and saw round the greater part of the institution. His knowledgeable interest in our work was greatly appreciated. Mr. C. B. Barrowclough, the District Inspector, and Mr. A. Stevens, the Official Visitor, paid us many visits and showed a kindly interest in the well-being of the patients. To Mrs. McLaren, the Matron, and to Mr. Beasley, the Head Attendant, I would tender my thanks for their loyal co-operation. They and their staffs worked most efficiently, and the way in which the nursing staff, both male and female, worked to make the insulin treatment a success is worthy of the highest commendation. I have also to thank Mr. Thomas, the Chief Clerk, and the various other heads of departments and their staffs. The shortage of medical staff placed much extra work on Dr. Hay and Dr. McLachlan, and the insulin treatment added to their already onerous duties. I wish to place on record my appreciation of their ungrudging work and helpful co-operation.

MENTAL NURSES. In December the usual examination was held for the registration of mental nurses, when the following passed : — Passed top for Dominion : Miss M. T. Miller (Porirua). Auckland: Nurses —J. R. Carnie*, E. J. Christie, I. E. H. Porter, E. J. Wendelborn. Papakura : Attendant —D. R. Curin. Nurses—N. L. Jackson, A. M. Jones, E. L. Quinn. Tolccmui: Attendants—L. H. Allen, C. A. McDonald, W. J. Pittams*, R. J. Wilkinson. Nurses —H. 0. Harris, P. Jacobs, M. D. Moyes, M. Puch. Porirua : Attendants—H. A. Beasley, B. C. Ewing, H. M. Stitt, C. Todd. Nurses—E. Burton, M. B. Cartwright, 0. Davies, E. Ford*, N. D. Hebbend, S. E. Hickman, K. V. Kane*, T. M. McConachy, M. T. Miller*, M. A. Poole, E. M. Shelton*. Nelson: Attendant—L. J. McMurray, Nurses—C. I. H. J. Higgs*, J. F. Knight, M. M. Pascoe, M. Rees. Hokitika: Attendants —J. S. G. Diedrichs, A. F. J. Dowling. Ghristchurch : Attendants—R. G. S. Burke*, D. E. A. Cocks, R. A. D. Fulton*, W. K. Greer, H. J. McLeod, C. P. Pablecheque. Nurses —M. N. Ashby, J. Cundell, E. M. Davidson, L. E. Hickman*, N. E. Johnson*, R. E. Torrie, R. M. White. Templeton Farm: Male Institution Officer —W. J. T. Maunder. Female Institution Officer—T. E. M. McAra. Seacliff: Attendants—H. D. Bell, B. Jaquiery, G. M. Proudfoot, A. Rankine, T. S. Ruddiman, L. Stewart. Nurses —J. M. B. Burns, P. M. Kofoed, M. A. Maker, J. J. Rankine, F. M. Valentine, E. V. M. Wilson.

* Passed with distinction.

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APPENDIX.

Table I.— Showing the Admissions, Readmissions, Discharges, and Deaths in Mental Hospitals during the Year 1938.

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 1938.

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M. F. T. M. F. T. In mental hospitals, 1st January, 1938 .. .. . • •• 4,352 3,545 7,897 Admitted for the first time .. .. •• •• 445 488 933 \ f)27 575 ]102 Readmitted .. .. . • • • • • • • 82 87 169 J Total under care during the year .. .. j .. 4,879 4,120 8,999 Discharged and died— Recovered .. . • • • • • • • • • 170 210 380 Not recovered . • .. • • • • ■ • 140 135 275 Died 273 274 547 583 619 1,202 (Not including transfers —Males, 52 ; females, 44.) Remaining in mental hospitals, 31st December, 1938 .. .. 4,296 3,501 7,79/ Decrease over 31st December, 1937 .. .. . . • • 56 44 100 Average number resident during the year .. .. .. •• 4,129 3,287 7,416

