MENTAL HOSPITALS OF THE DOMINION. (REPORT ON) FOR 1939.

Appendix to the Journals of the House of Representatives, 1940 Session I, H-07

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1940. NEW ZEALAND.

MENTAL HOSPITALS OF THE DOMINION. (REPORT ON) FOR 1939.

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

The Director-General to the Hon. H. T. Armstrong, Minister in Charge of the Department of Mental Hospitals. Sir,—- Wellington, Ist June, 1940. I have the honour to present my annual report upon the work of the Department of Mental Hospitals for the year ending 31st, December, 1939. Statistical. There were 8,310 names of persons upon our registers at the end of the year, including 43 patients and boarders at Ashburn Hall licensed private institution and 578 patients and boarders who were absent on probation in the care of relatives or friends. In actual residence in our eight State hospitals on 31st December there were 7,689 persons —an increase of 217 compared with the previous year—and of this number 7,360 were subject to a reception order, whilst 329 were voluntary boarders. There was an increase of 78 in the number of those admitted for the first time, and 340 ex-patients and boarders returned for further treatment. Of all classes of admissions we were able to discharge 872, or 55-65 per cent, calculated upon the number admitted, but not more than 463, or 29-55 per cent., were fully recovered at the time of discharge. This figure falls considerably short of the true recovery rate, as patients who go on probation and do not send a medical certificate or report to the institution require to be discharged as " unrecovered." As pointed out in previous reports, it is necessary when considering the recovery rate to differentiate between the congenitally mentally defective cases and cases of acquired mental breakdown, and for this purpose these classes are divided in the following tables :—-

(1) Mental Disorders.

(2) Mentally Deficient.

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Male. Female. Total. Male. Female. Total. In mental hospitals, 1st January, 1939 .. .. 3,225 2,844 6,069 Admitted for first time .. '.. .. ..535 508 1,043 Readmitted .. .. .. .. ..139 165 304- 674- 673 1,347 Total under care during year .. .. .. 3,899 3,517 7,416 Discharged— Recovered .. .. .. .. .. 216 235 451 Not recovered .. .. .. .. .. 180 176 356 Died .. .. .. .. .. 237 196 433 633 607 1,240 Remaining in mental hospitals 31st December, 1939 .. 3,266 2,910 6,176

| Male. Female. Total. Male. Female. Total. In mental hospitals, 1st January, 1939 .. .. 1,254 826 2,080 Admitted for first time .. .. .. ..107 77 184 Readmitted .. .. .. .. 16 20 30 123 97 220 Total under care during year .. .. • • 1,377 923 2 300 Discharged .. .. .. .. .. 62 46 108 Died .. .. .. .. .. 30 28 58 92 74 166 Remaining in mental hospitals 31st December, 1939 .. 1,285 849 2,134

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Table No. 1, which includes voluntary boarders as well as committed patients, discloses that 807, or 774 per cent., calculated upon the number admitted for the first time, wore discharged during the year, and of that number 451, or 43-2 per cent., had recovered. In the same class, the ratio to population of the admissions, including Maoris, was 8-27 (males 8-15, females 8-39) per 10,000 mean population, and of first admissions 6-40 (males 6-47, females 6-34), so that 1,219 persons in the general population contributed one patient, and 1,574 contributed a patient admitted for the first time. The congenitally defective, whose movements are shown in Table No. 2, do not recover, but 108 were able to be discharged to the care of friends and a number are capable of remunerative employment.

Voluntary Boarders.

Alterations, Additions, and Improvements. Capital expenditure incurred upon new buildings, additions, and improvements during the year amounted to £175,426, and the following summary shows the major items making up the total: Auckland (£7,118). Additions have been made to the Nurses' Home. A store-room for occupational therapy work has been erected. A new hairdressing-saloon has been built. Improved bathing-facilities have been provided in F. 7 Ward. Kingseat (£62,896). The Nurses' Home will be completed at an early date. The workshops block and departmental garages have been completed. Six villas have been renovated and painted during the year. Necessary roading, water-supply, and telephone services have been extended. Two male villas have been completed. Tokanui (£9,922). The now villa for male patients will be completed at an early date. A new slaughterhouse and yards have been crected. Additional separate kitchens have been provided. The general roading has been improved during the year. Porirua (£10,894). The new bakehouse and butcher's shop are now in occupation. Most of the equipment for the new boilerhouse and workshops block has been installed. A start has been made with an improved sewerage system. Nelson and Ngawhatu (£39,469). A new fire-service main has been installed at Nelson. The Nurses' Home is now in occupation. Three new male villas are nearing completion. A water-softening plant has been installed. Extensive roading-work has been carried out.

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Vm , ' First Not First ' Total ™ , ™ , Bemaining Admission. Admission. | Admissions. Discharged. on of Patients. J 31st December. M. If. T. M. F. T. M. F. T. M. F. T. M. F. T. M. F. T. M. F. T. 1912 .. .. 6 17 23 0 0 0 6 17 23 1 3 4 0 0 0 4 3 7 I 11 12 1913 .. .. 18 19 37 0 2 2 18 21 39 2 5 7 0 1 1 12 12 24 5 1+ 1!) 1914 .. .. 17 19 36 3 2 5 20 21 41 7 5 12 1 1 2 11 15 20 0 14 20 1915 .. .. 15 17 32 1 2 3 10 19 35 3 4 7 0 1 1 8 14 22 11 14 25 1910 .. ..13 23 30 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 0 6 12 0 1 1 10 23 33 9 19 28 1918 .. .. 23 38 01 5 11 10 28 49 77 1 4 5 2 2 4 15 30 45 19 32 51 1919 .. ..31 39 70 5 19 24 30 58 94 3 3 0 0 2 2 20 42 08 20 43 69 1920 .. .. 20 38 64 16 12 28 42 50 92 3 4 7 1 2 3 33 33 06 31 54 85 1921 .. .. 39 39 78 11 15 26 50 54 104 2 3 5 5 1 0 38 41 79 30 63 99 1922 .. .. 47 38 85 10 10 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 30 54 04 118 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 71120 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 70 157 133 290 8 10 18 10 8 18 102 97 199 117 141258 1929 .. ..102 03 105 50 43 93 152 100 258 11 3 14 9 9 18 119 110 229 130 125 255 1930 .. .. 152 84 236 41 35 70 193 119 312 15 9 24 8 6 14 130 79 209 170 150 320 1931 .. .. 166 9S 264 43 36 79 209 134 343 11 14 25 11 7 18 159 102 201 198 161 359 1932 .. .. 150 85 235 50 40 90 200 125 325 24 32 56 14 5 19 190 108 298 170 141 311 1933 .. .. 112 109 221 53 32 85 165 141306 11 14 25 5 4 9 121107 228 198 157 355 1934 .. ..132 90 221 50 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 151116 267 199 160359 1936 .. ..98 99 197 62 44 106 160 143 303 21 20 41 7 10 17 137 111 248 194 102 350 1937 .. .. 103 91 194 64 45 109 167 130 303 14 7 21 6 10 16 163 122 285 178 159 337 1938 .. .. 111 105 216 60 53 113 171 158 329 11 15 26 11 8 19 144 125 269 183 169 352 1939 .. .. 131103 234 03 72 135 194 175 309 22 21 43 10 15 31 157130 287 182 178 360

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Hohitiha (£26,793). Two new villas have been completed and are now in occupation. Alterations have been carried out in several wards. Christohurch (£11,684). A new workshops block has been erected. Alterations in the kitchen block are now complete. Now garages have been erected. Templeton Farm Colony (£5,568). The new laundry is now in operation. The general roading has been improved during the year. Seaclijf (£1,082). Fire-alarm system and fire services have been improved. The old boiler-house has been converted into an occupational centre and hairdresser's saloon. At Waitati a new kitchen was built in F. 2 Ward. Programme for Current Year. No doubt our programme of improvements to existing buildings will require to bo modified in view of war conditions, but the following are proposed : — Auckland. —An occupational block for patients at M. 3 Ward. It is hoped to commence the erection of a new boiler-house at another and more suitable site. Kingseat- Tenders are about to be let for the erection of seventeen cottages for married stall. An excellent site for the proposed settlement has been secured by the Department. Tokanui- It is hoped to begin the erection of the new services block during the year. The present blocks are not well situated and are not large enough for the present needs of Tokanui. Porirua. —Unavoidable delay in procuring machinery from abroad has held up the operation of the new service blocks, but they will be occupied by the end of the year. The whole sewerage system is being overhauled and modernized. It is intended to recondition the byres, which are almost fifty years old, and to install milkingmachines. It is almost impossible to get sufficient suitable labour to hand-milk nowadays. Nelson - -The old mental-hospital buildings in Nelson have almost come to the end of their possible usefulness, and a complete scheme of rebuilding is necessary. It is hoped to start this year. Hokitika. —There is an urgent need for a new butcher's shop and bakehouse, and we should bo able to commence this work before the end of the year. Christohurch.—lt is hoped to install some new equipment in the laundry and to erect an implementshed at Templeton. Seaclijf.—The unstable ground has affected the cottage and some of the wards on the female side, and these will require extensive repairs to make them safe. Occupational Therapy. For some years past, classes in handicrafts have been carried on at our hospitals, partly by voluntary workers and partly by experts who have received a small honorarium. This work is now past the experimental stage, and has grown to such dimensions that it requires co-ordinated direction under professional trained Occupational Instructors. Dr. Buchanan directed special attention to this matter on his recent visit to Great Britain, and oil his representations Miss Inman, a graduate of Dr. Gasson's School for Occupational Therapy, was appointed as Chief Occupational Instructor. It is intended that Miss Inman's duties will cover the whole of our hospitals, but in the meantime she is engaged at Auckland, where the greatest progress has been evident. In addition to the actual supervision of patients at work in the wards; an important part of the therapist's duty is to give lectures and practical training to the staff. The work carried on at the various hospitals may be summarized as follows Auckland.— I The old Mount Albert Borough Council pumping-station has been reconditioned for use as a centre for male patients. A lathe and some other machinery has been installed, and the work done is of a very high order. The therapeutic results have been most encouragiug. It is proposed to erect another centre for males of a difficult class near Male 3, and I feel sure that the small expenditure involved will be well justified. The Auckland Hospital Auxiliary have done great service on the female side, and the large number of women patients who show great interest in the work is a testimony to the efficiency of the Instructor. Kingseat. — Miss Waugh, working under the auspices of the Auckland Hospital Auxiliary, conducts a weekly handicraft class, which occupies 120 women patients. As Dr. Hunter says in his report, " Many of these were previously onlookers but are now active workers, with a corresponding improvement in their attitude towards life and their surroundings." A gardening class has been started. On the male side, the Rev. Jasper Calder carries on a handicrafts class with his well-known enthusiasm and lias also had very good results. Tokanui. —An occupational class for women has been started, and 80 per cent, of the men are engaged in some kind of work.

