MENTAL HOSPITALS OF THE DOMINION (REPORT ON) FOR 1947

Appendix to the Journals of the House of Representatives, 1948 Session I, H-07

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1948 NEW ZEALAND

MENTAL HOSPITALS OF THE DOMINION (REPORT ON) FOR 1947

Presented to both Houses of the General Assembly jmrsuant to Section 79 of the Mental Defectives Act, 1911

The Hon. M. B. Howard, Minister in Charge of Mental Hospitals, Wellington. Madam, — Wellington, 18th June, 1948. I have the honour to present my annual report upon the work of the Mental Hygiene Division of the Health Department for the year ended 31st December, 1947. Statistical At the end of the year there were 9,112 names of persons upon our registers, including 56 patients at Ashburn Hall private licensed institution and 790 patients who were absent on probation in the care of their relatives and friends. In actual residence in Government hospitals on 31st December there were 8,267 persons, an increase of 93 as compared with a year before, and of this number 7,905 were subject to a reception order and 362 were voluntary boarders. Admissions for the first time of patients and boarders totalled 1,747, an increase of 20 over the previous year, and of these 1,213 were the subject of a reception order and 534 were voluntary boarders. It is of interest that voluntary admissions continue to increase in number, and also proportionately with regard to total admissions.

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Of all classes of admissions, 1,542 were discharged, or 68*59 per cent, calculated on the number admitted. It is not possible to consider that all of these were fully recovered, but 43-73 per cent, were considered to have recovered from their mental breakdowns, a proportion which may be considered very creditable.

Voluntary Boarders

Mental Infirmity due to Old Age Attention is drawn to the increasing number of old people who are being cared for in mental hospitals. This age group in recent years has been forming a greater proportion of admissions, and it will be seen from Table IY that at 31st December there were resident 902 over seventy years of age and a further 1,397 between sixty and seventy years of age. A large proportion of these cases could be looked after in homes suitable for their own particular condition. They require very largely no specialized form of treatment for their mental condition, only sympathetic care and supervision, along with guidance into a more orderly and routine life which is so necessarv for them.

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Year. ■First, Not First Tnt.al Transferred Died. Remaining Admission. Admission. Admissions. to Register of Patients. Discharged. on 31st December. M. F. T. M. F. T. M. F. T. M. F. T. M. F. T. M. F. T. M. F. T. 1912 6 17 23 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 11 15 26 50 54 104 2 3 5 5 1 6 38 41 79 36 63 99 1922 47 38 85 10 16 26 57 54 111 6 5 11 4 4 8 40 48 88 43 60 103 1923 44 50 94 15 21 36 59 71 130 3 6 9 3 3 6 47 47 94 49 75 124 1924 38 44 82 16 20 36 54 64 118 4 8 12 6 3 9 39 48 87 54 80 134 1925 64 59 123 15 34 49 79 93 172 10 15 25 6 3 9 60 63 123 57 92 149 1926 71 60 131 11 29 40 82 89 171 10 11 21 7 2 9 49 71 120 73 97 170 1927 70 70 140 25 32 57 95 102 197 8 6 14 5 12 17 75 58 133 80 123 203 1928 120 94 214 37 39 76 157 133 290 8 10 18 10 8 18 102 97 199 117 141 258 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 18 159 102 261 198 161 359 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 85 165 141 306 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 11 15 26 11 8 19 144 125 269 183 169 352 1939 131 103 234 63 72 135 194 175 369 22 21 43 16 15 31 157 130 287 182 178 360 1940 128 124 252 65 63 128 193 187 380 18 18 36 10 12 22 176 167 343 171 168 339 1941 93 104 197 48 58 106 141 162 303 11 9 20 10 13 23 140 151 291 151 157 308 1942 88 108 196 44 74 118 132 182 314 14 15 29 15 8 23 124 160 284 130 156 286 1943 95 126 221 66 87 153 161 213 374 2 8 10 13 14 27 115 159 274 161 188 349 1944 146 168 314 70 104 174 216 272 488 4 7 11 11 10 21 172 243 415 190 200 390 1945 178 181 359 90 112 202 268 293 561 9 8 17 20 8 28 244 272 516 185 205 390 1946 233 229 462 80 137 217 313 366 679 4 10 14 15 7 22 283 348 631 196 206 402 1947 233 301 534 83 122 205 316 423 739 7 2 9 12 13 25 321 383 704 172 232 404

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The admission of many of these old people is due to a shortage of nursing staff generally and lack of other suitable homes for their care. I consider they are well cared for in our hospitals, but their presence in increasing numbers adds a considerable burden to our depleted nursing staff and is responsible very largely for the overcrowding of accommodation in our hospitals. Admission op Infants It is found that applications for admission of infants have also been increasing in recent years. Every effort has been made to have other arrangements made for mentally deficient children under three years of age. Parents or relatives, however, find that admission to children's or babies' homes is refused for various reasons, including staff shortage. At Nelson, Templeton Farm, and Levin Farm, where most of the children are cared for, the constant care and attention of even a few infants under three years of age is an added responsibility, particularly as the nursing staff have not been specially trained in the care of infants. When it is mentioned that 83 children under the age of five years were resident at the end of the year, it will be appreciated that the number admitted each year in this group is showing a gradual increase. Dietary and Clothing The improvement in the supply of commodities generally has allowed of an increase of variety in the diet of patients. Every effort is being made at the same time to improve the standard and variety of patients' clothing. It is hoped that further improvements may be carried out and may become more noticeable this year. Furnishings of Wards Although many of our older buildings may be considered out of date in their construction, &c., they are all capable of brightening up and of increased comfort, and steps have already been taken along these lines. Progress has been slow in some cases because of difficulty of supply, but again considerable improvement is now in sight. Patients' Comforts Allowance A small weekly allowance to those patients capable of its appreciation, was agreed to during the year, and has been of considerable benefit to the patients. A large number of patients have been materially assisted in this way, and it has been a " worthwhile " -expenditure, in that patients have been able to provide for themselves such personal articles as they themselves desired. In the canteens now instituted at all hospitals the variety of supplies is increased as is found desirable to the patients themselves. Building Programme The rate of progress of our building programme has been much slower than expected. This is attributable to the shortage of labour and materials and also the fact that plans of many new buildings had to be redesigned with the object of reducing the quantities of basic materials, particularly steel, which is in such short supply. Progress has been made in the rebuilding of Porirua Hospital and the erection of villas at Lake Alice ; but unfortunately this has not been rapid enough to alleviate our serious overcrowding.

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It lias not yet been possible to commence building at Cherry Farm ; but it is hoped that some villas will be started at an early date. At Levin Farm, buildings have been altered to meet our requirements and we now have nearly 200 children in residence. Progress is also being made in the provision of further accommodation. Alterations, Additions, and Improvements Capital expenditure on new works amounted to £195,588 during the year, and the following summary shows the principal items and hospitals at which this expenditure was incurred : (1) Avondcde (£10,938). —Alterations to the byres and installation of milkingmachines have been completed. New main boilers have been purchased. Improved bathing facilities have been provided for patients. Fire services have been improved. A new sports-ground and two grass tennis-courts have been provided and roading-work has been done. (2) Kingseat (£8,936). —Two staff residences have been completed and six more are in course of construction. A bus shelter has been erected and fire services and roading have been improved. (3) Raventhorpe (£10,925). —One new residence for staff has been erected. Extensive alterations to buildings have been made and heating of wards has been improved. (4) Tokanui (£8,065). —Two buildings for occupational therapy and a hairdressers' salon are in course of construction. Two bus shelters have been erected. An area of land is being prepared for the erection of about twenty-four staff residences. Roading and fire-protection services have been improved. (5) Levin Farm, (£10,234). —An additional building has been purchased from the War Assets Realization Board for conversion into a central dining-room to be run on the cafeteria system. Buildings are being converted to meet requirements. (6) Porirua (£58,335). —Installation of laundry machinery is proceeding. Two villas are nearing completion and a third is in course of construction. Fire-protection services have been extended and improved. (7) Nelson (£1,518). —Alterations are being made to store-rooms in villas atNgawhatu. Small laundry and drying-room has been erected at Nelson and a drying-room provided in the nurses' home at Ngawhatu. Roading has been extended. (8) Christchurch (£4,369). —A new granary has been erected at Templeton Farm.. Additions to administration offices and nurses' home are in course of construction. Ground is being prepared for a children's playground at Templeton Farm. (9) Seacliff (£25,752).- —A new wooden building is in course of erection to replace portion of old building rendered unsafe by land movement. Roading, water-supply, &c., has been carried out at Cherry Farm. Roading has been extended and improved at Waitati. (10) Lake Alice (£56,007). —Two villas to accommodate fifty patients each are nearing completion, and six villas, each to accommodate eleven patients, are under construction. Development work on water-supply, roading, fencing, &c., is proceeding.

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Registration of State Psychiatric Nurses The fallowing have passed the State Final Psychiatric Examination, held in June and December, and are thereby qualified for State registration : Passed top for Dominion —June : Nurse C. G. Foster. December: Nurse M. M. Palmer. Auckland — ' . Nurses : D. E. Metcalfe, J. Y. Briggs, L. A. Horridge. Kingseat — Nurses: P. M. Cain, N. E. Brooks, J. Nicholson, J. I. Waddick. Raventhorpe— Nurse : M. Bayly. Porirua — Nurses : M. E. Armstrong, N. A. Ra} 7 , C. J. Hughes. NelsonNurses : *C. G. Foster, I. B. Hockey, M. Ruff, M. Tippen. Christchurch— Attendant: M. Flanagan. Nurses : 0. L. Holm, E. W. Learmonth, M. M. Mcßae, G. L. Whetton. Seacliff — Attendant: F. C. Brenssell. Nurses : M. J. Wallace, M. M. Palmer. The following' obtained partial passes : Auckland — Nurse : H. R. Emery. Christchurch — Nurses : D. G. Harris, E. M. Jones. * Passed with distinction. Appreciation It gives me pleasure to express my" appreciation to the staff of the Division for their willing co-operation and assistance in the care of the patients under our charge during the year. J. Russell, Director.