, Admissions in 1938. Total Number | In Mental Hospitals 0 f Mental Hospitals. I on II Patients 1 1st January, 1938. Admitted for the 1 Not First Transfers under Care First Time. Admissions. I iransiers. unaer uire. i I 1 M. V. T. M. F. T. M. F. T. M. F. T. M. F. T. Auckland .. .. 712 609 1,321 111 130 241 22 22 44 9 .. 9 854 7611,015 Kingseat .. .. 297 287 584 2 .. 2 1 .. 1 7 2 9 307 289 596 Tokanui . 322 341 663 38 39 77 5 7 12 2 5 7 367 392 759 Porirua 872 595 1,467 111 125 236 35 24 59 6 6 12 1,024 750 1,774 Nelson . ..482 352 834 22 17 39 3 1 4 6 13 19 513 383 896 Hokitika .. •• 209 253 462 10 9 19 1 .. 1 5 6 11 225 268 493 Christchurch .. .. 773 621 1,394 96 101 197 11 19 30 12 8 20 892 749 1,641 Seacliff .. .. 671 462 1,133 52 64 116 4 14 18 5 3 8 732 543 1,275 Ashburn Hall (private 14 25 39 3 3 6 .. ..1 1 17 29 46 mental hospital) Totals .. 4,352 3,545 7,897 445 488 933 82 87 169 52 44 96 4,931 4,164 9,095 Patients discharged, transferred, and died. In Mental Hospitals Mental Hospitals. | Total discharged ,,, i ,, on . Discharged Discharged Transferre(t . DIed . transferred®, ' Slrt December, 1938. recovered. I not recovered. and died. M. F. T. M. F. T. M. F. T. M. F. T. M. F. T. M. F. T. Auckland . .. 38 48 86 33 25 38 6 8 14 56 67 123 133 148 281 721 613 1,334 Kingseat 1 1 4 .. 4 3 .. 3 9 4 13 16 5 21 291 284 575 Tokanui .. 12 17 29 10 11 21 5 1 6 21 26 47 48 55 103 319 337 656 Porirua .. 70 64 134 34 28 62 13 17 30 62 51 113 179 160 339 845 590 1,435 Nelson .. 11 9 20 5 2 7 4 1 5 39 17 56 59 29 88 454 354 808 Hokitika . .. 3 4 7 1 5 6 1 3 4 8 16 24 13 28 41 212 240 452 Christchurch .. 24 37 61 37 43 80 11 9 20 42 53 95 114 142 256 778 607 1,385 Seacliff .. .. 12 27 39 16 20 36 6 4 10 35 39 74 69 90 159 663 453 1,116 Ashburn Hall (private ..33..11 314 112 46 10 13 23 36 mental hospital) — — 1 — ' 1 Totals .. 170 210 380 140 135 275 52 44 96 273 274 547 635 663 1,298 4,296 3,501 7,797 . Percentages Percentages of ' I of Recoveries on Deaths on Average Mental Hospitals, resident during Admissions Number resident the Year. during the Year. during the Year. M. F. T. M. F. T. M. F. T. Auckland . .. .. •• 661 529 1,190 28-57 31-58 30-18 8-47 12-66 10-34 Kingseat .. .. .. -- 292 285 577 .. .. 33-33 3-08 1-40 2-25 Tokanui . 307 328 635 27-90 36-96 32-58 6-84 7-93 7-40 Porirua . •• 837 555 1,392 47-95 42-95 45-42 7-41 9-19 8-12 Nelson . •• - ■ 447 336 783 44-00 50-00 46-51 8-72 5-06 7-15 Hokitika .. •• 205 241 446 27-27 44-44 35-00 3-90 6-64 5-38 Christchurch . .. 716 554 1,270 22-43 30-83 26-87 5-87 9-57 7-48 Seacliff .. .. 650 434 1,084 21-43 34-62 29-10 5-38 8-99 6-83 Ashburn Hall (private (mental hospital) .. 14 25 39 100-00 50-00 7-14 4-00 5-13 Totals.. .. .. ■ ■ 4,129 3,287 7,416 32-26 36-52 34-48 6-61 8-33 7-38

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Table IV.—Ages of Patients on 31st December, 1938.

Table III.— Native Countries.

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I | fill Ashburn Hail | Countries. 1 Auckland. Kingseat. Tokanui. Porirua. Nelson. Hokitika. Christchurch. Seaclifl. (Prgate Mental 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. M. F. T. England and Wales .. 117 72 189 53 49 102 44 40 84 140 81 221 42 37 79 25 20 45 61 52 113 56 32 88 3 1 4 541 384 925 Scotland .. .. 24 21 45 13 5 18 13 5 18 37 20 57 21 11 32 6 9 15 21 11 32 41 28 69 3 1 4 179 111 290 Ireland .. .. 25 19 44 17 18 35 16 14 30 35 19 54 12 4 16 15 9 24 19 16 35 22 13 35 0 0 0 161 112 273 New Zealand !! ' ! 425 412 837 138 163 301 203 240 443 531 422 953 337 277 614 129 153 282 660 509 1,169 511 362 873 6 20 26 2,940 2,558 5,498 Australian States .. 35 28 63 17 12 29 8 13 21 36 21 57 8 8 16 14 10 24 9 14 23 15 9 24 1 1 143 116 259 Germany !! 213 2'3 5 112 101101 404 .. !« 1 19 Austria .. ..819606303 ' , 1 ° 1 , "A , " nno " 819 Norway .. ..101404202011 .. 10 1: -. 000 .. 8 1 9 Sweden .. .. .. 1 2 3 0 1 1 1 0 1 1 0 1 1 0 1 1 0 1 1 0 1 .. 6 3 9 iST :: :: 2 o 2 5 ? i ? o ! i o ' o 3 o l\ :: 0 :: 2E5. :: :: it *1 £ III A 1? *1 £ 11 £ . "2 s 0 0 0! 2 5 7 1 1 :: «i g } « Other countries .. 37 14 51 11 9 20 12 5 17 17 6 23 7 1 8 5 0 5 4 0 4 3 2 5 .. 96 37 133 Unknown .. 23 21 44 22 25 47 .. 14 12 26 11 39 50 .. 7 7 14 .. 77 104 181 Totals .. 721 613 1,334 291 284 575 319 337 656 845 590 1,435 454 354 808 212 240 452 778 607 1,385 663 453 1,116 13 23 36 4,296 3,501 7,797