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A special feature at Tokanui has been the physical-development class for schizophrenics. Porirua. Four nurses Were seconded for special instruction at the training college, and the Principal and Miss Hanham deserve our thanks for making this possible. Regular classes are held in many handicrafts, and specialized instruction is directed towards the chronic patients, whose activities require guiding from destructive to constructive occupation. The old workshops are being converted at very little cost into an occupational centre. Holahka.—The work here is carried 011 by some of the nurses, and the products which I have seen reflect great credit on them. Christchurch.—Under Miss Bowron a considerable number of patients are usefully occupied and the results are most gratifying. The classes are centred in the new occupational block, and arrangements have been made to double the time given to instruction. Seaclijf— Miss Miller continues to do good work as Instructress, and the Dunedin Branch of the Women's National Council carries on useful work in the wards. A full-time therapist is required here. The institution of occupational therapy has been an unqualified success, and the results so far achieved and to be expected are such as to justify a much increased expenditure upon equipment and additional Instructors. Staff. u ™f ,0 7 ear we have had the utmost difficulty in getting sufficient nurses to maintain our staff at full establishment. The position in this regard has been so difficult that we have been unable to transfer patients to occupy newly erected villas. Conditions of service are exceedingly good. Hours have been shortened to under forty-two per week, leave is liberal, and pay compares favourably with other occupations open to young women. It is small comfort to us to know that a precisely similar state of affairs exists in mental hospitals in Great Britain, where conditions of service have also been improved in late years. Advertising in the press and by radio has resulted in a certain number of fresh applications, but the position of our permanent establishment does not improve to any great extent. We have engaged the wives of men who have gone on active service, and taken other measures, without any material alteration in the position,, and it may become nccessary to look farther afield, possibly to Canada, where I understand there is some likelihood of obtaining recruits for the service. T. G. Gray, Director-General.

AUCKLAND MENTAL HOSPITAL. Dtf . Buchanan reports :— The total number of cases under care during the year was 1,826, with a weekly average of J,311. The total admissions numbered 403—under certification 142 males, 150 females; by transfer 11 males, 3 females ; on remand 6 males, 5 females ; and as voluntary boarders 50 males and 36 females. During the year 162 patients (71 males, 91 females) and 66 voluntary boarders (44 males, 22 females) were discharged. Transfers to other hospitals numbered 50 (29 males, 21 females). Deaths totalled 90. At the end of the year 196 patients were on probation, 52 on full parole, and 179 on limited parole. I append figures relative to the Psychiatric Clinic held at the Auckland Public Hospital by Drs. Hunter, Macky, and myself:— Tuesdays. ( «X). T °^ (1) Number of separate persons seen .. M. 206 144 350 F. 23 5 28 229 149 378 (2) Number of — (a) First visits .. .. .. .. 172 149 331 (b) Subsequent consultations .. .. 615 374 989 787 523 1,310 (3) Sources of reference—Pensions Department .. .. .. 151 121 272 Prisons Department .. .. ..18 .. 18 Police Department .. .. .. 8 .. 8 Medical practitioners .. .. ..20 ]2 32 Voluntary calls .. .. ..16 2 18 Public hospital .. .. .. .. 7 12 |y Social Welfare League .. . . . . I . . 1 Porirua Mental Hospital .. 1 .. | Christchurch Mental Hospital .. 1 .. 1 Mental Hospitals Department, Wellington 1 .. ] Department of Labour .. .. .. 1 .. 1 Valuation Department .. .. 1 ~ I Evelyn Firth Home .. .. .. 22 Officer Commanding, Northern Military Command .. .. 1 2 3 229 149 378

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lhe Inebriates Home at Eoto Roa Island was visited regularly by both Dr. Macky and mys -If. The health of the patients has generally been good. Much work has been done during the year in the development of the occupational work on both sides of the hospital. The buildings connected with the old pumping-station have been repaired and made into workrooms for the men. A lathe, circular saw and drill, jig saw, and planer have been installed-in one room, and they are m constant use. At the end of the year the average number of male patients occupied in the manufacture of furniture, toys, &c., was 38. The classes for the women are held in the dayrooms of Wards P. 5, F. 8, and F 9 The avera >e number employed at the end of the year was 120. It must be understood that no patient is taken away from essential or routine work to fill up the classes ; m fact, it is otherwise—i.e., patients who show improvement and are capable of undertaking increased responsibility are taken from the classes and used to help in the running of the institution llie work is progressing encouragingly, but there is still much to do to fully develop the scheme to the extent whereby nearly all patients will be usefully employed. I look forward to the arrival from England of Miss Inman, who has been specially trained in thii work, and who will act as Instructress to both the members of the staff and the patients. An administrative office and lecture-room have been built under M. 5 Ward for the use of the Instructress. m a^n °'^ ce > k e] ' n g too small and congested for present needs, necessitated a change over ot' offices lhe rooms previously occupied by the Assistant Medical Officers and Head Attendant and part of a male dormitory were altered so as to render them suitable as administrative offices. The Assistant Medical Officers are now utilizing the former clerical offices. The annual bazaar, which was opened by yourself, was a success both financially and as a day ol entertainment to the patients. The sum of £195 (approximately) was.realized. I wish to extend my grateful thanks to the many firms and individuals who made donations to our bazaar It was with deep regret that we learned of the death of Mrs. A. E. Armitage, who was associated with this hospital as an Official Visitor for twenty-three years. She is much missed by both the patients and the staff. Mrs. Teape was appointed in her place. She had already done much work for us as a member ot the Auckland Hospital Auxiliary. Many members of our staff have been called upon for duty overseas. I wish them all aood luck and a quick return.

KINGSEAT MENTAL HOSPITAL. Dk. Hunter reports : — The total number of patients under care during the year was 626 (322 males and 304 females) with a weekly average of 580. Patients admitted for the first time numbered 5 (3 males and 2 females). Patients admitted by transfer numbered 46 (28 males and 18 females). Transfers to other hospitals numbered 8(5 males and 3 females). There were 4 patients discharged (2 males and 2 females) and there were 13 deaths (11 males and 2 females). The total number of voluntary boarders under care during the year was 10 (7 males and 3 females), with a weekly average of 5. Boarders admitted for the first time numbered 5 (males). One voluntary boarder (male) was discharged, and there were no deaths. The general health of both patients and staff has been excellent. This year has been one of continuous activity. Two new villas each to house fifty male patients have been completed and equipped. Tenders for the erection of a Nurses' Home have been called, and the building commenced in April. This building was to have been completed fifteen months from commencement, but owing to Defence work construction was stopped for about six weeks, so that the date of completion will be extended. _ The adequate storage of our water-supply has been somewhat of a problem in the past, but the building of a 300,000 gallon storage reservoir at present in the course of construction should give us a good supply for fire-fighting should it ever be required. The service block, consisting of a laundry, butchery, bakery, and artisans' workshops, has been completed and equipped. These units have been in use since July of this year. The laundry has been very much appreciated by all members of the hospital, especially when one looks back to the old laundry, which had very few facilities for the work it was required to undertake. -The admission and treatment centre has been completed and equipped. Since August direct admissions have been taken, and both relatives and patients have remarked on the cheery outlook the feeling of freedom, and the lack of visible restraint which they feel. This must react favourably mental outlook and help considerably in the treatment of our nervous and mentally ill. _ Following the practice of renovating a certain number of villas each year, the renovation of Villas 1, 2, 3, and 4 has been completed, and the use of pastel shades in the painting of the sitting-rooms and dormitories has a pleasing effect and makes the rooms seem warmer and more homelike. The increasing number of patients and staff has created a difficulty, in that there is no suitable place ot entertainment at the hospital. Concerts, church services, and dances necessitate the using of three rooms in a villa and the transportation of seating-accommodation. The only satisfactory solution appears to be the provision of a recreation-hall, preferably with cinema facilities.

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The opening of the new villas and the admission centre coincided with the outbreak of the present war, and this has created a shortage of staff, both male and female, with the result that we have been unable to open the new villas. Of the thirty-four male attendant staff, eight have enlisted, and three of these are at present on active service overseas. The patients on the whole are happy and contented, and appreciative of their parole privileges, which have been extended to all patients as consistent with their mental conditions and the public safety. They are fully occupied in constructional work on the farm and in the grounds, in the gardens, laundry, and in the sewing room. Mr. McFarlane, 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 thankful. A weekly clinic is conducted at the Auckland Public Hospital. One hundred and forty-nine new cases were seen, whilst there were 523 attendances. New cases were referred by the Pensions Department, 121; medical practitioners, 12; hospital, 12; military authorities, 2; spontaneous, 2. I would like to welcome Dr. and Mrs. I. 11. Gray to Kingseat. Dr. Gray has been appointed Assistant Medical Officer. During the year, Mr. Tibbie, our Chief Clerk, was transferred to Tokanui Mental Hospital, and his place was taken by Mr. M. S. Moss, of Head Office. I would like to congratulate them both on their promotion.

TOKANUI MENTAL HOSPITAL. Dr. Tothill reports : — The total number of cases under care during the year was 795, which includes 37 voluntary boarders. Admissions numbered 121, of whom 6 were transfers from other institutions and 19 voluntary boarders. The discharges were 38 patients under certificate, 14 voluntary boarders, and 9 transferred. There were 37 deaths, heart-disease being the predominant cause. At the end of the year 691 patients, including 44 on probation and 17 voluntary boarders, remained on the register. Cardiazol treatment has been given to a number of patients. Approximately 80 per cent, of the male patients are engaged in some form of occupation. An occupational therapy class lias been commenced for the women. During the year considerable improvements have been carried out in the various buildings. Several wards are at present doing their own cooking, and during this year all but two wards will have an independent kitchen service. The officers' quarters are now in occupation, and the glasshouse has been completed. The new slaughterhouse would have been in use but for the delay in obtaining steel meat-rails. Tar-sealing of the front drive is in progress. It is hoped that work will soon be commenced on the new laundry block, as the increase in patients makes this most imperative. A farm workers' villa is in the course of construction. Developmental work continues on the farm, and the dairy herd was tuberculin tested. The usual sports and entertainments were provided.