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AUCKLAND MENTAL HOSPITAL Dr. Buchanan reports : I have the honour to present my annual report for the year ended 31st December, 19-47. The total number of cases under care was 1,936 and the average weekly number of residents was 1,311. The shortage of medical, nursing, office, and domestic staffs has been a handicap. It has been most creditable that, in spite of this, we have been able to carry on as well as we have done. Physical treatments on many of our patients continues to produce gratifying results and they are of great value on selected cases. Nursing-staff shortage has been a deterrent in carrying out more fully the treatment by leucotomy, but I hope that in the coming year we may be able to widen our field in this direction. Occupational-therapy classes continue to fulfil a most satisfactory aid in our treatments —40 men and 82 women were discharged to their homes directly from these classes ; 56 men and 80 women were transferred therefrom to utility services in the hospital. A total of 249 new patients have attended the classes during the year. The increasing number of admissions of senile cases makes the problem of bed accommodation increasingly difficult and adds a lot of extra responsibility to our already weakened nursing staff. Many of these old folk could be suitably looked after in other hospitals or homes than the mental hospital if outside nursing help was procurable. Mantoux testing has been introduced as a routine, following the advice of Dr. Chisholm McDowell, of the Green Lane Chest Clinic. It is hoped that this will allay muoh expressed anxiety as to the exposure of staff to infection. The appointment of a full-time Dental Officer is much appreciated, as also is the increase of dental equipment. It is to be hoped that before long an appropriate dental unit may be erected in the grounds and so avoid congestion in the dispensary. We are fortunate now in having two Tutor Sisters, who are occupied in lecturing and supervising nursing technique in wards, and their duties also embrace the major part of dispensing until such time as we may obtain the services of a fully-trained Dispenser. The acquisition of a 16 mm. projector is a great boon, firstly for staff training, and secondly in permitting pictures to be viewed in wards whose occupants cannot be allowed to attend the usual weekly 35 mm. screenings in the picture-hall. A fine sports area is now formed, and though this encroaches on our farm land, it has been worth while because of the apparent pleasure it has given to both patients and staff. Refrigerators for all kitchens are on order and many are already in use. Automatic sprinkler systems have been installed throughout the main building, Park House, and Male 3 Ward. Maintenance has been carried out as far as practicable. However, the difficulty of procuring many materials has been a great handicap. Once again I desire to express my sincere thanks to the various clubs and individuals who so willingly assist in making the lot of many of our patients happier and brighter. I would like specially to thank Mrs. Mathias and her band of helpers, who see to the stocking of the library. We owe much to the interest taken by Mrs. Teape in assisting with our outings for the patients and to her regular visits as Official Visitor to this hospital. During December, Mrs. L. A. Hirst, J.P., Mrs. E. S. Winks, J.P., and Mr. F. Kay-Stratton were appointed as Official Visitors, and appear very interested in the work here. In conclusion, I would like to record my thanks to the staff for their help and co-operation ; during these times their task is somewhat difficult.

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KINGSEAT HOSPITAL Dr. Lewis reports : I have the honour to present the annual report for the vear ended 31st December, 1947. The total number of cases under care during the year was 1,036 ; of these, 974 were subjects of a reception order and 62 were voluntary boarders. The weekly average number resident during the year was 854. The admissions totalled 138; 106 were certified patients, of whom 24 were transfers from other institutions and 32 were voluntary boarders. Seventy-five persons were discharged during the year and 41 were transferred to other institutions. At the end of the year 38 persons were well enough to be on probation in the care of relatives or friends. Forty-nine persons died during the year. There was a change of local administrator in the middle of the year, Dr. Tothill, the Medical Superintendent, leaving to take up the post of Deputy Director of the Division. There has been a good variety of clinical types amongst the admissions, although seniles and unstable adolescents of somewhat inferior intelligence have predominated. Electro convulsive therapy continues to be a very useful adjunct to psychotherapeutic measures, particularly in depressive states. Sub-coma insulin treatment has been used with success in suitable cases. The general health of the patients has been good. The chronic patient population is ageing. The senile age group is becoming larger and for many years senility amongst our chronic population will be a problem. The hospital block cannot cope with the admissions and with all the physically infirm patients. On the female side a day-room downstairs in Yilla 13 is used as a hospital ward ; now that barely meets the demand. A sluice-room, &c., is being provided which will give relief to the nursing staff and improve efficiency. A similar position is arising on the male side, and it is proposed to equip Villa 3 similarly. The erection of a villa for the infirm is contemplated. A recreation-hall is an urgent necessity for the patients as well as for the staff, because this hospital is in the country thirty miles from Auckland and ten miles from the nearest township. There is no recreation-hall here, and for any gathering of patients for dancing, pictures, &c., a day-room or dining-room in one of the villas has to be used — such a room is totally inadequate. Another important requirement is a separate building providing living-quarters, mess-room, and kitchen for the male staff. Six additional staff houses are in course of erection at the settlement. Occupational therapy has been carried on in the wards. We have a class now in both disturbed wards on the female side. It is gratifying to note that we are to have one separate occupational building in the near future. The new Patients' Comforts Fund has been a success, not the least of the benefits being that the majority of patients appreciate having some money of their own in their pocket to spend as they wish. There is still an acute shortage of male and female nursing staff —particularly the latter. A great deal of overtime is being worked, but it is a constant effort to provide reasonable coverage for the needs of our patients. The nursing staff has helped willingly, and on the patients' behalf I acknowledge that help. One of our particular difficulties here in recruiting and holding staff is the distance we are from outside social amenities. To meet this a station wagon has been provided to supplement existing transport. A feeder service is run to Papakura after 5 p.m. and at midnight. The wagon is used to take parties to games, dances, pictures, &c. During the day the wagon is used for patients and other hospital requirements. This innovation has been a success and has been greatly appreciated by the staff. Farming-operations have been carried on as usual. The orchard promises more fruit than ever before. The production from the vegetable-garden has been satisfactory, but the abnormally wet spring necessitated much extra work.

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I should like to express my thanks to the Official Visitor, Mrs. Moore, for her unceasing interest in the patients and the hospital. On behalf of our patients I wish to thank our many benefactors for gifts of money, clothing, books, &c., for bringing sports teams to our hospital, and for the excellent hospitality they have given when they have invited our patients to visit them. I should also like to thank the clergy who visit our patients and conduct services. To my medical colleagues, Doctors Crawshaw and Mulinder, I express my gratitude for their co-operation and help since I took over this hospital. In conclusion, I wish' to thank the whole staff for their good work during' the year.

TOKANUI HOSPITAL Dr. Hunter reports : I have the honour to submit my annual report for the year ended 31st December, 1947. The total number of cases under care during the year has been 939, with a weekly average of 772. The admissions were 129 (70 men, 59 women). Of these, 110 (61 men, 49 women) were admitted for the first time, an increase of 5 over those of last year. Discharges numbered 60 (20 men, 40 women), while there were 50 (20 men, 30 women) on probation. The number of transfers numbered 9(4 men, 5 women). Voluntary boarders treated were 67. (33 men, 34 women). Of these, 31 (16 men, 15 women), were first admissions, and discharges numbered 35 (14 men, 21 women). The general health of the hospital has been good, deaths totalling 67 (38 men, 29 women), most of these occurring in our elderly patients group. This year more early involutional melancholic types were admitted and, with electro convulsive therapy, improved rapidly and their hospitalization period was shortened. At the end of August, Matron Semple retired from the hospital after many years of sterling service in promoting the welfare of the patients and hospital generally. The staff shortage continues to be serious ; both the nursing and the attendant staffs are approximately half of the authorized establishment. There does not appear to be any immediate prospect of improvement, as few girls seem to be interested in this type of nursing. When the proposed staff houses are built, the attendant staffing position should improve, as housing accommodation is the main item in which applicants are interested when applying for positions on our staff at the present time. Occupational therapy is proving its worth in promoting the recovery of our patients, but is handicapped by the lack of sufficiently trained occupational therapists, and efforts are being made to overcome this difficulty. The two occupational therapy buildings are under construction, and will be ready for occupation within a few months. The hairdressing-salon for the use of the women patients is nearing completion and should improve considerably the outlook of the women patients, and, along with the use of individual suitable dress material which is available now, will encourage them to take; an interest in their personal appearance and so help their recovery. The fire-fighting service has been improved by the use of an up-to-date fire engine with the necessary equipment. Staff are being instructed in the proper use of the equipment and are becoming efficient. The manual-type telephone system installed when the hospital was opened has outlived its usefulness, and plans are being made to replace it with an up-to-date automatictelephone system.