Ashburn Hall Ages. Auckland. Kingseat. : Tokanui. Porirua. Xelson. Hokitika. Christclmrch. Seacliff. (PiWate Mental Total. 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. M. F. T. 1 to 5 vears 101 •• 044729011426011 ■■ 12 10 22 1 to 5 years .. 2 " ! 2 3 1 7 8 19 8 27 0 1 1 40 24 64 0 5 5 .. 62 48 110 " in " 15 " " 8 3 11 8 5 13 3 9 12 48 13 61 0 3 3 72 32 104 0 0 0 .. 139 65 204 15 " 9 0 " 16 23 39 3 0 3 11 8 19 20 24 44 50 19 69 5 2 7 115 69 184 17 15 32 1 0 1 238 160 398 " 90 " 30 " " 115 57 172 20 19 39 49 48 97 124 66 190 97 51 148 13 15 28 121 113 234 103 43 146 1 2 3 643 414 1,057 " 30 " 40 " " 137 134 271 38 43 81 53 56 109 158 92 250 42 49 91 32 22 54 106 73 179 135 52 187 3 0 3 704 521 1,225 " 40 " 50 " 149 130 279 60 55 115 46 77 123 169 136 305 44 63 107 27 42 69 101 80 181 120 99 219 1 1 2 717 683 1,400 " 50 " 60 " 140 141 281 79 79 158 65 67 132 201 142 343 52 69 121 58 73 131 129 95 224 137 111 248 1 11 12 862 788 1,650 " 60 " 70 " ' \ 89 75 164 66 50 116 64 49 113 112 63 175 51 53 104 42 56 98 56 76 132 93 80 173 2 3 5 575 505 1,080 " 70 " 80 " 40 33 73 20 19 39 21 22 43 42 42 84 30 22 52 32 20 52 25 36 61 47 37 84 4 4 8 261 235 496 " 8 0 " 90 " !! 9 8 17 2 3 5 1 3 4 12 4 16 6 4 10 0 1 1 8 5 13 9 7 16 0 2 2 47 37 84 Upwards of 90 " .. 2 0 2 1 0 1 I .. 011, .. •• 000202 .. 5 1 6 Unknown .... 14 8 22 2 16 18 | .. 3 0 3 8 1 9 3 4 7 1 2 3 0 3 3 31 34 65 Totals .. 721 613 1,334 291 284 575 ! 319 337 656 845 590 1,435 454 354 808 212 240 452 778 607 1,385 663 453 1,116 13 23 36 4,296 3,501 7,797

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Table V.—Length of Residence of Patients discharged "Recovered" during 1938.

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' I | j I Ashburn Hall. Length of Residence. ! Auckland. Kingseat. ! Tokanni. Porirua. Nelson. Hokitika. Christchurch. Seacliff. 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. M. F. T. Under 1 month -. 12 3 .. 10 1 10 1 .. • • • • • • n il oo 04 i From 1 to 3 months .. 6 2 8 .. 4 1 5 11 6 17 .. Oil 1 6 7 ? ' ' 01 w m ™ 3 6 3 1 4 .. 1 1 2 12 13 25 1 0 1 .. 5 10 lo 3 9 12 .. 25 34 o9 " 6 " 9 369 .. 358 11 7 18 022 011 268 347 .. 22 31 53 " 9 12 ;; *: t u il :: 145 6 7 13 123 213 527 1 3 4 .. » 3; » 1 2 year's 12 19 31 .. 1 3 4 16 18 34 1 2 3 .. 5 9 14 3 3 6 .. 38 54 92 2„ 3 „ .. Oil .. 1 2 3 6 5 11 3 1 4 .. 2 1 1 2 0 2 2 13 13 26 „ 3„ 5 „ .. 6 2 8 .. 0 1 1 3 8 11 1 1 2 .. 2 2 4 1 0 1 .. 13 14 27 5 7 „ .. 2 1 3 0 1 1 .. 1 0 1 1 1 2 0 1 1 2 0 2 .. .. 6 4 10 7 „ 10 „ ..0 2 2 .. .. 1 0 1 3 0 3 1 0 1 Oil .. .. o 8 8 „ 10 „ 12 „ .. .. .. 2 0 2 .. .. •• •• •• . ,, 12 ,, 15 ,, .. . • • • • • • • • • • • • * 10 1 Over 15 years .. ,.101 .. ... .. •• •• •• •• j Totals .. .. 38 48 86 Oil 12 17 29 70 64 134 11 9 20 3 4 7 24 37 61 12 27 39 0 3 3 170 210 380 I ! : 1

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Table VI.—Causes of Death, 1938.