PORIRUA MIiNTAL HOSPITAL. Dr. Lewis reports : — The total number of cases under care during the year was 1,999; of these, 1,771 were the subjects of a reception order ; 218 were voluntary boarders, and 10 were remanded for observation. The admissions totalled 443 during the year, of whom 336 were certified patients and 107 were voluntary boarders ; in addition, 9 were admitted on remand. We discharged 202 patients during the year, and 78 were well enough mentally to be on probation in the care of relatives or friends at the end of the year. There were 130 deaths during the year, and 22 were transferred to other institutions. The usual psychiatric work has been carried on outside the hospital, regular bi-weekly visits being made to the Wellington General Hospital, where the out-patients' clinic and the male and female psychiatric wards have continued to provide a useful service. The Palmerston North General Hospital has been visited each month, and some cases have been seen in some Government institutions. The number of separate cases seen in the course of this work was 212 in-patients at Wellington Hospital, 99 out-patients at Wellington Hospital, 66 patients at Palmerston North Hospital, and 10 other cases. Total cases seen outside this hospital, 387. During the year the new carpenter's, painters', and bootmaker's shops' in the new boiler-house block were occupied. The installation of the boilers has been completed, but unfortunately there has been difficulty in getting the copper piping required to connect up our new boilers with the existing hospital reticulation. We have not been able to occupy the new baker's and butcher's shop block as there are still minor details to be completed ; however, there is every prospect of. these buildings being occupied early in the New Year. The old carpenter's shop will make a satisfactory occupational block, and we hope to have some simple alterations completed at an early date. More active steps have been taken with the new sewerage scheme, and the completion of this very necessary work is in sight.

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Convulsive therapy (Cardiazol) was commenced during the vear The results fmm *i, n investigation of each case before treatment is commenced. 8 P^ Blcal Occupational therapy can be a very active and effective form of treatment both hv it ao lf l an adjunct to other forms of treatment. With a view to improving S£Sb tope Ltvariett of Ttt»™p, 7.™ P " d ■"** ™ te 10 tho Wclli "S'»» T ™'« <*** for special t^^SL'S'Z or guiding ttoi^^'^omcwhat^deetriictive^Ttare^to'tr^constrik'tK'o 1 ' variety of attractive occupations and an occupational centre away from the patients' wards ire both essential m getting the best results with the more difficult casesf ? 1 ° ih wit " fc <■ -w Ihe strength of the female nursing staff has been much nearer our establishment fio-ure than w™ orlnZ ™ k th> ««t "««» necessary for ZZlfSt wS JJ? e beginning of the year four new junior Assistant Medical Officers joined the staffers. Medlicott, Calvert, Daly, and Houghton. This has relieved the shortage which existed last voir and given us the opportunity to build up a medical team of reasonable size * ffH sggfc

Ti _ NELSON MENTAL HOSPITAL. JJr. Williams reports :—- The total number of patients under care during this neriod was Of)'} nf wlinm «sn i, 11 n a reception order »hil, » volnntary bo.rd.rsVd C,°^™n2 tSST' " """" sortim T f e +? a ad ™ lBBlons > 10 of these fc emg voluntary boarders and 13 being admitted under and 16 females. Disorders due to advancing years formed a large proportion of the'caLes of dl h ™i«.bieT/jL b i d ;r. wsr ° ot r N g s,r:a:^ ffssri A"=; .constomed to nnnnng th eam of patient, and .« of ,'bem „ very gold Meed P The health of the patients has been reasonably good. _ A fairly extensive building programme has been carried on during the vear the nrm„'™i ;t being the construction of three new male villas and of a Nurses' Home* Th/Sp£tiSTS2 htSr has been delayed because of difficulties attendant on the war. Extensive and damaging floods towards Yiir * m " M «•—° f * tat *»^«»° ecu py nstsj Much maintenance, repair, and painting work has been done at Nelson and at Nsawhatn iml many works and improvements of a minor nature have been carried out and borne attempt lias been made to institute occupational therapy classes for those not otherwise ' e acquisition of a full-time qualified officer would be a step well justified We have at the moment or some officer who might more profitably be employed elsewhen Attendant

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HOKITIKA MENTAL HOSPITAL. Dk. Childs reports : — At the commencement of the year the patients on the register numbered 452. The admissions proper were 23, while 54 males and 60 females were received on transfer. The discharges numbered 12, transfers to other institutions 24, and deaths 21. The total number under treatment was 589, and the number remaining on the register at the end of the year 532. There were 8 voluntary boarders on the register at the beginning of the year, 8 were admitted during the year, and 10 discharged. The general health of the patients has been very satisfactory. Cardiazol treatment was carried out on a small number of patients, but as the majority had been in hospital for a considerable period the results, although in most cases beneficial, were on the whole somewhat disappointing. Two modern villas, one male and one female, were erected and occupied during the year, the patients admitted being transfers from Seacliff. This has allowed of better classification, and in consequence more individual freedom, and already some benefit may be seen. A small nursery glasshouse in conjunction with a new flower-garden was completed during the year in order to increase the supply of flowers for the wards, while a number of trees and shrubs have been planted around the estate. The usual routine of farming, draining, and gardening has been carried out, 7 acres of land being drained, cleared, and left fallow, while 7 acres left fallow last year were sown in grass. In addition, the farm gangs have been busy making roads to and around the new villas. The gardening gang has taken in extra ground. The painting gang has been fully occupied during the year, and the usual maintenance work carried out. This is steadily increasing as the institution grows in size. A monthly clinic has been held at Greymouth. Westland Hospital has been visited when required, while it is noticed that the tendency is gradually increasing to come direct to the hospital for advice.

CHRISTCHURCH MENTAL HOSPITAL. Dr. McKillop reports : — On the Ist January, 1939, there were 1,385 patients (778 males, 607 females) on the register. During the year 238 patients (119 males, 119 females) were admitted and 28 patients were transferred from other institutions. Discharges totalled 142 (68 males, 74 females), and there were 1,651 persons under care during the year. In addition, 79 voluntary boarders (38 males, 41 females) were admitted. Twenty-eight male and 36 female voluntary boarders were discharged, 7.1 remaining for further treatment. In all, 141 voluntary boarders received treatment during 1939. The total death-rate was very low : there were 73 deaths (32 males, 41 females), the chief cause of death being senile decay. The results of the cardiazol treatment, carried out for the first time in this hospital, may be considered quite satisfactory. Eight cases received treatment. One appears to have made a complete recovery, while six have shown improvement varying from slight improvement to such a degree that the relatives consider that they are back to normal. One case showed no change. One case has been discharged as " recovered," one as " relieved," two are on probation, and the others remain here. Since 1927 the Wassermann reaction has been done on the case of every person admitted since that date. Ninety-four males out of 1,352, and 12 females out of 1,100, gave a positive reaction. Figures for males only

The results are very interesting: the peak years 1928 to 1931, and the very low figures during the past few years, show the incidence of the disease in the war period and the efficacy of the treatment carried out in recent years of causal factor. Many Vorks of major importance have been completed. At Templeton most up-to-date laundry machinery has been installed and is now in operation. This has greatly relieved the congestion in the Sunnyside laundry.

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i j I Year. ' Negative. Positive. Year. j Negative. Positive. I I _J 1927 .. .. 88 81 7 1934 .. .. 115 109 3 1928 .. .. 94 86 12 1935 .. .. 110 105 5 1929 .. .. 112 96 16 1936 .. .. 83 78 5 1930 .. .. 136 125 11 1937 .. .. 96 95 1 1931 .. .. 139 125 14 1938 .. .. 94 91 3 1932 .. .. 104 96 8 1939 .. .. 91 88 3 1933 .. .. 94 88 6

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The main drive has been tar-sealed, and we hope to have the roads at Jenkins Farm ready for sealing this year. A new villa has been pegged out at Jenkins Farm. I consider that a new villa for girls should be built at Templeton. At Sunnyside the renovations, installations of new ovens and boilers, have been completed. The female receiving home has been completely painted and renovated, and similar work is now being carried out on the male side. The reticulation of the new water-supply has been completed and wo are now assured of a copious supply for all purposes. The new workshops' block has been completed, and this has allowed the occupational therapy building to be used for the purpose for which it was intended. This affords employment for quite a number of patients, and many, previously unemployed, now take a keen interest in basketwork, fretwork, enamel-work, and simple handicrafts. A hairdressing-room has been added to the occupational block and will greatly benefit the female patients. The farm and gardens have had a very successful year. We have been able to dispose of much surplus produce to other institutions and to outside firms. A large area at Templeton has been set aside for garden purposes, and this is at present providing a very heavy crop of vegetables. It is intended to increase the Sunnyside gardens similarly so that increased vegetable-supplies may be available. The clinic at the Christchurch Hospital has been held weekly and the numbers attending have increased. Timaru has been visited monthly and many new patients have attended. We have had a full medical staff, and the arrival of Drs. Heath and O'Reilly has greatly lightened the work of the medical staff.

SEACLIFF MENTAL HOSPITAL. Dr. Brown reports : — At the beginning of the year there were 1,116 patients on the register. During the year, 177 patients were admitted, 79 were discharged, and 102 were transferred to other hospitals, whilst 40 voluntary boarders were under care, of whom 38 still remain. There were 78 deaths. At the end of the year there were resident 1,005 patients and 32 boarders. Fifty female patients and 44 male patients were transferred to Hokitika Mental Hospital towards the end of the year. The engineering and artisan staffs have been fully occupied in making the necessary repairs and renovations. The combination of old buildings and the slipping ground make our maintenance work very heavy. At Seacliff a new brick dining-room for F. 1 Ward, replacing that destroyed by fire .last year, has been completed and is in use. At Waitati the new kitchen in F. 1 Villa has been in use for some time and there has been, consequently, a marked improvement in the meals. That ward has been divided into two parts to provide separate dining and sitting room accommodation, and completely repainted and refurnished. The kitchen in F. 2 Villa is practically completed and will be in use very shortly. With its completion each ward on the female side at Waitati will have its own kitchen. The farm has had a satisfactory year. The grounds have been well looked after by the gardener, and the gardens have furnished an abundance of fresh vegetables at all times of the year. The completion of the hairdressing-room and the appointment of a hairdresser for the female patients has proved most valuable. Apart from the improvement in the appearance of the female patients as a whole, it is proving most valuable from the point of view of treatment. The insulin treatment of cases of schizophrenia, started in the middle of last year, has boon continued, and thirty cases have now been treated by this method. With a series of this number lam still hesitant to put our results in statistical form, but it may be said, roughly, that one-third of these cases has left hospital, one-third has shown what may be termed an "institutional improvement," and one-third has shown no response to the treatment. In no case where in the judgment of the medical staff the patient was considered to have a reasonable chance of recovery by the ordinary methods of treatment was the insulin treatment used, and, on the other hand, some cases were given the treatment when it was considered that they had little or no chance of improving under it. Under these circumstances it is very gratifying to be able to discharge one-third of the patients treated. Reports published from time to time from overseas have indicated a higher recovery rate than this, but one feels that these cases have been selected with regard to their suitability for insulin treatment. In our series of cases of less than eighteen months' duration, 71 per cent, showed a full remission and 86 per cent, were able to leave hospital. I repeat my dislike of expressing our results in figures at this stage, but I quote these to emphasize the need for early treatment. There is a tendency, a very natural one, for relatives to agree to insulin treatment only when everything else has failed. As to the permanency of the results it is too soon to give an opinion, but none of the patients whom we have discharged has returned to the hospital, and all those we are able to keep in touch with are doing well. The first of these patients to be discharged had been in a condition of stupor for five years ; I have seen him from time to time since he left the hospital and there has been no obvious deterioration in his condition.