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The drought periods during the last few years have shown the necessity for an adequate water-supply to the vegetable-gardens so that seeds and seedlings can survive planting and produce, throughout the year, the continuous supply of vegetables which are essential to the health and well-being of the patients and staff. The question of an increased water-supply to the gardens should be given early consideration. The new laundry, engine-room, butcher's shop, and bake house, becomes more urgent as the number of patients and staff increase; the old buildings are too small to cope with the work to be done. This replacement was authorized in 1939, but the war has prevented it being carried out. We hope that the necessary buildings will be commenced as soon as practicable. The patients' accommodation is overcrowded to the extent of two villas—that is, 50 men and 50 women —so that provision for further accommodation will require consideration very shortly. A permit has been granted for the building of new cow-byres, which are very necessary, as the old buildings and equipment are below the standard for the production of milk under satisfactory hygienic conditions. Amusements and recreation have been catered for as usual. Weekly dances and pictures, picnic parties, visits of bands and orchestras, and church services by various denominational ministers have been appreciated. The Te Awamutu Rotary Club continues to take am active interest in the welfare of the hospital, and this is much appreciated by both patients and staff. In conclusion, I wish to express my thanks to all members of the staff for their help and' co-operation in the work of the hospital.

PORIRUA HOSPITAL Dr. Hart reports : I have the honour to submit my report for the year ended 31st December, 1947. The total number of eases under care during the year was 1,994, of which 1,627 were committed patients, 354 voluntary boarders, and 13 persons were remanded for observation. Admissions for the year totalled 704, of which number 240 were voluntary boarders. The gradual increase-of the admission rate to this hospital over recent years has been predominantly due to the increase in the number of voluntary boarders admitted. This is well shown in the comparison of the figures of five years ago, when 108 voluntary boarders were admitted in 1942, as against 240 admitted in 1947. The figures in relation to length of residence of those discharged fully recovered in comparison with other years is also worthy of note. In 1942 the percentage of those cases discharged recovered within three months of admission was 25 per cent., whereas in 1947 the percentage was 38 per cent. Two noteworthy trends are shown in the hospital statistics : firstly, that more people and' a group or grade of mildly maladjusted people who formerly did not come to our hospitals are now seeking admission and treatment as voluntary boarders; and secondly, that the length of residence of these cases (patients and boarders) whom we were able to discharge fully recovered has been reduced. The latter change is no doubt due to the more modern methods of psychiatric treatment available in recent years. During the year under review 491 persons (patients and boarders) were discharged, 114 cases died, and 16 patients were transferred to some of our other hospitals.

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The two serious problems of staff shortage and lack of patients' accommodation remain. At the close of the year the hospital was overcrowded by 343 patients and there was a nursing staff shortage of 65 officers. At various periods during the year the female nursing staff shortage was such that an adequate standard of care, supervision, and treatment was only maintained with the greatest of difficulties and with considerable strain on medical and nursing staff personnel. In our hospital treatments we have continued to use electroplexy, electric narcosis, and sub-coma insulin as routine procedures, and the results continue to confirm the early promise of such therapys being the greatest forward step in recent years in psychiatric medicine. The building programme for various reasons progresses somewhat slowly, Villas 6, 7, and 8 are nearing completion, but are still unoccupied, and the new laundry block awaits its machinery and equipment. Plans have been finalized for a female occupational-sewing-room block, hospital, and administration blocks. A considerable amount of renovating has been carried out to buildings during the year and much progress has been made towards overcoming arrears of maintenance occasioned by the war. The exteriors of villas Montrose, Nairn, Kaumatua, Somerset, Weymouth, Rauta Block, H Cottage, and four officers' houses were painted. Some interior painting and renovations were also carried out in certain buildings. Refrigerators and additional cooking equipment were installed in the nurses' home, Rauta, and Lower Building blocks. A 16 mm. cinema projector was provided for the nurses' home, which apart from its entertainment value, is used for staff training to demonstrate anatomical nursing and treatment techniques. Three Zip heaters were installed and an acetone welding plant was added to the engineer's shop equipment. During the year some refurnishing was undertaken in some of the older wards. This, along with the furniture and equipment purchased for the new villas, has materially improved this aspect of the hospital. Activities in the hospital farm and gardens have continued as formerly, and during the year 229 tons of vegetables and tons of fruit were produced for hospital consumption. The hospital is indebted to many individuals and organizations for the lively interest they have taken in patients' welfare. It is impossible to mention all, but we particularly wish to thank the Joint Council of the Order of St. John and the New Zealand Red Cross Society, who have donated sports equipment, provide a weekly cinema, weekly bus rides, and many extra comforts for ex-servicemen patients. A fortnightly picture entertainment is also arranged for by the Army Welfare Educational Service. We thank the Women's National Reserve for their continued support in forwarding money and goods for the benefit of women patients. The regular hampers sent by the Country Districts Sub-centre New Zealand Red Cross, Masterton, were much appreciated. The Commercial Travellers' Association, Returned Servicemen's Association, and various charitable organizations have contributed liberally towards patients' extra comforts, entertainment, and recreation. The New Zealand Blind Institute have maintained a kindly interest in the welfare of blind patients. In addition to the above, from Government money, bus rides, picnics, &c., have been provided for patients and some £560 per month is being distributed direct to patients as a comforts allowance, largely for personal spending. The hospital continues, and will be for some years, in the throes of rebuilding, with its attendant difficulties and certain inconveniences. The total number of cases under care continues to rise each year and the building programme lags behind this rise; consequently, the overcrowding on 31st December, 1947, was greater than on 31st December, 1946.

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This hospital cannot, as general hospitals, defer the admission of certain prospective patients because of staff and accommodation shortage. In conclusion, I must thank the staff for having maintained a high standard of service, both medical and nursing, despite these difficulties.

NELSON MENTAL HOSPITAL Dr. Williams reports : I have the honour to present my annual report for the vear ended 31st December, 1947. The number of patients under care during this period was 1,162. Of these 1,110 were, admissions under reception orders and 52 were voluntary boarders. Admissions totalling 98 included four transferred from other mental hospitals, 37 under section 8 of the amendment of the Act, and 35 voluntary boarders. Fifty-eight, including 30 voluntary boarders, were discharged during the year. Twenty-nine were transferred to other mental hospitals. Deaths totalled 51. Admission of children dropped to a mere trickle comparatively, because of diversion to Levin, which is fortunate, in view of the indifferent facilities here ; though, otherwise, the site in Nelson has much to commend it. The general health of the patients has been good, excepting for mild epidemics of mumps and of infective hepatitis. Because of labour and other difficulties, which are general in the building world at present, little more than maintenance work has been possible. A number of amenities have been added, however. These include a new staff sitting-room at Nelson, washing and ironing machines, and a drying-room there also, which are most useful. A drying-room has been installed in the nurses' home at Ngawhatu; and. some improvements made to Matron's and Tutor Sisters' quarters. The kitchen at Dunoon for the male staff has been modernized and remodelled, with consequent better service. Tubular heaters were installed where required in staff bedrooms. Fire-escapes have been added to El Nido, and a changed and improved form of fire-fighting facilities installed. Staff changes have not been many really, though shortage on female nursing side persists. A full male staff has continued to buffer this position in some degree, and, generally speaking, we are fortunate indeed in our personnel. Their spirit is good and they have been genuinely co-operative in the best interests of the hospital and its patients. Dr. Cameron transferred from Seacliff during the year. He is a welcome addition to the medical roster. Miss Ahlstrom has been appointed as Occupational Therapist and Miss Nilsson as Tutor Sister, and both are doing good work. Mr. Irving has been, appointed Senior Clerk. Farm activities have proceeded satisfactorily and revenue therefrom continues buoyant. Unfortunately staff shortages have persisted there,. too, though the personal help of Mr. McPhail, the Farm Supervisor, and the efforts of Mr. Greig. Farm-manager, have greatly alleviated a trying state of affairs. The amusements and recreation side has been reasonably successful. The staff have had a monthly dance, and the annual ball was reinstated this year. Badminton, cricket, soccer, and bowls clubs have all been successful, though perhaps rather in the enthusiasm displayed than in the various championship ladders relevant. Parties of patients have gone regularly to the pictures ; fortnightly dances have been held; and visiting concert parties have been very kind also, and in this respect particular thanks are due to the Young People's Choir, and to Mr. Cole.

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Mr. Croucher is to be thanked, too, for his continued generosity in supplying buses to the patients for their various picnics and visits to various sports meetings and other functions in the district. I wish to express my appreciations also to the various ministers of religion for their attendance and work here; and also to the staff generally for their continued loyal help and co-operation.

SEAVIEW HOSPITAL Dr. Childs reports — I have the honour to submit my report for the year ended 1947. The number of cases under care during the year was 560 (279 males and 281 females). The admissions numbered 24 (17 males and 7 females). There were 19 transfers (3 males and ; 16 females) and 4 voluntary boarders (2 male and 2 female). Patients discharged were 10 (5 males and 5 females), voluntary boarders 2 (1 male and 1 female), while there were 5 transfers (3 males and 2 females). There were 21 deaths (12 males and 9 females). At the end of the year 10 males and 6 females were on probation. The health of the patients generally has been good. The Grey River Hospital clinic has been held monthly ; occasional visits have been made to the Westland Hospital and consultations held at this hospital. Few of the cases admitted this year have been suitable for electric convulsive therapy. A considerable part of the hospital estate has been taken over by the Public Works Department for the purpose of building an aerodrome. The Medical Officer's cottage, owing to difficulties in obtaining supplies, has not yet been completed. Through the good will of the Country Library Service a small well-equipped library is now at the benefit of the patients. A sound projector was supplied by the Department during the year, and this is an acquisition. Good programmes have been shown to the patients, and it will be useful for teaching. The usual routine of farming and gardening has been carried out satisfactorily. Maintenance work has been in progress throughout the year, but owing to shortage of supplies maintenance at times is difficult. Recreation and amusement have been carried out as much as possible. There was a very successful picnic—the picnic is becoming the event of the year. Thanks are due to the various local societies for entertaining the patients at the hospital, and in particular the Hokitika Band, which plavs for the dances. I would also like to thank the various ladies' committees, the racing club, and others for inviting the patients to local functions. The clergy have made frequent visits and held regular services. Mr. Shand, Head Attendant, has retired after forty years' service with the Department, and good wishes are extended to him and Mrs. Shand. Although the nursing shortage position was relieved to some extent during' the year, it is now acute again on the female side, and for the first time the male side shows a considerable shortage. I wish to thank-the staff generally for their help during the year.