16

I . I •3 i 3a~ ■a ■ I i i w a3 Causes - 1 I 1 S d I i I «• §s& i cf 5 I I a -a 1 §§S 3 & n ° ® .2 o> «'s o ■<) ' t3 H CM W | O CO -*q H I.—Genekal Diseases. Tuberculosis— M. E. M. E. M. E. m. i<\ m. e. m. e. m. f. m. e. m. e. m. e, General .. .. .. .. .. .. .. .. 20 .. .. .. .. 20 Of lungs .. .. .. ..1 1 .. 0 3 3 2 1 1 .. 2 633 .. 10 16 Of intestines .. .. .. .. .. .. 01 .. .. .. 10 .. 11 Cancer .. .. .. ..0110224201 .. 0 111 .. 88 Eurunculosis .. .. ..01 .. .. .. .. .. .. .. .. 01 Typhoid .. .. .. ..01 .. .. .. .. .. .. .. .. 01 Toxajmia .. .. .. .. .. .. 1022 1 0 .. .. .. .. '42 Diabetes .. .. .. .. .. .. 10100110 .. .. .. 31 Purpura haemorrhagica .. .. .. .. .. 10 .. . . .. .. .. 10 Asthenia .. .. .. .. .. .. .. .. 3002 .. .. .. 32 II. —Diseases oe the Nervous System. Mania, exhaustion from .. ..21 .. 01 .. 12 .. 12 .. .. 46 Melancholia, exhaustion from ..44 .. 1001 .. .. 10 .. .. 65 Confusional insanity, exhaustion from .. .. .. 01 .. .. .. .. .. .. 01 Genoral paralysis of the insane ..11 10 .. 32 1001 3020 .. 114 Epilepsy .. .. .. ..1 2 .. 1 1 2 5 6 2 .. 2 3 3 2 .. 15 15 Cerebral haemorrhage .. ..56 31 10 21 .. 02 24 24 .. 15 18 Cerebral thrombosis .. .. ..6 3 .. 1321 11 01 .. 11 .. 11 10 Cerebral syphilis .. .. ..02 .. .. .. .. 10 .. .. .. 12 Hydrocephalus (internal) .. ..10 .. .. .. .. .. .. .. .. 10 Post Encephalitic Parkinsonism . . .. .. .. 10 10 . . .. .. . . 2 0 Primary cerebral sclerosis .. .. .. .. .. 0 1 .. .. .. .. .. 0 1 III.—Diseases oe the Respiratory System. Pneumonia, lobar .. .. ..22 .. 0 1 24 12 .. 02 .. .. 5 11 Broncho-pneumonia .. .. ..89 .. 0 1 1 1 60033521 .. 20 20 Acute septic pharyngitis .. ..10 .. .. .. .. .. .. .. .. 10 Bronchitis .. .. .. .. .. .. 0101 .. 01 .. 01 .. 04 Hypostatic pneumonia .. .. .. .. .. .. .. 01 .. .. 1011 Pulmonary fibrosis .. .. .. .. .. .. .. .. 0 1 .. .. .. 0 1 Pulmonary oedema .. .. .. .. .. .. .. .. .. 0 110 .. 11 Empyema .. .. .. .. .. .. .. . . .. .. 10 .. .. 10 IV. —Diseases oe the Circulatory System. Heart-disease .. .. 9 15 1 2 4 6 4 4 5 1 4 3 8 19 5 11 .. 40 61 Arterio-sclcrosis .. .. ..2 3 2 0 .. 8 3 .. 1 0 6 0 0 1 .. 19 7 Coronary thrombosis. . .. ..02 .. .. 3110 .. .. .. .. 43 Aortic aneurysm .. .. • • .. .. .. .. .. .. 10 .. .. 10 V. —Diseases oe the Digestive System. Peritonitis .. .. .. ..01 .. .. .. 1001 .. 10 .. 22 Bacilla,ry dysentery .. .. ..16 .. .. .. .. .. .. .. .. 16 Ulcerative colitis .. .. ..11 .. .. .. .. .. .. .. .. 11 Volvulus .. .. .. .. .. .. .. 10 ..• .. .. .. 10 VI.—Diseases oe the Genito-urinary System. Nephritis .. .. .. .. .. 1110 10 10 .. 0 110 .. 5 2 Uraemia .. .. .. ..11 .. .. .. .. .. .. 20 .. 31 Pyonephrosis .. .. ..20 .. .. .. .. .. .. .. .. 20 VII.—Old Aoe. Senile decay .. .. ..2 1 8 4 18 17 6 5 1 0 12 6 8 14 0 1 55 48 VIII.—External Causes. Suicide .. .. .. .. .. .. .. 2 0 .. .. 0 2 1 0 .. 3 2 Exposure or exhaustion .. .. .. .. .. .. 01 .. .. .. .. 01 TX. —Died while on Trial ..63 .. 0222 .. .. 01 10 .. 98 Totals .. .. .. 56 67 9 4 21 26 62 51 39 17 8 16 42 53 35 39 1 1 273 274

3—H. 7.