2—H. 7.

9

H.—-7.

The cases which have been classified as institutional improvements are, of course, far from well, but have improved to a stage where they are more easily nursed, are able to look after their own needs, to employ themselves usefully, and to enjoy the recreations and entertainments of the hospital. Another year's experience confirms the opinion I expressed in my last report that insulin therapy is a marked advance in the treatment of the schizophrenic patient. It has its dangers, but when the gloomy prognosis of most of these cases is considered I think that the risks are well worth while. A few cases of schizophrenia have been treated with cardiazol, but I am not yet in a position to report on them. I am greatly indebted to Professor D'A.th, of the Otago Medical School, for much help in the laboratory investigation of these cases, and to Dr. Thomson, Medical Superintendent of the Dunedin Public Hospital, and his staff for assistance in the radiological and cardiological examinations. As formerly, I visited the psychiatric wards and held an out-patient clinic twice weekly in the Dunedin Public Hospital. I also held a monthly clinic in the Oamaru Public Hospital. Dr. Hay, my Deputy Superintendent, conducted a monthly clinic in the Invercargill Public Hospital. An increasing use of his services on his visits there has been made by the Borstal Institute in the examination of problem cases there. Mr. C. B. Barrowclough, the District Inspector, Mrs. R. E. S. Reeves and Mr. A. Steven, the Official Visitors, have visited us from time to time and have shown a keen interest in the patients. Attendants F. Dudman, T. F. Olsen, and W. J. Shaw have been granted special leave and are shortly leaving with the Second Expeditionary Force. I wish them good health and a speedy return. The advent of Dr. McLean and Dr. Milne relieved the burden of my other two medical officers. I would thank Dr. Hay, my deputy, for his valued assistance. Dr. McLachlan has been the medical officer in immediate charge of the insulin treatment, and a thesis on the insulin treatment of schizophrenia which he presented to the University of New Zealand for the M.D. degree has been accepted.

MENTAL NURSES. In November the usual examination was held for the registration of mental nurses, when the following passed Passed top for Dominion: Nurse K. G. Alexander (Porirua). Auckland : Attendants —E. W. Bowie, C. H. Driver, S. Dubourdieu, G. Duncan, R. C. Hickey, R. H. Smith, G. H. Sullivan, D. H. Suttie, W. J. Williamson, H. A. L. Wright*. Nurses —J. M. Anderson, A. S. Brittain. Papakura: Attendants —0. P. Amoore*, H. R. Clifford, H. G. Eastwood, P. A. Hunter, H. EL Kindleysides, T. Parkinson. Nurses—W. E. S. Hargreaves, M. 8001, H. M. Dunning, A. S. S. Pulman. Tokanui: Attendants—C. H. Allen, R. L. Brewer, W. A. George, R. Hood, D. M. McCabe, A. L. Mills, M. J. Phillips, S. E. Pratt. Nurses—A. M. Fry, G. H. Buss, M. K. McArthur, M. E. Thomas*, G. F. Oakden, L. P. D. Duncan, H. M. Duncan, M. M. Prince, E. D. McMahon*, M. J. Armstrong*. Porirua: Attendants —T. H. Costley, R. B. Daly, C. J. Forrest, P. J. Grace, J. A. Ivey, S. R. G. Jones, V. J. Meates*, J. S. Wyrill. Nurses —K. G. Alexander*, I. A. Challis*, C. R. Dolan, M. E. M. Hardie, D. L. Milne, E. Robb, N. M. Smith, E. V. M. Williams. Nelson: Attendants—R. F. Blanch, W. H. Chase*, R. L. Edmonds*, S. G. Page, G. T. Snook, A. J. Walters. Nurses—E. V. Andrews, C. J. Cunningham, T. M- Fowler, D. T. Hawkins, E. D. M. Llovd, J. J. McMillan, I. A. Rogers, N. A. Ryan. Hokitika: Attendants —C. W. Barrowman, A. J. Cooper, 0. F. J. Fowler, K. P. Hanrahan, E. J. Holloway*, K. F. O'Brien, D. M. Oldham, J. A. Roberts, W. G. Veale, F. J. Wallace, Nurses —E. A. Chandler*, A. Mcllhatton. Christchurch Attendants—R. M. Arnott, R. F. S. Buckley, W. Cameron, E. H. Dudley, W. A. Ferguson, L. G. Grant, L. C. Jolly*, W. R. Mackrell, T. A. Moran, F. A. Newell, F. A. Partridge*, W. Ritchie, P. W. Shannahan, J. Y. Snee, S. A. Young*. Nurses— R. M. Barrett*, I. Clark, P. J. Devlin, M. J. Frisby, F. E. Hallins. E. L. Kearney*, S. J. Masters, A. R. Sayer, M. J. Smith, E. M. Sullivan. Templet on Farm: Institution Officers (Male) -A. A. Allen, F. G. J. Ashby, P. S. Cocks, I. L. C. Jolly, E. A. Vincent, G. T. Wylie. Institution Officers (Female) —K. A. Archer, H. M. Croxford*. Seacliff: Attendants- A. L. Aitclieson, F. 11. Aitcheson, W. 0. Buchler, T. Casserly, D. Fyfe, G. L. Hawkins, D. A. Ireland, C. E. Ives, W. H. Legal, W. S. Nicoll, J. Sullivan. Nurses—M. Burke, H. B. Burns, L. I. Carruthers, W. J. Currie*, W. R. Devlin, M. H. Gillon*, E. M. Grant, N. J. Hamilton, E. M. P. Hislop, G. W. Knox, J. Millar, P. C. Phela'n, M. D. Pickup*, I. E. Taylor, A. C. Trczise, H. A. Troy*, N. Wallace, T. Wyber.

* Passed with distinction.

10

H.—7.

APPENDIX.

Table I. Showing the Admissions, Readmissions, Discharges, and Deaths in Mental Hospitals during the Year 1939.

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 1939.

11

M. F. T. M. If. T. In mental hospitals, 1st January, 1939 .. .. .. .. 4,296 3,501 7,797 Admitted for the first time .. .. .. .. 511 482 993 \ KnK . lr ,r. Readmitted 92 113 205 / 603 595 1,198 Total under care during the year .. .. .. 4,899 4,096 8,995 Discharged and died— Recovered .. .. .. .. .. .. 147 181 328 Not recovered .. .. .. .. .. 132 125 257 Died .. .. .. .. .. .. 251 209 460 530 515 1,045 (Not including transfers—Males, 143 ; females, 116). Remaining in mental hospitals, 31st December, 1939 .. .. .. 4,369 3,581 7,950 Increase over 31st December, 1938 .. .. .. .. .. 73 80 153 Average number resident during the year .. .. .. . . 4,106 3,320 7,426

Admissions in 1939. Total Number In Montai Hospitals __ iotaI umDer Mental Hospitals. on I v-iiientc 1st January, 1939. Admitted for the Not First Transfers under'Care First Time. Admissions. I -iransters. un <ler utre. ; I ; M. F. T. M. F. T. M. F. T. M. F. T. M. F. T. Auckland .. .. 721 613 1,334 119 125 244 23 25 48 11 3 14 874 766 1,640 Kingseat .. .. 291 284 575 3 2 5 28 18 46 322 304 626 Tokanui .. .. 319 337 656 38 48 86 5 5 10 6 6 368 390 758 Porirua .. .. 845 590 1,435 132 119 251 32 38 70 8 7 15 1,017 754 1,771 Nelson .. . . 454 354 808 26 17 43 4 4 8 11 11 22 495 386 881 Hokitika .. 212 240 452 11 9 20 2 1 3 54 60 114 279 310 589 Christchurch .. .. 778 607 1,385 102 94 196 17 25 42 16 12 28 913 738 1,651 Seacliff .. .. 663 453 1,116 77 63 140 9 14 23 9 5 14 758 535 1,293 Ashburn Hall (private 13 23 36 3 5 8 .. 1 1 16 29 45 mental hospital) Totals .. 4,296 3,501 7,797 511 482 993 92 113 205 143 116 259 5,042 4,212 9,254 Patients discharged, transferred, and died. __ In Mental Hospitals Mental Hospitals. Total rti»ph»rmiVI on Discharged Discharged Transferred Died transferfel 31st December, 1939. recovered. not recovered. iranslerrod. Died. transferred, M. F. T. M. F. T. M. F. T. M. F. T. M. F. T. M. F. T. Auckland .. .. 42 54 96 29 37 66 29 21 50 28 53 81 128 165 293 746 601 1,347 Kingseat .. .. 224 .. 6 3 8 11 2 13 18 7 25 304 297 601 Tokanui .. 10 19 29 6 3 9 8 1 9 18 19 37 42 42 84 326 348 674 Porirua .. .. 42 44 86 23 18 41 10 12 22 77 38 115 152 112 264 865 642 1,507 Nelson .. .. 5 5 10 4 1 5 4 3 7 28 16 44 41 25 66 454 361 815 Hokitika .. .. 6 1 7 2 3 5 13 11 24 11 10 21 32 25 57 247 285 532 Christehurch .. 24 33 57 44 41 85 23 11 34 29 41 70 120 126 246 793 612 1,405 Seacliff .. .. 15 22 37 24 18 42 49 53 102 48 29 77 136 122 258 622 413 1,035 Ashburn Hall (private 1 1 2 ..4 4 2 1 3 1 1 2 4 7 11 12 22 34 mental hospital) Totals .. 147 181 328 132 125 257 143 116 259 251 209 460 673 631 1,3044,369 3,581 7,950 A verafzp Nrnnhpr Percentage Percentage of M „„, . Tr™,r.tfoio of Recoveries on Deaths on Average Mental Hospitals. resident during Admissions Number resident during the Year. during the Year. M. F. T. M. F. T. M. F. T. Auckland .. .. .. .. 675 540 1,215 29-58 36-00 32-88 4-15 9-82 6-66 Kingseat .. .. .. .. 294 286 580 66-66 100-00 80-00 3-74 0-70 2-24 Tokanui .. .. .. .. 306 331 637 23-26 35-85 30-21 5-88 5-74 5-81 Porirua .. .. .. .. 815 583 1,398 25-61 28-02 26-79 9-45 6-52 8-23 Nelson .. .. .. .. 436 336 772 16-66 23-81 19-61 6-42 4-76 5-70 Hokitika .. .. .. .. 205 238 443 46-15 10-00 30-43 5-37 4-20 4-74 Christehurch .. .. .. .. 710 550 1,260 20-17 , 27-73 23-95 4-08 7-45 5-55 Seacliff .. .. .. .. 652 434 1,086 17-44 28-57 22-70 .7-36 6-68 7-09 Ashburn Hall (private mental hospital) .. 13 22 35 33-33 16-66 22 -22 7-69 4-55 5-71 Totals.. .. .. .. 4,106 3,320 7,426 24-38 30-42 27-38 6-11 6-30 6-19

H.—7.