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SUNNYSIDE HOSPITAL Dr. McKillop reports : I have the honour to forward my report for the year ended 31st December, 1947. The total number of committed patients under care was 1,710 (858 men, 852 women). Two hundred and forty-three patients (114 men, 129 women) were admitted and 6 men and 25 women were transferred from other institutions. One hundred and fifty-five patients (76 men, 79 women) were discharged and 48 patients were transferred, leaving 1,424 patients (736 men, 688 women), inclusive of 83 men and 87 women absent on probation, receiving treatment at the end of the year. Eleven patients were admitted on remand for observation and 4 were committed, but the others were discharged after a short period of treatment. Almost 40 per cent, of our total admissions applied voluntarily for treatment —138 patients (59 men, 79 women) came here under this section. Sixty-three men and 71 women were discharged, 3 men and 1 woman were committed as ordinary patients, and 1 man and 4 women died. Seventy-five voluntary boarders were receiving treatment on the 31st December, 1947. The general health of the patients has been very satisfactory. There were 83 deaths (40 men, 43 women),, most of the deaths being due to senile causes. We have at present almost three hundred patients over sixty years of age, and there is an increasing admission of senile cases, probably due to the difficulty of getting efficient help in the bome to look after such cases. Electric-shock therapy continues to give favourable results—l 34 patients were treated during the year, and 100 were discharged fit to resume their ordinary duties. The addition of extra occupational officers has enabled this branch of therapy to be greatly extended. Work is now carried out in several of the wards and in the new occupational block. The supply of material has improved. The difficulty in getting material has hampered not only our maintenance work, but also major works in the course of construction —e.g., the nurses' sick-room and the extensions to the nurses' dining-room. The additions to the office and the new granary at Templeton have been completed. The programme of building for 1948 includes a tuberculosis block, female villa, nurses' home (Templeton), and an admission block. Approval has been given to refurnish many of the wards in the old building, and this is now being done. Clinics have been held at Timaru and Christchurch Hospitals and the attendances have been well maintained. The farm and gardens have had a successful year and the supply of milk and vegetables has considerably improved. The recreation of the patients has been carried out on the usual lines : the new asphalt tennis-court has been completed, and it is hoped during 1948 to have the bowlinggreen relaid and extended to full size. I wish specially to thank the National Council of Women, the Mental Welfare Society, the Justices of the Peace Association, the Presbyterian Social Service Association., and many private individuals who have done so much to help our inmates. The Official Visitors and the chaplains of various denominations have paid regular visits and have taken a keen interest in the progress of the institution. We are fortunate in having a full male staff, but our nurses have had another very trying year. They have carried out their extra duties willingly and efficiently. To the staff generally I tender my thanks for their loyal co-operation and assistance.

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SEACLIFF HOSPITAL Dr. Brown reports : I have the honour to submit my report for the year ended 31st December, 1947. During the year there were 1,203 persons (678 men and 525 women) under care. In that period 185 patients were admitted, 111 discharged, and 21 transferred to other hospitals. In addition to these patients, 64 voluntary boarders were admitted and 62 were discharged. The number of deaths was 53, and in 28 of these the cause of death was senile decay. Early in the year the effects of the slipping ground, on which I commented in last year's report, on the buildings on the female side of the hospital became more obvious and frequent inspections were made, at my request, by officers of the Public Works Department. It eventually became necessary to make temporary safety measures for the day-room of F2 Ward and to proceed with the erection of a wooden structure to replace it. This work is advancing, and it is hoped to get the patients into it fairly soon. On the male side, which for a time seemed to be reasonably safe from the effects of the slip, there is now evidence that this is not the case, and that, in one part at least, there is cause for some apprehension. The trouble caused by the slipping ground is extensive and makes the satisfactory running of the hospital far from easy. The main sewer has broken on numerous occasions and, by the nature of the terrain through which it runs, repairs are difficult, involving arduous work, and are not always satisfactory. Breaks in the watermain from Double Hill Reservoir are an almost every-day occurrence. A second pump, electrically driven, at Evansdale is almost ready for use, and this should make the watersupply much more satisfactory. Much maintenance work has been done, but difficulties with supplies and lack of staff have hindered the work and much remains to be done. The age of the hospital and its insecurity have made this" work difficult, costly, and often unsatisfactory. The farm has had a satisfactory year. In the early spring very heavy rains caused flooding, which ran through the vegetable-garden, washing away not only the planted crops, but also the topsoil, and the effects of this must necessarily limit the vegetable crops next year. The effect of the modern forms of treatment is shown in the annual statistics. The number of admissions has not been less than average, but the number of patients discharged has shown an increase, an increase which has been cumulative over the last few years. This is shown by the fact that while in 1940 the average resident population was 1,014, in the year under review the number was 961. (Despite this decline in population, the hospital is still overcrowded by modern standards.) Mr. Murray Falconer, the Neuro-Surgeon at Dunedin Hospital, has performed leucotomy in a few more cases, and the results confirm my previous reports to you that successful results can be expected only in a limited number of cases. Electro convulsive therapy has undoubtedly played a large part in the increased discharge rate, but once again I would like to emphasize that none of these treatments in itself is sufficient. The care and attention which only a welltrained staff of psychiatric nurses can give is perhaps even more important than these mechanical aids to treatment. Clinics conducted by the members of the medical staff were held in Invercargill, Gore, Balclutha, and Oamaru as well as in the Dunedin Public Hospital. The problem of staffing the hospital is well known to you, and the remedy, if any, does not form part of this report. I can only put on record my appreciation of the members of the existing staff, who have worked long hours and done such a good job of work.

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To a number of people not actually on the staff of the hospital I must record my gratitude for their help and interest. Mrs. R. B. S. Reeves, one of the Official Visitors, has visited consistently and has shown a sympathetic interest in our difficulties and an .appreciation of what we have been able to do. Mr. A. Steven, not only an Official Visitor, but also Chaplain to the Patients and Prisoners Aid Society, has been the means of •organizing various concert parties and bands who have entertained us during the year. His weekly visits are looked forward to by many patients. Mr. C. B. Barrowclough, the District Inspector, has been most helpful, and his work in regard to the individual patient who has a grievance has been most painstaking. Mr. I. Wilson, the local Presbyterian minister, has collected funds and established a library for the patients; for his efforts in that, as well as for the way he has carried out his pastoral duties, I have to thank him. The close liaison between this hospital and the Otago Medical School has been maintained, and I am indebted to the Dean, Sir Charles Hercus, and to Professor DAth for much help. I must thank all members of the staff for the good work done, despite many difficulties.

Table I.—Showing the Admissions, Readmissions, Discharges, and Deaths in Mental Hospitals during the Year 1947 M. F. T. In mental hospitals, Ist January, 1947 .. .. .. .. 4,556 4,046 8,602 M. p. T. Admitted for the first time .. .. 597 616 1,213\ -jq 790 j -na Readmitted .. .. .. .. 122 174 296 / Total under care during the year .. .. .. .. 5,275 4,836 10,111 Discharged and died— Recovered .. .. .. .. 236 325 561 Not recovered .. .. .. 154 123 277 Died .. .. .. 318 247 565 — 708 695 1,403 (Not including transfer : males, 68 ; females, 162.) Remaining in mental hospitals, 31st December, 1947 .. .. .. 4,567 4,141 8,708 Increase on 31st December, 1946 .. .. .. .. .. 11 95 106 Average number resident during the year .. .. .. .. 4,309 3,753 8,062

15

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Table II. —Admissions, Discharges, and Deaths with the Mean Annual Mortality and Proportion of Recoveries, Etc., per cent. on the Admissions during the Year 1947