H.-7.

Table VII.— Principal assigned Causes of Insanity, 1938.

17

~ r i 4 • j . 1 a M causea - l 1 ! ill I ! Ml i 1 , j g s s 1 Ml !_ -!"• '• M 4 '6 U 4 M 1 0 10 F 1 M a F i M '.. F ' 42 *6 Alcohol •• 9 0 0 18 5 •• 4 3 0 9 .. 21 26 Arterio-sclerosis 7 8 o 2 0 5 •• •• " 07 Climacteric .. .. •• 8 4 9 g 15" 4 2" 2 39 23 10 12 104 69 Congenital .. .. 21 15 .. 8 ■>« ,.» .. .. .. 39 79 Constitutional .. 13 31 • • • • *' 10 10 Deprivation of senses.. • • • • i n 0 1 . • • • 3 1 Encephalitis 2 0 - •• " 2 3 11 .. 16 8 El>*W •• •• 2 0 0 2 ° 4 4 3 2 1 .. 0 3 .. 1 2 21 17 Heredity .. y * , o 10 . . • • • • 2 3 Ill-health .. ■ • •• •• 0 O 3 i" 1 1 1 1 12 2 3 .. 20 31 Involution .. . . 12 11 .. n 12 9 12 1 1 1 2 13 26 12 19 .. 59 100 Mental stress .. 12 28 .. U 0 12 1.. .. 88 Organic brain disease A 0 •• 10 •• ■ " 1° Post operative .. •• 01 • •• • ■ 01 Post poliomyelitis . ,, 9d q" 1 1" 1 2 2 9 19 .. 79 73 Previous attack 22 22 0 • " 2 2 3 0 15 19 1 4 0 1 22 28 Puberty or adolescence .. •• n 7 0 2 .. 05 .. •• 0 21 Puerperal .. • • 0 7 .. ■"7 q 2 14 21 14 10 1 0 69 84 Senility .. •• 14 22 .. 4 9 2 S 3 .. 2 0 5 0 .. .. 15 7 Syphilis •• ..64.. •• 05 .. 10.. 35 Toxic ' • 2 I ■■ 2 1 Transfers° i 9 0 7" 2 2" 5 6 6 6"l3 5 6 12 8 5 3 0 1 52_M Totals •• 142 152 10 2 45 51 152 155 31 31 16 15 119 128 61 81 3 4 579 619

H.—7.

Table VIII. 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.

18

Discharged V* . , , _ —— ' Remaining, . -»„„»» Percentage Percentage of Deaths Admitted. Died. 31st December in of Recoveries on on Average Numbers Recovered. Relieved. Not Improved. each Year. esiaeni. Admissions. resident. r i i i i i i 1 i i i r M * F ' T - M * F. T. M. j F. T. M. F. T. M. 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 j 12 48 519 264 ! 783 491 257 748 54-53 66-01 57-56 8-21 3-58 6-70 1877 .. 250 112 362 123 57 180 20 5 25 3 2 5 42 I 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 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 I 71 695 36l! 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 3961 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 79 827 442 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 i 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 6-13 188.8 .. 215 146 361 116 j 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 .. I 230 | 160 390 98 j 88 186 23 17 40 12 5 17 76 35 111 i 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 ..I 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 s 1,917 1,125 714 1,839 38-53 48-lo' 42-42 6-58 4-76 5-87 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 I 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 .. j 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 j 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 i 72 174 1,654 1,119! 2,773 1,622 1,094 2,716 39-06 46-64[ 42-17 6-29 i 6-58 6-41 JiSo '• 362 1 192 544 135 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 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 j 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 190o .. 360 251 611 149 121 270 29 24 53 .. .. .. 147 67 214 1,836 1,276 3,112- 1,796 1,232 3,028 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 • 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 .. .. j .. 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 •• 448 317 76 5 163 168 | 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 1,641 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 3ffl 879 j 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

H.--7.

19

i ;; |1 11 1 1S 11 S! IIII Illillllllli!! i :: S S S li 1 1 1 s i s a i lis II I! § H§!! I! Is ;5 11 il ii :: i S i ii :I S I 1 I I \ i I a :l s ti IS S lis IS li Is ss sr. ;:b »| j:« S S S a w ffi a 8 8 8 8 8.8 S IS 5 Sin iS SIS S IIS| SS 1 SJJ «. a? :: S a MS a is B s S S 8 S S g S S S S:S :S S iS «•» «. ts 111 :: S IS K S 8 S 8 S S S g S i ! : S IE I : i I' l 5 ; a lis Is!«:« 5:2 tl J:S 1934 479 504 983 114 146 260 64 72 36 .. .. -.. 233 203 436 4,133 3,30U ,,433 3,899 3,039 6,938 _3 80 28 9, g » 6 . u SS :: 553 tltl'S HI M9 105 96 | !! !! !! 252 213 m 4,357 go. T>» 4,093 3,195 «£ £» *-76 6-18 • £ «;38 } 9 38 :: 527 575 !',!o2 170 2ll 380 ul ls5 2TC i73 i?4 547 i'.M 7>7 3:287 7,416 32-26 36-52 34-48 6-61 8-33 7-38 24,12818,585 42,713 8,469 7,446 15,915 539 2,272 4,811 9,306 5,619 14,925 Excluding transfers between institutions —2,725 males, 2,164 females.