Table IV.—Ages of Patients on 31st December, 1939.

Table III.— Native Countries.

12

Countries. Auckland. Kingseat. Tokanul. Porirua. Nelson. Hokitika. Chrfetchurch. Seaeliff. (MvateSfentel Total. Hospital). T, . J , T1 , , M - F - T - M - T - M. r. T. M. F. T. M. F. T. M. F. T. M. F. T. M. jr. T M F T M F T England and Wales .. 121 65 186 55 52 107 37 39 76 132 90 222 42 33 75 22 22 44 67 52 119 54 28 82 '3 1 4 533 382 915 Scotland .. 26 15 41 12 5 17 13 5 18 37 16 53 21 12 33 8 7 15 22 14 36 39 28 67 3 1 4 181 103 284 Ireland .. 24 19 43 17 19 36 15 13 28 31 18 49 11 5 16 14 10 24 22 16 38 21 14 35 155 114 269 New Zealand .. 452 428 880 150 170 320 221 248 469 562 4691,031 341 284 625 164 195 359 658 5081,166 474 324 798 5 if) 24 3 027 2 645 5 672 Australian States .. 34 22 56 15 12 27 9 14 23 32 19 51 8 10 18 11 8 19 13 13 26 14 8 22 1 1 2 137 107 244 France ....011.. 101011 ,A , Germany .. 2 0 2 1 0 1 2 1 3 2 3 5 1 2 3 2 0 2 1 ' i 2 ! 3 ' 1 4 " 14 8 22 Austria ....718606303 .. X 0 1 " 17 118 Norway •' 101 404 202 112 101101 1 '6 1 " " n 1 12 Sweden .. ..101123011101101202 2 '6 2 " 8 3 11 Denmark .. .. .. 1 0 1 2 1 3 2 1 3 5 0 5 1 0 1 .. 1 0 1 " 12 2 14 Italy •• 303 011 101 202 0 1 113 0 3 .. " q 2 11 China .. ..336101101415 .. " " Q4 1S Maoris .. .. 14 19 33 5 0 5 9 21 30 40 17 57 7 2 9 .. 6 5 11 1 '6 1 " 82 64 146 Other countries .. 41 14 55 16 10 26 10 5 15 15 6 21 3 0 3 3 0 3 3 3 2 5 " 94 40 134 Unknown .. 17 14 31 20 26 46 .. 4 0 4 12 12 24 16 43 59 .. 10 8 18 " 79 103 182 Totals .. 746 601 1,347 304 297 601 326 348 674 865 642 1,507 454 361 815 j 247 285 532 j 793 612 1,405 ! 622 413 1,035! 12 22 34" 4,369 3.581 7,950 . ! ! '

j j 7 | 7 Ages " Auckland. Kingseat. Tokanui. Porirua. Nelson. Hokitika. Christchnrch. Seaclifl. (Mvatellfntel Total. , l_ III Hospital). , . . M. F. T. M. F. T. M F. T. ! M. F. T. M. F. T. ! M. F. T. j M. F. T. M. f. T. M. F. I. M. F T From 1 to 5 years .. .. .. 1 1 2 0 2 2 13 5 18 0 1 1 6 4 10 0 3 3 20 16 36 „ 5„10 „ .. 3 0 3 .. 1 5 6 1 8 9 15 8 23 0 2 2 49 22 71 1 3 4 " 70 48 lis » 10..16 „ .. 10 5 15 0 1 1 4 1 5 4 15 19 42 13 55 1 2 3 67 40 107 1 1 2 " 129 78 20^ » 15 „ 20 „ .. 23 25 48 4 0 4 15 7 22 19 16 35 54 18 72 5 4 9 115 75 190 22 11 33 " 257 156 111 " 20 ,, 30 „ .. 117 63 180 1/ 15 32 45 52 97 112 76 188 94 49 143 18 20 38 132 106 238 83 36 119 1 3 4 619 420 1 039 „ 30 „ 40 „ .. 136 128 264 37 46 83 58 48 106 166 114 280 54 58 112 43 28 71 100 75 175 135 42 177 2 1 3 731 Sn 1'o?? „ 40 „ 50 „ .. 158 135 293 58 51 109 40 78 118 ! 179 134 313 41 61 102 35 62 97 111 83 194 109 83 192 2 1 3 733 688 1'421 „ 50 ,, 60 „ .. 142 118 260 76 86 162 71 78 149 199 149 348 49 72 121 70 82 152 125 98 223 128 100 228 1 4 5 861 787 VTA „ 60 „ 70 „ ..88 84 172 72 57 129 64 45 109 119 72 191 55 50 105 44 59 103 53 70 123 85 84 169 0 7 7 580 528 1108 » TO,, 80 » •• 41 29 70 34 28 62 23 28 51 50 43 93 25 21 46 28 21 49 26 35 61 46 41 87 6 2 8 279 *48 52^ » 80 "90 „ .. 8 2 10 2 4 6 2 1 3 15 11 26 6 5 11 1 0 1 8 4 12 10 5 15 0 4 4 52 ~36 81 Upwards of 90 „ ..2 0 2 1 0 1 .. 0 1 1 .. .. 1 0 1 9 i q r 9 « Unknown .. 18 12 30 39 12 246 112 617 246 .. 033 '' 32 34 66 Totals .. 746 6011,347 304 297 601 326 348 674 865 642 1,507 454 361 815 247 285 532 793 612 1,405 622 413 1,035 ~12 22 4.369 3,581 7,950 —' * : f r !

H.—7.

Table V.—Length of Residence of Patients discharged "Recovered" during 1939.

13

Length of Residence. Auckland. Kingseat. Tokanni. Porirua. I Nelson. Hokitika. Christchurch. Seacliff. ; (Private Mental j Total. ' • i j I Hospital). ! Under 1 month .. *8 0 3 *' ' *i '% "l "l % "l *" '* T " M " F " T " f \ % From 1 to 3 months 4 7 11 .. 1 2 3 8 3 11 .. 1 0 1 3 4 7 2 3 5 " 19 19 38 "a" q " " 1 a if " ! 2 4 H 13 24 Oil Oil 8 10 18 5 8 13 0 1 1 27 41 68 :: r? 12 :: Il'J 011 •• lil III 101 £ g » I" l^ S ■ " " ? n ° , "A , 2 5 7 7 8 15 3 2 5 2 "o 2 3 6 9 3 4 7 " 33 11 £ " t" I " '■ t t a 10 1 Oil 1 5 6 2 0 2 1 0 1 Oil . . .. 9 13 22 " g" 7 " '• f f I •• 1 0 1 6 1 7 .. 1 0 1 3 2 5 Oil .. 15 6 21 " 7 " 10 " " In? ? n i " •• Oil 1 0 1 0 2 2 .. .. 2 6 8 " JO " 12 " " 10 1 10 1 .. Oil .. .. 112 101 .. ' 426 " 12 15 ;; ;; ;; ;; •• • • ■ • ■ Over 15 years .. .. .. . 10 1 " " 10 1 Totals •• 42 54 96 2 2 4 10 19 29 42 44 86 5 5 10 6 1 7 24 33 57 15 22 37 1 1 2 147 181 328

H.—7.

Table VI.—Causes of Death, 1939.