16

Hospitals. In Hospitals on 1st January, 1947. Admissions in 1947. Total Number of Patients under Care. Admitted for the First Time. Not First Admissions. Transfers. Avondale Kingseat Raventhorpe Tokanui Levin Farm .. Porirua Nelson Seaview Sunnyside .. Seacliff Ashburn Hall* Totals .. M. F. T. 722 638 1,360 461 407 868 9 228 237 415 395 810 95 .. 95 647 528 1,175 599 448 1,047 259 258 517 738 698 1,436 592 426 1,018 19 20 39 M. P. T. 141 119 260 25 40 65 61 49 110 37 17 54 132 166 298 25 30 55 13 6 19 99 107 206 56 72 128 8 10 18 M. F. T. 26 40 66 7 10 17 .. 2 2 6 9 15 42 59 101 14 5 4 15 15 22 37 21 24 45 .. 3 3 M. F. T. 11 9 20 7 17 24 3 27 30 3 14 10 22 32 11 42 53 4 .. 4 3 16 19 6 25 31 9 3 12 1 .. 1 sr. F. T. 900 806 1,706 500 474 974 12 257 269 485 454 939 142 39 181 832 795 1,627 629 482 1,111 279 281 560 858 852 1,710 678 525 1,203 28 33 61 4,556 4,046 8,602 597 616 1,213 122 174 296 68 162 230 5,343 4,998 10,341 Hospitals. Discharged recovered. ■ Patients discharged, transferred, and died. Discharged not recovered. Transferred. Died. Total discharged, transferred, and died. Avondale Kingseat Raventhorpe Tokanui Levin Farm Porirua Nelson Seaview Sunnyside Seacliff Ashburn Hall* Totals M. F. T. 53 54 107 16 16 32 1 1 12 31 43 80 105 185 8 18 26 9 <1 37 53 90 25 39 64 3 5 8 M. F. T. 29 20 49 5 9 14 2 2 8 9 17 4 4 33 34 67 3 14 3 2 5 39 27 66 29 18 47 112 M. F. T. 13 6 19 7 34 41 3 34 37 4 5 9 10 6 16 11 18 29 3 2 5 6 41 47 8 13 21 3 3 6 M. F. T. 68 61 129 30 16 46 37 29 3 14 69 39 108 33 12 45 12 9 21 40 43 83 19 34 53 7 7 M. F. T. 163 141 304 58 75 133 3 40 43 61 74 135 7 18 192 184 376 55 49 104 20 16 36 122 164 286 81 104 185 14 9 23 236 325 561 154 123 277 68 162 230 318 247 565 776 857 1,633 Hospitals. In Hospitals on 31st December, 1947. Average Number resident during the Year. | Percentage of Recoveries on Admissions during the Year. Percentage of Deaths on Average Number resident during the Year. Avondale Kingseat JRaventliorpe Tokanui Levin Farm Porirua Nelson Seaview Sunnyside Seacliff Ashburn Hall* .. Totals M. F. T. 737 665 1,402 442 399 841 9 217 226 424 380 804 135 38 173 640 611 1,251 574 433 1,007 259 265 524 736 688 1,424 597 421 1,018 14 24 38 M. F. T. 674 556 1,230 444 382 826 9 216 225 408 364 772 101 15 116 612 519 1,131 560 409 969 253 260 513 666 617 1,283 566 395 961 16 20 36 M. F. T. 31-74 33-96 32-82 50-00 32-00 39-02 .. 50-00 50-00 17-91 53-45 34-40 45-97 46-67 46-37 30-77 52-94 43-33 11-76 42-86 20-83 32-46 41-09 37-04 32-47 40-63 36-99 37-50 38-46 38-10 M. F. T. 10-08 10-97 10-49 6-76 4-19 5-57 1-39 1-33 9-07 7-97 8-55 2-97 6-67 3-45 16-18 7-51 9-55 5-89 2-93 4-64 4-74 3-46 4-09 6-01 6-97 6-47 3-36 8-61 5-52 42-5 .. 19-44 4,567 4,141 8,708 4,309 3,753 8,062 32-82 41-14 37-18 7-38 6-58 7-01 * Private mental hospital.

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Table III. —Native Countries

Table IV.—Ages of Patients on 31st December, 1947

2—H 7

17

Countries. Avondale. Kingseat. Raventhorpe. Tokanui. Levin Parm. Porirua. England and Wales • Scotland Ireland New Zealand Australian States Prance ■ Germany Austria Norway Sweden Denmark Italy ►China Maoris •Other countries Unknown Totals M. F. T. 86 69 155 18 9 27 15 12 27 473 497 970 30 15 45 1 . . 1 12 3 5 5 1 .. 1 3 1 4 2 . ' 2 3 i 4 34 23 57 43 13 56 22 23 45 M. F. T. 63 53 116 13 10 23 17 14 31 275 279 554 15 12 27 1 !! I 5 . . 5 4 4 2 13 112 2 13 15 11 26 16 18 29 13 4 17 M. F. T. .. 20 20 . . 8 8 18 9 8 160 168 . . 11 11 . . 7' 7 .. 3 3 M. F. T. 40 43 83 13 8 21 18 13 31 296 278 574 11 12 23 1 . . 1 .. 1 1 2 2 2 2 1 .. 1 2 2 30 16 46 8 9 17 M. F. T. 12 3 2 .. 2 126 34 160 2 .. 2 4 4 .. 2 2 M. F. T. 73 71 144 26 21 47 18 18 36 446 451 897 22 14 36 I . . 1 II 2 1 ! .' 1 2 2 2 2 4 34 25 59 14 8 22 737 665 1,402 442 399 841 9 217 226 424 380 804 135 38 173 640 611 1,251 Countries. Nelson. Seaview. | Sunnyside. Seaciff. Ashburn Hall (Private Mental Hospital). Totals. England and Wales Ireland New Zealand Australian States Prance •Germany Austria .. ... Norway .. : Sweden Denmark Italy 'China Maoris -Other countries Unknown Totals M. F. T. i 37 33 70 20 9 29 8 3 11 450 355 805 9 7 16 1 .'.' 1 1 . . 1 4 4 1 1 2 2 17 14 31 6 1 7 19 10 29 i M. F. T. 24 20 44 9 4 13 10 6 16 186 192 378 5 10 15 i ;; 1 1 .. 1 3 3 12 3 19 31 50 M. F. T. 36 41 77 15 9 24 12 6 18 646 605 1,251 11 15 26 2 2 6 5 11 8 7 15 M. F. T. 33 22 55 31 23 54 20 9 29 477 357 834 13 4 17 1 !! 1 2 2 1 1 8 6' 14 11 .. 11 M. F. T. 1 .. 1 2 2 10 22' 32 112 .. i' 1 31. F. T. 394 374 768 149 101 . 250 119 89 208 3,393 3,230 6,623 119 101 220 3 3 6 4 10 13 . . 13 6 .. 6 8 2 10 9 1 10 9 2 11 11 4 15 141 96 237 122 95 217 65 42 107 574 433 1,007 259 265 524 1 736 688 1,424 597 421 1,018 14 24 38 4,567 4,141 8,708

Ages. Avondale. Kingseat. Raventhorpe. Tokanui. Levin Farm. Porirua. M. F. T. M. F. T. M. F. T. M. F. X. M. F. T. M. F. T. From 1 to 5 years 3 3 1 1 2 10 3 13 1 1 ,, 5 „ 10 „ 1 i" 2 1 "% 3 5 7 12 17 8 25 2 '6 8 „ 10 „ 15 „ 7 l 8 6 4 10 5 8 13 20 3 23 3 10 13 „ 15 „ 20 „ 27 7 34 21 11 32 i" 1 14 7 21 32 9 41 17 33 50 „ 20 „ 30 „ 100 83 183 23 36 59 i 4 5 54 54 108 44 13 57 83 87 170 » „ 40 „ 164 116 280 59 58 117 19 19 87 70 157 12 1 13 158 98 256 „ 40 „ 50 „ 147 123 270 78 75 153 i 33 34 67 74 141 1 1 107 97 204 f, 50 „ 60 „ 110 161 271 91 83 174 4 64 68 63 66 129 127 100 227 „ 60 „ 70 „ 106 101 207 98 81 179 2 60 62 69 57 126 85 95 180 „ 70 „ 80 „ 49 45 94 52 36 88 1 28 29 48 28 76 50 62 112 80 90 „ 14 15 29 6 12 18 5 5 9 7 16 7 23 30 Upwards of 90 years dnknown 12 12 24 4 'i 5 3" 3 2 i 3 Totals 737 665 1 ,402 442 399 841 9 217 226 424 O 00 0 OO CO 135 38 173 640 611 1 ; ,251

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Table IV. —Ages of Patients on 31st December, 1947—continued

Table V.—Length of Residence of Patients discharged "Recovered" during 1947

18

Ages. Nelson. Sea view. Sunnyside. Seacliff. Ashburn Hall (Private Mental Hospital). Totals. M. F. T. M. F. T. M. F. T M. F. T. 31. F T. M. F. T. Prom 1 to 5 years 23 19 42 11 10 21 1 1 50 33 83 „ 5 „ 10 „ 52 31 83 29 22 51 7 7 114 77 191 „ 10 , 15 „ 53 31 84 1 2 3 42 22 64 2 4 6 139 85 224 „ 15 „ 20 „ 33 25 58 2 3 5 69 43 112 6 10 16 2' 2 221 151 372, „ 20 „ 30 „ 61 45 106 15 16 31 166 116 282 72 36 108 3 3 6 622 493 1,115 , 30 „ 40 „ 102 57 159 41 33 74 105 112 217 110 57 167 1 1 2 839 622 1,461 „ 40 „ 50 „ 67 51 118 40 40 80 112 94 206 133 67 200 2 2 754 655 1,409- „ 50 „ 60 „ 68 72 140 56 64 120 80 97 177 107 85 192 2 '2 4 708 794 1,502 „ 60 „ 70 „ 66 60 126 71 74 145 76 100 176 97 91 188 1 7 8 671 726 1,397 „ 70 „ 80 „ 36 35 71 28 22 50 38 59 97 50 55 105 3 5 8 355 375 730 „ 80 „ 90 „ 4 5 9 3 6 9 7 12 19 11 14 25 2 2 4 63 101 164 Upwards of 90 years 1 1 2 1 1 1 2 3 2 2 2 6 8 Unknown 8 1 9 2 '5 7 i 1 29 23 52' Totals 574 433 1 ,007 259 265 524 736 688 1 ,424 597 421 1 ,018 14 24 38 4,567 4,141 8,708-