H.—7.

Table IX. —Showing the Admissions, Discharges, and Deaths from Ist January, 1876, to 31st December, 1938 (excluding Transfers). M. I<. T. In hospitals, 31st December, 1875 .. .. .. .. 482 254 736 Admissions 24,128 18,585 42,713 24,610 18,839 43,449 Discharged — M. F. T. Recovered .. .. .. 8,469 7,446 15,915 Not recovered .. .. .. 2,539 2,272 4,811 Died .. .. .. .. 9,306 5,620 14,926 20,314 15,338 35,652 Remaining on 31st December, 1938.. .. .. .. 4,296 3,501 7,797

Table X. —Summary of Total Admissions: Percentages of Cases since the Year 1876

20

Males. ! Females. ! Both Sexes. Recovered .. .. .. .. 34-41 39*53 36*63 Not recovered .. .. .. .. .. 10*32 12*06 11*07 Died .. .. .. .. .. .. 37*81 29*83 34*35 Remaining .. .. .. .. 17*46 18*58 17*95 100*00 100*00 100*00

H.—7.

Table XI.—Debits for the Financial Year, 1938-39.

21

__ Kiogseat. Tokanui. | j ~ " Hokitika" ; CMstchurch. | SeacUff. Head Office. Totals^ £ s. d. £ s. d. £ s. d. £ s. d. £ s. d. £ s " i , S g 71 gig j4 2 9,928 4 0 409,061 8 4 Salaries, including overtime .. .. 59,628 12 6 21,453 12 6 37,454 6 9 74,966 3 0 37,672 9 o 2o,2 0 6 7 7 j 71,085 18 5 71 .. 100 12 4 Official Visitors 48 6 0 .. - 22 8 4 .. 4 4 0 -5 4 4g g g m 18 g 320 12 11 Advertising, books, &c. .. .. 26 10 5 23 19 11 30 1 / 49 1' 110 1 18 1 •• •• ,' Bacteriological research .. •• 168 6 0 •• •• : J-Jj *" 9 »o£ ia q 650 18 10 4,041 8 11 •• 31,424 1 11 Bedding and clothing .. •• 5,094 12 11 1,971 17 5 2,530 6 1 1 6 . , o "'.745 17 n 1242 19 9 891 4 9 •• 4,498 19 11 Buildings, including additions, &c. .. 759 1 10 18 3 8 430 15 7 73:, 13 6 1 1 245 17 0 1,-4. 19 9 76 i8 3 Dental services 9 15 5 4 14 6 6 4 8 2 7 3 12 17 0 6 7 7 j 3 7 16 g37 g Farms, maintenance of .. • • 1,081 2 0 821 6 0 2,906 6 t Q « ' rfi ~ 4 ?7 8 2 111 9 1 158 15 6 •• Fencing, draining, and roading .. 4 9 8 135 18 8 177 10 6 30 8 6 | q 9 384 14 0 0 3 4 1,882 13 2 Freight, cartage, and transport .. 78 4 2 158 1 4 252 0 1 333 11 < . . , 9 •> g 7 151 16 3 5,955 6 6 48 18 1 42,243 5 5 FueUight, water, &c. .. .. 7,348 18 0 2,587 1 5 4,367 19 11 7,603 7 3 5,036 15 4 2,143 2 8 ,,161 lb 3 770 12 6 Funeral expenses .. . • •• 67 10 0 56 0 0 88 0 0 157 2 g 7 29 3 u 5 10 10 4,283 19 5 Furniture and fittings .. .. 349 2 5 232 4 1 325 13 4 1. 292 11 3 202 0 7 36 10 3 786 9 35 18 3 .. 570 12 3 Gardens and shrubberies .. •. 57 17 11 56 15 9 69 17 5 84 5 3 ; ,, „ 1 9 3 449 4 7 •• 2,310 0 6 Laundry 249 4 1 251 16 11 191 0 2 474 13 7 126 1/ 11 4o 14 0 oZl » a 4 18 6 Legal and inquiry costs .. •• 270 . • j •• 2 11 6 •• •• 72 1,411 4 10 SaHL rePairS ' andSt0reS :: 64! 14 7 1 1 ». U3H0 667 » 0 68 14 6 *63 0 0 5lS 18 6 323 14 6 .. 2,433 4 1 "SS225i- 22,0 9$ . . 188 11 6 120 7 7 82 0. U » • » » J ~ | j g "I sSS"— :: " «». » • . » . . «'»>? » ♦ » "j »» ™ { { "J U •'» » "SK • Office equipment 6 0 10 7 10 S .. 0 9 10 - - 0 i v .. « 10 0 - 3 0 0 72 11 2 11.11 19 17 0 •• » » » - *» 2 S ESfc, :: :: :: m,, m t j •» »{ 1$ 15 :: '•SBJ Transfers .. •• •• 20 07 1 o 8 .. 84 19 0 q 11 193 5 1 832 3 5 Postages, telegrams, &c 83 12 9 45 7 6 59 - 8 8 -130 7 11 47 2 10 24 10 0 - i 77 10 4 92 18 5 1,545 9 9 Printing and Stationery .. .. 245 14 0 106 18 6 116 9 10 320 9 8 5/ 10,238 10 0 •• 93,288 3 8 Rations 14,948 19 11 8,596 14 7 6,606 11 3 20,463 9 3 9,295 2 0 6,o84 11 'ggg 14 3 p>4 0 0 648 13 4 1,186 0 2 Rents and rates .. .. ■ • .. .. • - • ■ _ gjg jg 0 __ 6,104 9 3 Stores .. •• •• •• 720 18 11 328 18 7 556 15 1 1,558 6 11 4/8 5 7 397 12 10 1,147 1/ 1U 4 2,915 12 3 Surgery and dispensary, drugs, &c. .. 517 5 1 202 2 4 122 17 3 o21 7 11 -6 _ ~ 108 g g 116 17 3 99I 12 9 Telephone services .. .. .. 56 7 5 143 16 7 107 12 7 160 13 5 58 4 5 32 4 6 11/ 1 67 6 8 2 10 2 190 19 9 Transfer and removal expenses .. 8 9 5 33 3 6 4 15 0 . . 32 15 2 49 4 4 229 9 9 233 17 2 990 17 4 Travelling-allowances .. .. 164 7 1 85 6 6 79 15 9 » 66 0 / 32 5 2 49 4 4 336 4 1 1,740 6 10 Travelling-expenses 87 19 6 148 14 7 141 6 11 375 3 10 15 3 8 9 19 1 365 "SS"'™'.'-'"*' .. 194 13 6 . 12 0 4 2 0 204 17 0 21 4 6 3 2 . 1«7 |3 0 10.8 0 •• ™ J» » S '*« •• . •: .. - " S2X A„ „ - ,,V * * " ,',0 »!l 93 1110 .. 584 12 11 Contingencies and miscellaneous .. 1120 0119 .. Totals .. .. .. 94,113 3 5 38,017 14 3 57,932 18 4 121,565 1 1 59,538 3 2 38,924 1 4 112,315 4 3 106,932 0 4 11,714 18 9 641, 0o3