14

• • i alt CauBes. 9 g 'I g a I s w §.S& aaSIISSi lis •s I t I I I $ s § ip w o I. —General Diseases. Tuberculosis — M- F - M - *• M - F - M - r - M - F - M - y - M - F " M " M " F ' M- FGeneral •• •• } 0 " •• •• " J ° Lungs 11 •• 023110 .. .. 13 .. 67 Cancer 0 3 0 1 1 1 2 0 3 1 0 2.. 1 1.. 7 9 Eurunculosis .. •• ..02 .. .. .. •• •• ■ • •• •• 0 K2L :: :: :: :: :: :: r. :: r. ° ! ."t :: S » Diabetes .. • - -- ..01 .. .. 10 ■■ 20 .. .. .. 31 Syphilis .. .. . • • • •• •• 10 •• ** ** " " 0 j Bacillary dysentery .. .. ..01 .. .. • • • • • • • • • • • • Addison's Disease .. .. •• 10 .. .. .. ■■ •• Hymphadenoma .. .. • • • • • ■ • • • • • • o 1 " 0 1 Chronic pancreatitis .. .. •• •• •• •• •• •• n 1 0 1 Hsemorrhagic jaundice .. •• •• •• •• •• 01 .. .. ? n Osteo-myelitis .. • ■ ■ • • • • ■ • • 10 II.—Diseases of the Nervous System. Mania, exhaustion from .. .. 0 1 ■ ■ 0 1 .. 0 1 .. 0 2 10 .. 15 Melancholia, exhaustion from .. 12 .. 10 .. .. .. f '[ •• •• . , ~ General paralysis of the insane ..22 .. .. 64 .. .. 1020 .. 11 b Cerebral syphilis .. . • • • 10 .. .. .. • ■ ■ • •• 1 « .. Cerebral haemorrhage .. " 2 o?ni"nni " n' lni d Cerebral thrombosis .. .. ..2210100 1 .. 0 .. .. SCTT. :: :: » ? :: ■"» »"• *" 1 - >"• ■■ » ; Post Bncephalitic Parkinsonism ..10 .. .. 1 0 .. .. ui .. .. in Meningitis, tubercular .. ■ • • ■ • • ; • « ? " '' '' " 0 1 Cerebral oedema, alcoholic .. •• •• •• •• 0 1 .. .. 10 10 Huntingdon's chorea III. —Diseases of the Respiratory System. P LX°r nia ~ ..1 3.. 0 4 1 4 0 1.. .. 1 1.. 3 13 Broncho" " .. ..3 7.. .. 6 3 5 1.. 3 1 1 0 .. 18 12 Hypostatic 1 0 - •• •• 0 1 0 1 0 2 .. .. 14 Bronchitis .. •• " n " " " " " 10 Empyema .. .. •• 10 .. •• •• ■■ •• Pulmonary oedema IV. —Diseases of the Circulatory Heart-disease SYS ™ M ' .. .. 3 5 2 0 6 6 11 7 1 3 3 3 3 7 10 9 .. 39 40 Arteriosclerosis 1 1 2 0 4 2 .. 1 0 6 8 .. .. 14 11 Coronary 4 2 1 0 .. 1 0 6 1 .. 12 3 V. —Diseases of the Digestive System. no n a Enteritis 0 2 .. .. .. •• ..0 2.. ..0 4 Intestinal obstruction .. ..0 1 .. •• a" i " " " 0 1 Cholecystitis VI.—Diseases of the Genito-urinary System. , 0 „ Ef :: :: :: :: V I • :: 102-1 :: :: r« :: « 1 Senile decay VII "" 0LDAGB '.. .. 3 11 2 0 4 2 20 4 7 5 3 1 8 9 20 9 1 1 68 42 VIII.—External Causes. , , , , „ ci • *j 0 110.. U i 1 1 . . & o Suicide ..•••••••• • l o 10 During insulin treatment, " Natural causes " IX.—Died whilst ON Probation ..2 1 .. 1 0 6 5 .. .. 1 0 10 6 Totala _ .. .. 28 53 11 2 18 19 77 38 28 16 11 10 29 41 48 29 1 1 251 209

H.—7.

Table VII.—Principal assigned Causes of Insanity, 1939.

Table VIII.-Showing the Admissions, Discharges, and Deaths from Ist January, 1876, to 31st December, 1939 (excluding Transfers). In hospitals, 31st December, 1875 .. ... Admissions " "" 254 736 Admissions Discharged— M . r T 25 ' 213 19 ' 434 Recovered 8,616 7,627 16,243 Not recovered 2,671 2,397 5,068 JJled •• •• •• •• 9,557 5,829 15,386 — 20,844 15,853 36,697 Remaining on 31st Docembor, 1939.. .. .. 4;369 3>681 ? 950

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

15

• =3 •a " 3l~ Cau8es - S i i «• . i 1 I | | I I 1 1 I 1 Iff I a j f 1 I i I || M | Alcohol .. .. M 5 4 M i *i M g 4 M ' * n \ »• M " *• M " *• *• * Arterio-sclerosis ..31 .. 1124 on a 2 " 27 10 Climacteric .. ..0 5 .. 0 2 0 5 o" 1 " - 0 3 0 1 12 10 Congenital .. .. 12 18 0 1 8 4 10 10 14 8 " ±a." to in t 0 16 Constitutional 29 26 40 90 q " o 10 3 .. 104 70 Encephalitis " " n l " n" , " •• 72 58 Epilepsy .. .. 43 T 7 q o'' i ? i '' * * 02 Heredity .. ..5 9 " 7 15 H 14 4 ' 0 3 3 17 n 7 ° n" o 28 12 111 health .. ..3 2 .. 0 3 . " 0 2 47 54 Involution .. .. 6 10 3 i l is o n •• 3 5 Mental stress .. 13 19 .'.' 11 11 2 0 4 1 10 19 lr iq " 16 61 Organic brain-disease ..21 01 0 l ' 9 15 19 .. 55 69 Parkinsonism .. .. .. .. l" 0 " " " 33 Post operative ..10 .. .' 10 " " 10 Previous attack .. 23 25 0 9 m ?s o" a o" i r,",. •• 2 0 Puberty or adolescence 2 1 .. 2 10 111 q i I « 0 2 83 109 Puerperal .. ..0 6.. 0 2 0 5 0 1 o ? 3 , 17 16 & :: ::"" 8 :: I y s? "• ! i i? Traumatic .. ..01 .. 1010 01 " ? n 2 3 " 65 Transfers .. ■■ 11 8 88 18 6 0 8 7 II 11 54" 6 Q 16 12 9 " 5 " 143 116 Totals .. 153 153 31 20 49 53 172 164 41 32 67 70 135 131 95 82 ~3

| Males - | Females. Both Sexes. Recovered .. .. .. .. -u-17 :: jfg I™ " :S •• :: :: ftS 8:2 J}:" 100-00 100-00 10(M)0

H.—7,

Table X.-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.

16

I Discharged. . | 81s^^^|' rin Average Numbers of Reroverireon o^Av^eN^btrs Year. Admitted. Recovered. i Relieved. Not Improved. ' each Year. resi en . Admissions. _ i J J 1 j j 1 j ~ j ' ■n ! u n- m AT T. M. F. T. M. F. | T. M. F. T. m. ! r. | t. M - F. T. M. | IP. T. M. | . I . . . j | .[ 482 254 736; .. .. I .. .. ' •• •• •• •• 1875 .. .. i •• •• •" "' "c, •; iA "oa i2 48 519 264 783! 491 257 748 54-53 66-01 57-56 8-21 3-58 6- 70 1876 .. 221 117 338 | 129 79 208 17 8 25 | - j 8 10 , 36 12 48 I glg 4g 2Q 40 . 72 ? . 76 7 . 5g 7 . 70 1877 .. 250 112 362 123 57 180 20 5 25 3 2 5 42 21 ; 48-98 51-90 50-00 8-48 5-61 7-52 1878 .. 247 131 378 121 68 189 14 14 28 4 4 8 51 17 b8 bd« 666 337 i, 00 3 45-16 50-33 47-11 8-25 4-74 7-07 1879 .. 248 151 399 112 76 188 15 13 28 9 4 | 13 , 5 | ?4 72g 3g6 j 12g 703 371 1>074 43. 66 44.96 44-17 7-68 5-39 6-89 1880 .. 229 149 378 100 67 167 36 2o 61 1,175 747 388 1,135 40-08 51-10 44-01 6-29 3-60 5-55 1881 .. 232 127 359; 93 65 158 41 36 77 9 2 49 14 63 769 ® 421 35 . 58 38 . 81 36 -75 7-53 4-51 6-49 1882 .. 267 152 : 419 1 95 59 154 49 32 81 o 6 11 g3 gg2 4g3 2 37fi g60 47g 133g 40 . 00 4 6 . 98 42-75 7-55 3-78 6-21 1883 .. 255 166 421 102 78 180 13 20 33 10 9 19 60 g g0 . 32 7 . 46 4 . 82 6 . g3 1884 .. 238 153 391 89 77 166 17 9 26 18: 12 30 68 24 92 938 514 W 528 38-62 ! 57-14 45-12 7-56 4-16 6-36 1885 .. 246 133 379 95 76 171 10 5 15 2o , 2 27 . ?6 , 604 1;61 o 984 559 1,543 47-82 36-36 42-74 5-79 3-39 4-91 1886 .. 207 165 372 99 60 159 11 17 28 12 7 19 : j 0g3 643 1>696 1,034 613 i, 6 4 7 40-39 48-75 43-61 7-15 4-40 6-13 1887 .. 255 161 416 103 78 181 34 17 51 .. .. -■ 7 > g0 g3g _ 63 . 01 g7 . 62 7 . 56 4 . 05 6-16 1888 .. 215 146 361 116 92 208 31 28 59 2 3 5 78 2b 104 1,041. x ?61 660 1, 70 7 40-43 32-92 37-34 6-69 4-54 5-86 1889 .. 230 161 391 93 53 146 31 30 61 1X1 i'o95 702 1,797 1,078 685 1,763 42-61 55-00 47-69 7-05 5-11 6-29 1890 .. 230 160 390 98 88 186 23 li 40 12 5 734 1,849 1,089 699 1,789 37-61 43-27 40-00 7-25 5-86 6-71 1891 .. 234 171 405 88 74 162 33 24 57 14 ... 154 763 1;917 1>12g 714 1,839 38-53 48-10 42-42 6-58 4-76 5-87 1892 .. 231 158 389 89 76 165 21 17 38 8 , glQ 7gg 1>g3() 3g . 94 4g . 72 41 . 30 6 . 66 3 . 03 0 .2 3 1893 .. 281 | 179 460 101 89 190 17 1-. -9 0 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 1894 .. 270 176 446 107 76 183 lo 11 5 4 9 j ggg g g4g 4167 46 . 66 43-64 7-69 4-94 6-61 1895 .. 252 165 417: 105 77 182 24 19 43 1 2 3 101 42 143 , 925 2 315 1,347 882 2,229 37-41 44-02 39-13 6-38 3-63 5-29 1896 .. 278 159 437 104 70 174 25 16 41 2 1 3 86 32 118 1,390 2 430 ' 1411 944 2,355 35-92 37-82 36-69 7-44 4-55 6-28 1897 .. ; 284 193 477 102 73 175 17 12 29 •• gg j4g 1>008 2>480 1>438 973 2 ,411 44-88! 51-89 48-07 6-12 6-17 6-14 1898 .. j 254 212 466 114 110 224 13 23 06 7 lg7 x gl2 1,045 2,557 1,487 1,004 2,491 33-98 49-49 40-83 7-67 4-28 6-30 1899 .. 259 199 458 88 99 187 15 19 34 1 3 4fi 145:1531 1,091 2,672 1,534 1,049 2,583 34-33 47-54j 39-64: 6-45 4-38 5-61 1900 .. 300 202 502 103 96 199 29 10 39 .. 4 4 , , 46 . 64 42 . 17 6 . 2g 6 . g8 6 . 41 1901 .. 320 223 543 125 104 229 20 17 37 2 2 102 72 174 }' 7 i5 IJ33 1)848 i|67! l'n4 2,785 38-35 51-56 43-01 7-18 4-94 6-2S 1902 .. 352 1,92 544 135 99 234 26 15 41 j 10 9 44 173 i l, 7 7l! 1,188 2,959 1,741 1,160 2,901 40-56 44-69! 42-17 7-41 3-79 5-96 1903 .. 355 226 581 144 101 245 26 24 5Q . - - 1,801, 1,237 3,038 1,780 1,198 2,978 47-59 44-91 46-30 6-74 5-84 6-38 1904 .. 332 236 568 157 106 263 : 24 11 35 1 .. 1 120 . 0 190 1 sui * 41-Sg! 48-21 44-19 8-18 5-44 7-07 1905 .. 360 251 611 149 121 270 29 24 . 53 .. .. -- 147 67 214 1 Mb, 42-94=| 8-01 6-71 7-48 1906 .. 395 264 659 157 126 283 28 22 50 .. 232 i )90 9 1,331 3,240 1,851 1,285 3,133 44-29 57-68 49-84 9-08 4-98 7-39 1907 .. 359 241 600 160 139 299 22 13 3? .. -. •• ? 7 3^ u l gg4 1346 3;24Q 42 . 2g 4g . gl 43 . 82 7 . 8 i 5 . 50 6-85 1908 .. 426 318 744 180 146 326 9 - 21 1 .. 1 18 2,033 1,465 3,548 1,970 1,404 3,374; 42-72 57-24 48-74! 6-90 4-84 6-00 1909 -- 419 297 716 179 170 349 17 11 28 .. 283 : 2,160 1,510' 3,670 2,028 1,44513,473 38-40:46-18 41-50 9-17 6-71 8-la 1910 .. 474 314 788 182 145 327 29 27 06 .. •• •• 2,220 1,536 3,756 2,105 1,496 ! 3,601 36-38 53-00 43-27i 9-41 7-02 8-41 1911 .. 448 317 765 163 168 331 23 16 j 39 4 2 6 280 ! 2,273 1,640 3,913 2,146 1,551 3,697' 40-17 37-01! 38-74 8-99 5-61 7-57 1912 .. 458 381 839 184 141 325 17 44 61 3 g 4 2 2g2 1 597 3 849 37-55 50-94 42-98 8-70 6-96 7-98 1913 .. 466 318 784 175 162 337 35 48 83 1 6 6 196 111 30/ 2,33. 1,632 3,964 g 1914 .. 509 359 868 207 162 369 27 -9 5 li9 2g4 2,448 1,752 4,200 2,391 1,703 4,094 ; 44-89, 43-21 44-88 7-19 6-o8 | 6-94 1915 .. 450 361 811 ?60 j I ! 33? 35 34 69 | J " . 15 ! 209 j 80 ! lit \ 2,555 2:483! K251 30-8 9 ! !7-37 37-66 8-42 , 4-52 I 6-80