Length of Residence. Avondale. Kingseat. Raventhorpe. Tokanui. Levin Farm. Porirua. Under 1 month "From 1 to 3 months 3 „ 6 „ „ 6 „ 9 „ „ 9 „ 12 „ 1 „ 2 years „ 2 „ 3 „ » 3 „ 5 „ 5 „ 7 „ „ 7 „ 10 „ „ 10 „ 12 „ „ 12 „ 15 „ Over 15 years Totals M. F. T. 2 4 6 13 8 21 6 2 8 10 18 28 5 9 14 12 6 18 3 2 5 12 3 3 3 1 1 M. F. T. ..2 2 5 2 7 3 3 6 3 3 6 13 4 12 3 112 1 . . 1 1 .. 1 M. F. T. .. i 1 M. F. a?. 2 3 5 15 6 2 9 11 4 6 10 2 4 6 . . 11 112 1 1 1 1 M. F. 1. M. F. T. 2 3 518 27 45 23 31 54 13 18 31 7 9 169 9 18 15 6 .. 3 3 4 4 1 .. 1 2 2 53 54 107 16 16 32 1 1 12 31 43 80 105 185 Length of Residence. Nelson. Sea view. Sunnyside. Seacliff. Ashburn Hall (Private Mental Hospital). Totals. Under 1 month From 1 to 3 months „ 3 „ 6 „ „ 6 „ 9 „ » 9 „ 12 „ „ 1 „ 2 years .. „ 2 „ 3 „ .. „ 3 „ 5 „ . . „ 5 „ 7 „ . . » 7 „ 10 „ .. 3 10 „ 12 „ . . „ 12 „ 15 „ Over 15 years Totals m. f. t. 1 .. 1 1 1 1 1 5 5 3 3 14 5 13 4 2 2 112 1 1 1 1 M. P. X. .. i l I !! i I .. I i I I I M. F. T. 4 '3 7 9 5 14 10 16 26 3 10 13 5 10 15 13 4 12 3 2 13 2 2 1 1 2 2 M. F. T. 2 .. 2 .. 8 8 112 8 13 21 7 6 13 7 7 14 .. 3 3 1 1 M. F. T. 2 '2 4 13 4 1 M. F. T. 7 7 14 37 52 8947 48 9546 78 124 31 46 77 39 46 85 9 23 323 13 16 9 6 15 2 4 6 2 2 3 3 3 38 18 26 2 3 5 37 53 90 25 39 64 3 5 8 236 325 56L

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Table VI. —Causes of Death, 1947

19

Causes. Avondale. Kingseat. Raventhorpe. Tokanui. Levin Farm. Porirua. I. —General Diseases M. F. T. M. F. T. M. F. T. M. F. T. M. F. T. M. F. T. Tuberculosis — General 1 .. 1 Lungs 4 3 7 1 .. 1 14 5 5 16 Cancer 3 2 5 ..2 2 4 3 7 Toxaemia 3 2 5 .. 1 1 2 13 Septicaemia 12 3 Diabetes 1 1 1 1 Meningitis Congenital debility Rheumatic fever II. —Diseases of the Nervous System Exhaustion 1 .. 1 Exhaustion of mania 1 !! 1 General paralysis of the insane .. 5 5 Cerebral haemorrhage 13 12, 25 .. i l .. i 1 i !! I 1 . . 1 Cerebral thrombosis 1 .. 1 l .. l I .. I 1 1 Cerebral tumour l .. l Epilepsy 3 3 2 13 . . i 1 Organic brain-disease 2 2 4 Huntingdon's chorea 1 1 III—Diseases of the Respiratory System Pneumonia — Broncho 3 11 14 l .. l 4 4 8 112 2 2 4 Hypostatic 15 6 . . 2 2 Lobar 2 2 1 .. 1 Bronchitis Pulmonary— (Edema 1 1 Embolism .. *2 2 Infarct Pleurisy Laryngeal spasm i l IV. —Diseases of the Circulatory System Heart-disease 29 15 44 14 1 15 7 9 16 23 9 32 Arterio-sclerosis 6 6 7 7 Syphilitic aortitis 1 1 -- V. —Diseases of the Digestive System Gastric ulcer Peritonitis 1 1 Colitis .. 'i l Intestinal obstruction i !! I Pyloric stenosis .. i 1 VI. —Diseases of the Urinary System Uraemia Nephritis l I VII.—Old Age Senile decay 112 3 5 8 11 6 17 19 15 34 VIII. —External Causes Asphyxia 12 3 1 .. 1 Suicide .. 2 2 Shock 1 i 2 .. i 1 Accidentally killed i i IX. —Died whilst on probation .. 2 4 6 1 .. 1 11 1 .. 1 14 5 Totals 68 61 129 30 16 46 .. 3 3 37 29 66 13 1 4 69 39 108

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Table VI.—Causes of Death, 1947 —continued

20

Ashburn Hall Causes. Nelson. Seaview. Sunnyside. Seacliff. (Private Total. Mental Hospital). M. F. T. M. F. T. M. F. T. M. F. T. M. F. T. M. F. T. I.—General Diseases Tuberculosis — General 3 3 1 1 5 5 Lungs 2 2 2 1 2 3 14 12 26 Cancer 1 1 1 1 3 3 9 10 19 Toxaemia 5 4 9 Septicaemia 1 1 2 2 4 Diabetes 1 1 1 1 4 4 Meningitis .. .. ... 1 1 1 1 Congenital debility 1 i 2 2 i 3 3 2 5 Rheumatic fever i 1 1 1 II. —Diseases of the Nervous System Exhaustion 1 1 Exhaustion of mania 2 "i 3 3 i 4 General paralysis of the insane .. 1 l 2 i 1 6 2 8 Cerebral haemorrhage 4 4 8 i 2 3 20 20 40 Cerebral thrombosis i 1 1 1 1 1 5 2 7 Cerebral tumour 1 1 Epilepsy .. ' .. 2 2 1 1 1 1 i 1 9 "3 12 Organic brain-disease 1 1 1 1 3 3 6 Huntingdon's chorea 1 1 1 1 2 III. —Diseases of the Respiratory System Pneumonia — Broncho 1 1 1 1 3 3 1 1 14 21 35 Hypostatic 9 9 1 16 17 Lobar 1 1 2 2 4 Bronchitis 1 1 1 1 Pulmonary— (Edema 1 1 Embolism 2 2 Infarct 1 1 "i 1 Pleurisy i 1 i 1 Laryngeal spasm 1 1 IV.—Diseases of the Circulatory System Heart-disease 7 2 9 3 2 5 18 14 32 3 3 6 104 55 159 . Arterio-sclerosis 1 1 2 1 1 3 3 18 1 19 Syphilitic aortitis 1 1 Y. —Diseases of the Digestive System Gastric ulcer 2 2 2 2 Peritonitis 1 1 Colitis i 1 Intestinal obstruction ,i 1 Pyloric stenosis "i 1 VI. —Diseases of the Urinary System Uraemia 3 3 1 1 4 4 Nephritis 1 1 2 2 VII. —Old Age Senile decay 10 9 19 3 4 7 1 4 5 9 19 28 3 3 60 63 123 VIII. —External Causes Asphyxia 2 2 4 Suicide 1 1 1 2 3 Shock 1 2 3 Accidentally killed 1 1 IX.—Died whilst on probation .. 1 1 2 '2 4 1 "i 2 9 12 21 Totals 33 12 45 12 9 21 40 43 83 19 34 53 • 7 . . 7 318 247 565

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Table VII.—Principal Assigned Causes of Insanity, 1947

3—H 7

21

Causes. Avondale. Kings eat. Raventhorpe. Tokanui. Levin Farm. Porirua. Alcohol Amaurosis Arterio-sclerosis Cerebral tumour Chorea Congenital Climacteric Constitutional Drug addiction Encephalitis Epilepsy Exhaustion Heredity 111 health Involution Mental stress Organic brain-disease Previous attack Puberty or adolescence Puerperal Senility Syphilis Toxic —exhaustive psychosis, &c. Transfers Totals M. F. T. 4 .. 4 .. 1 1 8 12 20 17 i6 27 2 2 48 28 76 7 7 .. 1 1 1 1 6 15 21 28 1 29 26 41 67 .. 2 2 .. 3 3 13 38 51 6 3 9 3 2 5 11 9 20 M. F. T. 1 .. 1 1 1 7 '6 16 8 i8 26 1 .. 1 2 '2 4 .. i 1 .. i 1 7 io 17 .. '2 2 5 7 12 7 i.7 24 M. F. T. 2 - 2 3 27 30 M. F. T. 1 . . 1 8 6 14 29 32 61 2 'i 3 .. '4 4 .. "i 1 18 12 30 1 .. 1 8 2 10 3 14 M. F. T. 37 li 54 10 22 32 M. F. T. 3 3 7 il 18 11 'il 22 2 2 55 62 117 2 2 3 "3 6 1 .. 1 2 4 6 8 15 23 9 3 12 42 59 101 5 5 27 ' 49 76 4 15 11 '42 53 178 168 346 39 67 106 3 29 32 70 59 129 47 39 86 185 267 452 Causes. Nelson. Sea view. Sunnyside. Seacliff. Ashburn Hall (Private Mental Hospital). Totals. Alcohol Amaurosis Arterio-sclerosis Cerebral tumour Choera Congenital Climacteric Constitutional Drug addiction Encephalitis Epilepsy Exhaustion Heredity 111 health Involution Mental stress Organic brain-disease Previous attack Puberty or adolescenee Puerperal Senility Syphilis Toxic —exhaustive psychosis, &c. Transfers Totals M. F. T. 5 '2 7 8 5 13 .. 3 3 16 7 .. '2 2 3 2 5 4 *4 8 .. *3 3 .. 1 1 5 "(5 11 4 !. 4 M. F. T. 1 .. 1 1 !! 1 4 '3 7 1 i 2 1 !! 1 4 15 5 '2 7 3 i.6 19 M. F. T. 9 8 17 .. i 1 34 23 57 22 29 51 1 '3 4 1 " 1 3 4 7 4 12 16 16 18 34 .. 4 4 23 27 50 1 .. 1 6 25 31 M. F. T. 4 2 6 3 ~4 7 15 12 27 1 !! 1 2 13 .. i 1 9 9 i.8 27 45 21 24 45 .. i 1 15 22 37 3 .. 3 4 '3 7 M. F. T. 1 .. 1 3 '4 7 .. i 1 .. 1 1 1 '4 5 3 '3 6 1 !! 1 M. F. T. 15 2 17 1 1 29 33 62 1 . . 1 1 1 126 85 211 7 7 185 196 381 1 .. 1 1 .. 1 17 10 27 1 1 7 6 13 12 3 7 15 22 40 74 114 37 4 41 117 160 277 3 3 16 16 114 166 280 15 4 19 11 4 15 63 162 225 30 34 64 20 23 43 120 154 274 86 99 185 9 13 22 787 952 1,739