11. 7.

Table XIa.—Credits for the Financial Year, 1938-39.

Table XII.— Average Cost of each Patient per Annum.

22

Auckland. Kingseat. Tokanui. Porirua. Nelson. Hokitika. Christchurch.' Seaciiff. Head Office. Total. £ s. d. £ s. d. £ s. d. £ s. d. £ 8. d. £ s. d. £ s. d. £ s. d. £ s. d. £ s. d. Receipts from maintenance .. .. 31,613 16 4 9,977 19 9 13,295 9 3 36,957 3 11 11,554 11 4 6,422 13 9 27,348 8 5 24,964 10 9 .. 162,134 13 6 Receipts from farms .. .. 705 14 3 2,157 15 9 4,072 10 0 1,468 10 4 1,908 18 10 56 18 2 2,332 7 5 3,248 4 7 .. 15,950 19 4 Miscellaneous .. .. .. 6,619 7 11 I 2,911 19 3 4,312 1 10 9,874 4 8 3,621 1 7 j 2,786 10 7 7,925 14 3 7,430 6 6 i 3 15 7 45,485 2 2 Totals .. .. .. 38,938 18 6 15,047 14 9 21,680 1 1 48,299 18 11 17,084 11 9 9,266 2 6 37,606 10 1 35,643 1 10 3 15 7 223,570 15 *0