3—H. 7

H.—7.

17

1917 .. 470 374 844 171 152 323 32 20 52 6 5 11 205 113 318 2,611 l,904j 4,515 1,825 4,368 36-38: 40-641 38-27 8-06 6-19 7-28 1918 .. 437 402 839 142 141 283 17 36 53 12 12 24 274 174 448 2,603 1,943 4,546 2,602 1,899 4,501 32-49 35-07 33-7310-53 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 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 4,868 33-00 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,SOS 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 1929 549 407 956 145 144 289 30 28 58 22 16 38 227 153 380 3,399 2,694 6,093 3,215 2.495 5,710 26-41 35-37 30-23 7-06 6-13 6-65 1930 .. 621 474 1,095 138 128 266 28 34 62 31 23 54 251 172 423 3,572 2,811 6,383 3,342 2,590 5,932 22-22 27-00 24-29 7-51 6-64 7-15 1931 .. 587 476 1,063 127 120 247 29 30 59 29 30 59 221 199 420 3,753 2,908 6,661 3,503 2,696 6,199 21-64 25-21 23-37 6-31 7-39 6-76 1932 .. 587 484 1,071 ]41 160 301 39 42 81 38 41 79 219 169 388 3,903 2,980 6,883 3,681 2,738 6,419 24-02 33-05 28-10 5-97 6-17 6-06 1933 563 554 1,117 117 144 261 35 27 62 28 22 50 221 124 345 4,065 3,217 7,282 3,809 2,932 6,741 20-78 25-99 23-36 5-80 4-23 5-16 1934 479 504 983 114 146 260 64 72 136 233 203 436 4,133 3,300 7,433 3,899 3,039 6,938 23-80 28-97 26-45 5-98 6-68 6-28 1935 567 502 1,069 117 136 253 72 55 127 229 206 435 4,282 3,405 7,687 4,003 3,111 7,114 20-63 27-09 23-67 5-72 6-62 6 11 1936 .. 553 556 1,109 121 149 270 105 96 201 252 213 465 4,357 3,503 7,860 4,093 3,195 7,288 21-88 26-80 26-76 6 18 6-66 6-38 1937 .. 557 567 1,124 180 179 359 121 110 231 261 236 497 4,352 3,545 7,897 4,112 3,272 7,384 32-32 31-57 31-94 6-35 7-21 6-73 1938 .. 527 575 1,102 170 210 380 140 135 275 273 274 547 4,296 3,501 7,797 4,129 3,287 7,416 32-26 36-52 34-48 6-61 8-33 7-38 1939 .. 603 595 1,198 147 181 328 132 125 257 251 209 460 4,369 3,581 7,950 4,106 3,320 7,426 24-38 30-42 27-38 6-11 6-30 6-19 24,731 19,18043,9118 ,6167,627 16,2432,671 2,397 5,068 19,557- 5,829 15,386 Excluding transfers between institutions —2,868 males, 2,280 females.

H—7.

Table XI.—Debits for the Financial Year, 1939-40.

18

lit! I Auckland. I Kingseat. Tokanui. Poriraa. Nelson. Hokitika. Christchurch. Seacliff. Head Office. Totals. £ s. d. £ s. d. £ s. d. £ s. d. £ s. d. £ s. d. £ s. d. £ s. d. £ s. d. £ s. d. Salaries, including overtime .. .. 61,020 3 2 25,650 15 2 38,466 17 6 77,575 11 5 37,910 19 5 26,161 1 9 73,038 0 9 72,620 10 10 8,972 0 5 421,416 0 5 Official Visitors .. .. .. 44 2 0 .. .. 25 0 0 .. 10 10 0 25 4 0 .. .. 104 16 0 Advertising, books, &c. .. .. 17 12 8 30 3 11 22 5 4 14 5 11 12 15 11 33 15 8 20 10 5 49 14 2 88 17 9 290 1 9 Bacteriological research .. .. 77 17 0 .. 9 19 6 114 14 0 0 10 6 0 10 6 3 19 8 .. .. 207 11 2 Bedding and clothing .. .. 4,868 16 10 2,118 19 0 2,521 19 8 4,981 9 2 2,721 17 2 3,127 14 6 5,393 7 11 4,347 2 0 .. 30,081 6 3 Buildings, including additions, &c. .. 972 13 11 117 4 4 526 7 11 548 7 11 267 12 11 270 9 5 864 1 5 1,119 4 0 .. 4,686 1 10 Dental services .. .. .. 0 17 6 8 15 3 3 7 6 5 6 6 11 18 1 7 3 10 134 17 8 18 10 3 .. 190 16 7 Farms, maintenance of .. .. 1,238 8 2 1,389 8 11 3,296 11 5 2,039 13 6 969 2 6 345 4 3 1,189 7 3 7,141 1 0 .. 17,608 17 0 Fencing, draining, and reading .. 20 16 4 78 1 1 204 15 11 128 9 3 30 8 11 17 10 7 59 18 1 162 1 10 .. 702 2 0 Freight, cartage, and transport .. 94 10 4 189 10 8 285 2 9 215 5 11 371 8 10 52 5 1 512 16 5 357 19 2 .. 2,078 19 2 Fuel, light, water, &c. .. .. 7,739 7 0 3,021 8 6 4,433 12 3 6,858 16 1 5,922 18 2 2,251 7 1 7,571 19 1 5,810 10 7 46 4 0 43,656 2 9 Funeral expenses .. .. .. 41 17 6 36 15 0 71 10 0 70 10 0 101 17 5 27 0 0 79 5 0 104 10 0 .. 533 4 11 Furniture and fittings .. .. 462 11 2 509 19 6 164 15 7 694 9 11 480 8 10 264 17 1 474 0 2 277 17 4 43 0 11 3,372 0 6 Gardens and shrubberies .. .. 63 16 5 39 19 7 61 8 9 18 15 11 15 1 10 14 12 6 115 12 9 21 19 0 .. 351 6 9 Laundry .. .. .. .. 237 1 9 226 16 0 299 16 10 418 10 7 163 10 8 80 6 10 352 11 6 315 12 6 .. 2,094 6 8 Legal and inquiry costs .. .. 13 15 6 .. .. 1 5 0 .. .. .. .. .. 15 0 6 Machinery, repairs, and stores .. 125 6 3 103 13 1 106 0 7 165 16 7 143 12 10 33 8 11 193 6 11 158 12 5 .. 1,029 17 7 Medical fees .. .. .. 661 14 8 2 2 0 111 1 0 759 10 6 68 17 0 58 8 0 431 6 3 327 1 6 .. 2,420 0 11 Motor-vehicles — Maintenance of .. .. .. 19 7 10 44 3 9 80 0 0 257 4 7 98 0 4 23 13 0 271 2 2 231 2 3 .. 1,024 13 11 Purchase of .. .. .. .. .. .. 207 7 6 .. .. .. .. 207 7 6 Nursing staff uniforms .. .. 241 8 11 114 12 3 140 11 1 364 14 2 105 2 6 166 9 1 491 19 5 570 13 3 .. 2,195 10 8 Office equipment .. .. .. 14 4 6 3 11 4 .. 08 11 290 4 13 6 0 15 6 .. 387 29 11 4 Patients' expenses connected with — Gratuities .. . . .. 13 8 4 0 1 6 2 15 0 77 1 10 117 13 5 14 2 6 3 1 8 27 9 8 .. 255 13 11 Friends .. .. .. .. .. .. .. .. .. .. 50 0 0 .. 50 0 0 Recreation - .. .. .. 977 19 2 360 17 2 551 13 8 1.095 6 5 542 3 4 403 8 2 886 4 5 825 15 8 .. 5,643 8 0 Transfers .. .. 22 10 3 0 1 8 22 5 0 73 5 10 16 14 7 7 18 3 91 16 7 251 14 11 .. 486 7 1 Postages, telegrams, &c. .. .. 146 2 10 67 1 0 84 12 2 173 15 9 46 15 5 28 0 0 129 12 4 179 9 11 134 15 6 990 4 11 Printing and stationery •• 210 0 3 101 16 10 106 19 7 211 4 5 97 0 3 71 14 0 230 11 9 145 0 2 76 2 10 1,250 10 1 i Rations .. .. .. .. 16,882 2 0 8,417 10 3 8,249 13 6 21,954 17 6 11,202 12 4 6,248 4 10 18,865 6 4 11,215 9 10 .. 103,035 16 7 Rents and rates .. .. .. .. .. •• 7 12 7 .. 518 16 8 4 0 0 654 13 7 1,185 2 10 :Stores .. .. .. .. 720 13 2 475 3 9 431 5 2 721 3 3 600 6 3 646 15 5 999 14 6 873 15 3 . . 5,468 16 9 Surgery and dispensary, drugs, &c. .. 297 5 6 165 4 9 120 4 2 543 1 9 115 6 2 138 18 1 331 17 3 288 16 3 .. 2,000 13 11 Telephone services .. .. .. 73 8 5 175 13 10 97 9 4 177 5 2 58 9 1 35 12 0 135 18 4 208 14 1 116 19 5 1,079 9 8 Transfer and removal expenses .. 11 1 4 41 17 5 6 18 9 11 2 5 1 16 2 6 18 9 19 7 4 31 11 2 .. 130 13 4 Travelling-allowances .. .. 85 2 8 96 18 4 57 12 7 77 11 2 78 4 5 50 4 10 63 1 3 188 10 10 100 19 8 798 5 9 Travelling-expenses.. .. .. 136 6 1 21 9 4 19 9 6 107 4 6 22 0 0 29 16 1 92 17 8 151 12 7 143 8 2 724 3 11 Treatment in general hospitals — Patients . . .. .. 73 3 6 69 4 0 12 14 0 142 6 6 0 10 0 3 13 6 58 10 0 115 16 0 .. 475 17 6 Staff .. .. .. .. 5 12 6 10 13 0 .. 9 7 0 17 10 0 .. 2 2 0 1 0 0 .. 46 4 6 Contingencies and miscellaneous .. 58 7 6 0 10 0 3 16 0 62 19 4 61 5 5 15 0 0 55 12 9 114 16 9 0 10 6 372 18 3 Totals .. .. .. 97,689 12 11 43,690 2 2 60,573 12 0 120,695 18 8 62,591 19 9 40,651 8 0 113,708 13 2 108,307 15 2 10,381 1 4 658,290 3 2