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Table Vlll.—Showing the Admissions, Discharges, and Deaths from Ist January, 1876, to 31st December, 1947 (excluding Transfers) M. 1\ T. In hospital, 31st December, 1875 .. .. .. .. .. 482 254 736 Admissions .. .. .. .. .. .. .. 29,624 24,773 54,397 30,106 25,027 55,133 Discharged — M. f. t. Recovered .. .. .. .. 9,902 9,529 19,431 Not recovered .. .. .. 3,667 3,350 7,017 Died .. .. .. .. .. 11,970 8,007 19,977 25,539 20,886 46,425 Remaining on 31st December, 1947 .. .. .. 4,567 4,141 8,708

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

22

— Males. Females. Both Sexes. Recovered 32-89 38-07 35-24 Unrecovered 12-18 13-39 12-73 Died 39-76 31-99 36-23 Remaining 15-17 16-55 15-80 100-00 100-00 100-00

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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, 1906

23

Year. Discharged. Died Remaining Average Numbers resident. Percentage of Percentage of Aamiiiea. Not prov 31st December Recoveries on Deaths on Average Recovered. Relieved. Im 3 d in each Year. Admissions. Numbers resident. M. F. T. M. F. T. M. F. T. M. F. T. M. F. T. M. F. T. M. F. T. M. F T. 3 it. F. T, 1906 395 264 659 600 157 126 283 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 359 241 160 139 299 22 13 35 168 64 232 1,900 1,331 3,240 1,851 1,285 3,136 44 29 57 68 49 84 9 08 4 98 7-39 1908 426 318 7 44 180 146 326 19 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 27 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 9 27 56 186 97 283 2,160 1,510 3,670 2,028 1,445 3,473 38 40 46 18 41 50 9 17 6 71 8-15 1911 448 317 765 363 168 331 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 99 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 37 74 98 8 5 61 96 7-57 1913 466 509 318 784 175 162 337 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 8 70 6 7-98 1914 359 868 811 207 162 369 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 88 8 36 5 36 7-11 1915 450 361 202 157 359 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 7 19 6 58 6-94 1916 518 361 879 160 171 331 35 34 69 7 8 15 209 80 289 2,555 1,820 4,375 2,483 1,768 4,251 30 89 47 37 37 38 66 8 42 4 52 6-80 1917 470 374 844 171 152 323 32 20 52 6 5 11 205 113 318 2,611 1,904 4,515 2,543 1,825 4,368 36 38 40 64 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 73 0 53 09 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 18 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 22 35 51 7 85 8 40 8-08 6-69 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 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 38 44 40 67 37 39 31 7 67 8 92 8-21 1923 442 366 808 168 152 151 319 42 38 80 15 5 20 194 131 325 2,839 2,157 4,996 2,789 2,079 4,868 00 41 25 48 6 95 6 30 6-67 1924 446 377 823 128 280 30 42 72 9 11 20 221 95 316 2,873 2,258 5,131 2,808 2,146 4,953 34 08 33 95 34 02 7 87 4 42 6-37 1925 445 430 875 144 175 319 29 37 66 23 17 40 201 123 324 2,921 2,336 5,257 2,830 2,203 5,033 32 36 40 69 36 45 7 45 5 57 6-43 1926 508 439 947 136 145 281 27 35 62 15 25 40 207 147 354 3,044 2,423 5,467 2,926 2,287 5,213 26 18 30 75 29 67 6 16 6 42 6-77 1927 531 414 945 157 128 285 40 42 82 14 9 23 217 132 349 3,147 2,526 5,673 3,022 2,373 5,395 29 56 30 91 30 16 7 17 5 65 6-47 1928 506 450 956 115 134 249 40 30 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 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 1,063 138 128 266 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 587 476 127 120 247 29 30 59 20 30 59 221 199 420 3,753 2,908 6,661 3,503 2,696 6,199 21 64 25 21 23 28 37 6 31 7 39 6-76 1932 587 484 1,071 1,117 141 160 301 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 99 10 36 5 97 6 17 6-06 1933 563 554 117 144 261 35 27 62 28 22 50 221 124 345 4,065 3,217 7,282 3,809 2,932 6,741 20 78 25 23 5 80 98 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 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 80 23 26 67 5 72 6 62 66 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 17,288 21 88 26 76 6 18 6 6-38 1937 557 567 1,124 1,102 180 179 359 121 110 231 261 236 497 4,352 3,545 7,897 4,112 3,272 3,287 7,384 32 32 31 57 31 94 48 6 35 7 21 6-73 1938 527 575 170 210 380 140 135 275 273 274 547 4,296 3,501 7,979 4,129 7,416 32 26 38 36 52 34 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 30 42 60 27 38 6 11 6 30 6-19 6-53 1940 553 595 1,148 153 188 341 135 95 230 281 215 496 4,353 3,678 8,031 4,168 3,422 7,590 27 67 31 29 70 6 74 08 6 28 1941 605 637 1,242 128 186 314 130 130 260 297 260 557 4,404 3,738 8,142 4,192 3,474 7,666 21 12 29 09 25 20 7 7 48 7-27 1942 563 648 1,211 146 197 343 126 152 278 313 343 656 4,383 3,693 8,076 4,189 3,498 7,687 25 09 30 56 89 28 41 88 7 47 9 81 8-53 1943 550 658 1,208 138 223 361 138 119 257 281 263 544 4,376 3,746 8,122 4,181 3,513 7,694 25 09 33 29 6 72 7 49 84 7*07 1944 600 763 1,363 137 218 355 101 90 191 327 249 576 4,411 3,952 8,363 4,231 3,640 7,871 22 83 28 57 26 05 7 73 6 7-32 1945 657 715 1,372 165 295 460 106 118 224 327 320 647 4,470 3,934 8,404 4,229 3,689 7,918 25 11 41 26 33 53 7 73 8 67 8-17 1946 645 788 1,433 183 270 453 107 125 232 269 281 550 4,556 4,046 8,602 4,266 3,706 7,972 28 37 34 26 31 61 6 31 38 7 58 6-90 1947 i 719 790 1,509 236 325 561 154 123 277 318 247 565 4,567 4,141 8,708 4,309 |3,753 8,062 32 82 41 14 37 18 7 6 58 7-01 21,691 19,648 41,339 6,623 i 1 7,085 13,706 2,443 2,406 4,849 •• | •• 9,556 6,980 16,536 1 .. 1 | .. Excluding transfers between institutions— -3,943 males, 3,668 females.