Average Number Bedding Buildings Fuel, Light,! Surgery . Total Cost me nts for Other NetjCost Net Cost Decrease Increase Mental Hospital. i Resident Salaries. and and Farm. Water, and j Provisions. | and ' per - n j lie- per Previous in | in (inclusive of Clothing. Repairs. Cleaning. I Dispensary. Patient. * tenanee ' P a y men ts. Patient. Tear. 1938-39. 1938-39. Boarders). j I | ' . . £ s. d. i £ s. d. £ s. d. £ s. d. £ s. d. ; £ s. d. £ s. d. ; £ s. d. £ s. d. 1 £ s. d. : £ s. d. £ s. d. £ s. d. £ s. d. { £ s. d. Auckland .. .. .. 1,278 46 13 2 3 19 9 0 11 11 0 16 11 5 15 0 11 13 11 0 8 1 3 14 1 73 12 10 24 14 9 j 5 14 8 43 3 5 42 15 4 .. | 0 8 1 Kingseat .. .. .. 581 36 18 6 3 7 11 0 0 7 1 8 3 4 9 1 14 15 11 0 6 11 4 1 6 65 8 8 17 3 6 I 8 14 6 39 10 8 33 0 7 .. 6 10 1 Tokanui .. .. 651 57 10 8 3 17 9 0 13 3 4 9 4 6 14 2 10 3 0 0 3 9 5 7 11 88 19 10 20 8 6 12 17 7 55 13 9 53 14 10 .. 1 18 11 Porirua .. .. .. 1,506 49 15 7 4 8 10 0 9 9 1 7 3 5 1 0 13 11 9 0 6 11 5 13 4 80 14 5 24 10 10 7 10 8 48 12 11 45 7 1 .. 3 5 10 Nelson .. .. 792 47 11 4 3 18 9 0 4 5 1 9 3" 6 7 2 11 14 9 0 6 7 3 11 3 75 3 6 14 11 9 6 19 8 53 12 1 48 1 11 .. 5 10 2 Hokitika .. .. .. 452 55 17 6 5 2 11 0 10 11 0 14 4 4 14 10 14 11 4 0 10 1 4 0 5 86 2 4 14 4 2 | 6 5 10 65 12 4 63 6 9 .. 2 5 7 Christchurch .. 1,320 53 17 1 4 5 7 0 18 10 1 4 4 ; 5 8 4 12 10 10 0 7 9 1 6 9 0 85 1 9 20 14 4 : 7 14 5 56 13 0 52 18 2 .. 3 14 10 Seacliff .. .. .. 1,117 64 2 3 3 12 4 0 15 11 6 3 5:5 6 8 9 3 4 0 9 10 6 0 9 95 14 8 22 7 0 9 11 2 63 16 6 61 4 3 .. 2 12 3 Head Office .. .. .. 159 .. .. | 0 0 2 j .. .. 046 1 10 5 .. .. 1 10 5 1 10 1 .. 004 Total average cost .. 7,697 53 2 11 418 0 11 8 239|599jl2 25 077 6 0 83 5 9 21 1 4 j 7 19 8 54 4 9 51 3 8 .. 31 1 * Note. —Cost does not include interest and depreciation on land, buildings, &c.

H.—7.

Table XIV.—Total Expenditure out of Public Works Fund for Buildings and Equipment at each Mental Hospital from 1st July, 1877, to 31st March, 1939.

Table XIII.—Expenditure out of Public Works Fund on Mental Hospital Buildings, etc., during the Financial Year ended 31st March, 1939.

Approximate Cost of Paper.—Preparation, not given; printing (610 copies), £35

By Authority : E. V. Paul, Government Printer, Wellington.— 1939.

Price 9d. ]

23

Total Net Expenditure Mental Hospitals. 1877-1929. 1929-30. 1930-31. 1931-32. 1932-33. 1933-34. 1934-35. 1935-36. 1936-37. 193<-38. 1938-39. 1939° I ! ; ; ; 1 j i Auckland .. .. 2,279 3,372 621 676 155 2,321 307 842 5,668 907 Qqo'464 Christehurch .. .. 232,052 35,291 , 23,993 4,650 7,960 3,481 23,489 12,397 23,970 16,397 b,/84 4 891 Dunedin (The Camp) .. 4,891 .. ! .. .. .. •• •• •• Hokitika 46,050 3,064 14,764 8,381 3,107 8,753 5,629 2,739 7,580 2,09- 1,140 Hornby .. .. .. 11,102 .. .. .. .. .. •• •• ' ' Motuihi Island .. .. 561 .. . . .. • • • • • • ■ • ' ' NeSon and Stoke !! '64,556; 33^250 12,251 28,552 18,307 16,218 2,234 15,458 223,339 Puhitahi (Kingseat) .. .. !. 16,130 16,433 10,278 35,438 29,784 21,973 65,192 52,144 71,149 318,521 Seacliff 252,187 34,609 8,914 3,065 414 6,618 4,888 1,453 2,958 570 2,o27 318,-03 Tokanui .. .. .. 146,595 32,405 27,787 7,164 2,918 6,295 3,797 12,682 18,839 2,855 6,903 Waitati .. .. .. 19,142 2,170 9,557 936 516 .. .. •• •• • " 29641 Wellington .. .. 29,641 .. .. .. .. .. •• qq7'j.sq Wellington (Porirua) .. 332,617 9,028 3,129 1,349 207 29 170 .. 6,510 20,502 , Totals .. 1,363,932: 152,096 134,140 45,938 28,756 73,020 98,630 69,858 142,109 102,457 128,816 2,339,7o2

Net Expenditure for Year Mental Hospitals. ended 31st March, 1939. £ Auckland .. .. .. • - • • • • • • • ■ • • ®2? Christchureh .. .. .. .. .. .. Hokitika .. .. .. ■■ •• •• •• •• ,M*a Nelson and Stoke .. . • • • • • • • • • • • • • Porirua Kingseat .. .. .. .. ■■ •• •• •• I'lw Seacliff 2,527 Tokanui 6 > 903 Waitati Total I 28 ' 816