H.—7.

Table XIa.—Credits for the Financial Year, 1939-40.

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

19

Auckland. Klngseat. Tokanui. Porirua. Nelson. Hokitika. | Ohristchurch. Seaclifl. Head Office. Total. £ s. d. £ s. d. £ s. d. £ s. d. £ s. d. £ s. d. £ s. d. £ s. d. £ s. d. £ s. d. ♦Receipts from maintenance .. : 18,769 12 3 11,891 17 8 7,022 17 9 28,211 14 1 12,740 13 2 5,363 14 1 15,607 1 6 i 22,973 11 5 .. 122,581 1|11 Contribution from Social Security Fund ] 27,601 4 11 12,899 18 2 13,946 1 11 32,570 7 10 16,782 19 2 9,995 8 2 28,545 5 11 23,658 13 11 .. 166,000 0 0 'Receipts'from farms .. .. j 673 6 9 2,169 12 5 4,376 15 3 1,410 18 8 1,948 12 3 13 16 2 2,950 0 10 4,156 7 3 [ .. 17,699 9 7 Miscellaneous] .. .. .. 7,040 16 2 3,514 10 8 ; 3,988 12 8 10,524 16 10 3,914 10 1 2,905 12 7 8,408 6 10 ! 7,831 3 10 128 5 3 48,256 14 11 Totals .. .. .. 54,085 0 1 30,475 18 11 ! 29,334 7 7 72,717 17 5 35,386 14 8 : 18,278 11 0 i 55,510 15 1 58,619 16 5 i 128 5 3 354,537 6 5 _ ; . ' | * Outstanding accounts as at 31st March, 1939.

Average i ! j ContribuNumber Bedding j Buildings j Fuel, Light,! Surgerv I , f . Total Cost 'tionsfrom Other Set Cost Net Cost ! Decrease Increase Mental Hospital. Resident Salaries. and and j Farm. Water, and j Provisions. and ! per ! Social Re- per Previous in in (inclusive of Clothing. Repairs. ' Cleaning. | Dispensary. ; Patient. Security payments. Patient. Year. 1939-40. 1939-40. Boarders). -j- -j j (a) Fund. (6) (6) j j 5 I 1 £ s. d. £ s. d. £ s. d. ' £ s. d. £ s. d. | £ s. d. £ s. d. [ £ s. d. i £ s. d. £ s. d. £ s. d. £ s. d. £ s. d. £ s. d. £ s. d. Auckland .. .. .. 1,311 46 10 10 3 14 3 0 14 10 0 18 11 5 18 1 12 17 6 0 4 6 3 11 3 74 10 2 21 6 6 5 17 8 47 6 0 43 3 5 .. 4 2 7 Kingseat .. .. .. 592 43 6 6 3 11 7 0 4 0 2 6 11 5 2 1 14 4 5 0 5 7 4 14 11 73 16 0 21 6 6 9 12 0 42 17 6 39 10 8 .. 3 6 10 Tokanui .. .. .. 655 58 14 6 3 17 0 0 16 1 5 0 8 6 15 5 12 11 11 0 3 8 4 10 4 92 9 7 21 6 6 12 15 5 58 7 8 55 13 9 .. 2 13 11 Porirua .. .. .. 1,527 50 16 0 353 072 169 49 10 14 77 071 412 79 0 10 21 66 7 16 4 49 18 0 48 12 11 .. 151 Nelson .. .. .. 790 47 19 938 11 06914679 11 14 3702 11 483 79 47 21 66785 50 98 53 12 1325 Hokitika .. .. .. 471 55 10 10 6 12 10 0 11 6 0 14 8 4 15 7 13 5 3 0 5 11 4 9 7 86 6 2 21 6 6 6 3 11 58 15 9 65 12 4 6 16 7 Christeliureh .. .. 1,335 54 14 2 4 0 10 0 12 11 0 17 10 i 5 13 5 14 2 7 0 5 0 4 16 9 85 3 6 21 6 6 8 10 2 55 6 10 56 13 0 1 6 2 Seaclifi .. .. .. 1,104 65 15 7 3 18 9 1 0 3 6 9 4 5 5 3 10 3 3 0 5 3 5 4 5 98 2 1 21 6 6 10 17 2 65 18 5 63 16 6 .. 2 1 11 Head Office .. .. 7,785 1 31 .. .. .. 001 .. .. 0 3 6 1 68 .. 0 0 4 1 641 10 5 0 41 Total average cost .. j 7,785 54 2 8 3 17 3 0 12 0 2 5 3 5 12 2 13 4 8 0 5 2 4 12 0 84 11 2 21 6 6 8 9 5 54 15 3 54 4 9 .. 0 10 6 I I - _ i Notes. —(«) Cost does not include interest and depreciation on land, buildings, &c. (6) "Receipts from Maintenance" shown in Table XIa not included.

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, 1940.

Table XIII.—Expenditure out of Public Works Fund on Mental Hospital Buildings, etc., during the Financial Year ended 31st March, 1940.

Approximate Cost of Paper.—Preparation, not given; printing (560 copies), £34.

By Authority: E. V. Pauj, Government Printer, Wellington.— 1940.

Price 9d ,]

20

J. V WiUi iUilUUlij xt/ iv. Total Net Expenditure Mental Hospitals. 1877-1930. 1930-31. 1931-32. 1932-33. | 1933-34. 1934-35. , 1935-36. | 1936-37. 1937-38. | 1938-39. j 1939-40. £ £ £ £ i £ £ | £ £ £ £ £ £ Auckland .. .. 226,670 3,372 621 676 155 2,321 307 842 5,658 907 7,118 248,647 Christchurch .. .. 267,343 23,993 4,650 7,960 3,481 23,489 12,397 23,970 16,397 6,784 17,252 j 407,716 Dunedin (The Camp) .. 4,891 .. .. .. .. .. .. .. •• •• • • Hokitika.. .. 49,114 14,764 8,381 3,107 8,753 5,629 2,739 7,580 2,097 1,140 j 26,793 130,097 Hornby .. .. .. 11,102 .. .. .. • • •• •• •• j •• Motuihi Island .. .. 561 .. .. .. • • • • • • • • • • • • • • Napier .. .. .. 147 .. .. .. • • • • • • • • • • • • • • 147 Nelson and Stoke .. .. 97,806 26,494 3,339 2,680 12,251 28,552 18,307 16,218 2,234 15,458 39,469 262,808 Puhitahi (Kingseat) .. .. 16,130 16,433 10,278 35,438 29,784 21,973 65,192 52,144 71,149 62,896 381,417 Seaclifi 286,796 8,914 3,065 414 6,618 4,888 1,453 2,958 570 2,527 1,082 319,285 Tokanui .. 179,000 27,787 7,164 2,918 6,295 3,797 12,682 18,839 2,855 6,903 9,922 278,162 Waitati .. .. .. 21,312 9,557 936 516 .. .. .. .. .. .. .. 32,321 Wellington .. ... 29,641 .. .. ■. .. .. .. • • i ■ - • ■ • • 29,641 Wellington (Porirua) .. 341,645 3,129 1,349 207 29 170 .. 6,510 20,502 23,948 10,894 408,383 Totals . 1,516,028 134,140 45,938 28,756 73,020 98,630 69,858 142,109 102,457 128,816 175,426 2,515,178 i ! 1 - ■ ■ I - i 1 i I ! 1

, r » | Tr-j- ... Net Expenditure for Year Mental Hospitals. ended 31st March, 1940. £ Auckland .. .. . • • • • • • • • • • • • • 7,118 Christchurch .. .. .. . • •• •• •• •• •• 17,252 Hokitika .. .. .. • • • • • • • • • • ♦ • 26,793 Nelson and Stoke .. .. •• •• •• •• •• •• 39,469 Porirua .. .. .. •• •• •• •• •• •• 10,894 Kingseat .. .. .. • • • • • • • • • • • • 62,896 Seacliff .. . • .. • • • • • • • • • • • • *»0^2 Tokanui .. .. .. • • • • •• • • • • • • 9,922 Total 175,426