H—7

Table XI.—Debits for Financial Year 1947-48

24

Avondale, Auckland. Kingseat, Papakura. Raventhorpe, Papakura. Tokanui, Te Awamutu. Levin. Porirua. £ s. d. £ s. d. £ s. d. £ s. d. £ s. d. £ s. d. Salaries, including 108,843 6 0 61,810 11 8 13,320 14 3 59,421 3 5 10,981 9 1 121,496 1 0 overtime Official Visitors 26 19 8 6 5 0 Advertising, books, &c. 38 6 1 61 12 9 li'lO 2 36 0 11 28' 1 6 41 17 0 Bacteriological research 15 15 0 2 7 0 13 8 0 240 13 7 Bedding and clothing 11,498 7 1 10,666 0 1 3,099 18 7 4,927 14 0 4,459' 2 6 22,716 12 4 Buildings, including 2,231 3 2 1,362 18 6 233 13 6 1,825 8 6 243 4 6 496 0 1 additions, &c. Compensation under Workers' Compensation Act Dental services 542 9 5 27 17 8 77 14 10 48 15 11 25 7 0 40 18 3 Expenses of medical 522 11 8 officers and occupational therapists from United Kingdom to New Zealand Farms, maintenance of 2,117 18 11 2,098 8 7 70 1 1 6,392 2 3 271 16 8 4,098 16 0 Fencing, draining, and TfiA rl in o94 2 4 61 11 5 108 17 7 7 17 10 163 15 2 luaiuu^ Freight, cartage, and fro ti qrinri, 182 19 11 444 13 2 190 16 11 432 10 2 36 4 9 489 17 7 Fuel, light, water, &c. 10,199 9 4 5,641 8 1 1,631 12 8 5,851 9 1 1,631 8 8 11,404 18 3 Funeral expenses 55 0 0 115 0 0 10 0 0 57 0 0 40 0 0 Furniture and fittings 2,040 11 1 2,115 10 1 2,155 11 10 1,400 18 9 2,825 18 11 5,287 7 11 Gardens and shrubberies 165 7 8 123 15 8 69 10 4 143 6 3 63 11 6 143 4 0 Grants to widows or 170 16 8 136 13 4 relatives of deceased officers Laundry 463 7 10 1,027 10 5 125 6 8 516 11 6 72 12 9 837 15 1 Machinery repairs and 541 15 8 384 5 2 514 12 10 1,593 10 10 73 2 6 526 4 7 stores Medical fees 772 9 7 196 4 10 4 7 6 221 13 9 156 17 0 953 5 10 Motor-vehicles— Maintenance of 55 8 1 291 8 7 124 1 3 516 12 9 25 19 0 392 7 4 Purchase of 492 6 0 254 13 6 407 0 2 Nursing staff uniforms 342 12 10 239 3 9 2512 9 239 1 10 12' 1 6 45i 16 9 Office equipment 75 12 8 0 8 8 3 13 6 44 13 11 7 6 9 47 10 11 Patients, expenses connected with — Comforts 3,048 7 10 2,050 10 3 152 14 7 1,451 1 11 450 0 0 2,339 5 7 Friends Gratuities - i' 8 6 210 0 60' 0 0 Recreation 1,762 8 3 805' 8 3 105'18 7 930 15 3 227" 4 8 1,746 8 1 Transfer 5 2 2 61 16 0 15 9 12 7 3 28 14 10 Payment of monetary equivalent of leave due to deceased officers Postages, telegrams, &c. 165 4 6 115 15 2 62 5 0 166 9 3 57 1 8 304 14 1 Printing and stationery 398 12 3 230 12 1 123 18 6 228 13 8 98 18 5 331 17 7 Rations 27,635 17 6 16,576 18 6 6,990 12 4 10,645 16 3 3,797 1 3 30,643 11 0 Rents and rates Staff training: expenses 8317 9 190*10 0 83' 7 5 83' 6 3 incidental thereto Stores 3,574 4 0 2,533 16 0 648 18 6 637 2 0 936 3 6 2,104 17 10 Surgery and dispensary 1,828 16 8 1,093 6 4 378 14 9 953 10 5 127 2 8 2,418 4 3 Telephone services .. 126 10 6 252 11 3 251 16 2 183 12 10 28 17 2 243 9 5 Transfer and removal 84 9 2 189 1 1 • 2 18 10 139 0 10 182 15 11 231 3 5 expenses Travelling-allowances 90 11 0 103 15 9 107 12 6 42 2 7 Travelling-expenses .. 575 9 0 71 4 3 519 11 135 5 8 24* 6 4 291 19 2 Treatment in general hospitals— Patients 54 0 0 38 0 0 17 9 6 52 10 0 Staff11 12 0 3' 0 0 5 11 6 Contingencies and 102 19 2 65' 2 5 3 4 0 33 12 1 i' 2 10 478 12 10 miscellaneous Totals 180,434 17 6 111,658 0 4 30,464 1 10 100,027 19 0 26,948 11 6 211,412 16 11

H—7

Table XI.—Debits for the Financial Year 1947-48 —continued

25

— Nelson. Seaview, Hokitika. Sunnyside, Christchurch. Seacliff. Head Office, Wellington. Totals. £ s. d. £ s. d. £ s. d. £ s. d. £ s. d. £ s. d. Salaries, including 76,793 13 9 46,308 0 4 119,996 0 1 108,087 17 0 13,081 3 11 740,140 0 6 overtime, Official Visitors 14 10 10 47 15 6 Advertising, books, &c. 38* 4 0 18'19 5 23 15 1 147 18 4 234 0 0 683 11 3 Bacteriological research 8 8 0 119 5 2 78 4 6 478 1 3 Bedding and clothing 9,882 17 0 8,98213 1 10,223 10 0 11,683 11 0 98,140 5 8 Buildings, including 596 10 1 471 16 4 2,372 4 2 969 7 0 3 3 3 10,805 9 1 additions, &c. Compensation under 200 0 0 200 0 0 Workers' Compensation Act Dental services 49 4 4 16 6 0 32 15 11 21 12 7 883 1 11 Expenses of medical 130 i2 6 653 4 2 officers and occupational therapists from United Kingdom to New Zealand Farms, maintenance of 2,073 17 5 1,263 18 7 2,907 8 8 3,684 5 7 24,978 13 9 Fencing, draining, and 10 9 2 100 10 5 102 15 9 48 2 4 698 2 0 roading Freight, cartage, and 369 1 0 82 8 7 531 15 .4 889 3 3 3,649 10 8 transport Fuel, light, water, <ftc. 7,442 16 9 3,430 8 5 12,871 13 3 9,758 18 4 125 17 3 69,990 0 1 Funeral expenses 93 0 0 89 5 0 67 12 0 10 5 0 537 2 0 Furniture and fittings 1,638 14 9 644 13 1 3,110 5 11 2,900 5 7 93 2 7 24,213 0 6 Gardens and shrubberies 298 10 10 74 8 10 255 14 0 81 4 7 1,418 13 8 Grants to widows or 90 1 8 397 11 8 relatives of deceased officers Laundry 361 4 1 227 13 3 535 10 10 255 4 8 4,422 17 1 Machinery repairs and 228 10 4 108 11 11 872 0 5 507 6 9 5,350 1 0 stores Medical fees 149 10 9 47 9 6 526 6 4 353 9 11 3,381 15 0 Motor-vehicles— Maintenance of 155 10 3 125 0 8 514 9 8 446 14 10 2,647 12 5 Purchase of 626 15 3 492 6 0 1,454 8 9 3,727 9 8 Nursing staff uniforms 381 19 11 261 17 11 426 18 0 467 13 10 2,848 19 1 Office equipment 12 2 11 2 10 8 157 4 2 4 15 9 11 8 8 367 8 7 Patients, expenses connected with— Comforts 920 15 10 711 3 11 1,562 19 2 1,387 13 6 14,074 12 7 Friends 50 0 0 50 0 0 Gratuities 248 17 5 2 4 0 21 17 8 339 17 7 Recreation 885 16 0 533 3 3 1,50814 2 1,436 13 5 9,942 9 11 Transfer 93 8 5 15 4 3 114 3 6 17 12 10 349 15 0 Payment of monetary 2 14 1 2 14 1 equivalent of leave due to deceased officers Postages, telegrams, &c. 84 10 2 47 4 0 143 5 6 237 18 10 118 15 7 1,503 3 9 Printing and stationery 299 1 1 182 7 9 344 13 8 318 17 5 229 0 5 2,786 12 10 Rations 18,600 4 9 11,407 17 4 24,061 0 7 23,280 19 1 173,639 18 7 Rents and rates 11 6 11 520 15 0 4 0 0 353' 2 11 889 4 10 Staff training : expenses 83 9 10 173 13 3 6 13 704 5 9 incidental thereto Stores 140 9 4 1,118 2 0 2,245 15 10 2,449 19 1 17,989 8 1 Surgery and dispensary 1,138 19 7 559 4 10 1,255 18 5 1,169 18 5 20 "l 4 10,943 17 8 Telephone services .. 115 18 10 196 8 2 164 8 4 260 18 7 53 1 1 1,877 12 4 Transfer and removal 282 12 6 139 13 2 140 6 9 165 18 0 1,557 19 8 expenses Travelling-allowances 87 16 5 48 16 9 216 13 6 400 16 1 375 11 10 1,473 16 5 Travelling-expenses .. 84 6 4 51 5 1 66 10 7 817 8 2 626 1 9 2,749 16 3 Treatment in general hospitals— Patients 6 15 0 168 14 6 Staff 2 10 0 22 13 6 Contingencies and 98 ' 8 3 23 15 7 170 11 5 369 6 3 258 '6 8 1,605 1 6 miscellaneous Totals 125,987 2 3 78,049 3 0 188,177 12 0 174,286 8 0 15,885 9 0 1,243,332 1 4

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Table XIa.—Credits for the Financial Year 1947-48

Table XII. —Average Cost of each Patient per Annum

26

— Avondale, Auckland. Kingseat, Papakura. Raventhorpe, Papakura. Tokanui. Te Awamutu. Levin Farm, Levin. Porirua. Receipts from maintenance* Receipts from farms .. Miscellaneous Totals £ s. d. 985 1 6 1,396 12 3 9,239 19 8 £ s. d. 724 8 0 2,100 10 0 5,141 19 5 £ 8. d. 1,44515 9 £ s. d. 898 2 11 3,735 12 6 6,680 11 7 £ s. d. 91l'i5 3 £ s. d. 1,344 0 0 1,652 14 0 10,594 17 6 11,621 13 5 7,966 17 5 1,445 15 9 11,314 7 0 911 15 3 13,591 11 6 Nelson. Seaview, Hokitika. Sunnyside, Christchurcli. Seacliff. Head Office, Wellington. Total. Receipts from maintenance* Receipts from farms .. Miscellaneous Totals £ s. d. 332 5 1 1,995 14 11 7,059 17 8 £ s. d. 1,245 8 6 1,076 1 5 4,182 15 7 £ s. d. 1,507 6 10 5,805 17 9 10,159 4 8 £ s. d. 1,921 2 4 5,461 13 1 9,553 2 9 £ s. d. 202"6 0 202 6 0 £ s. d. 8,957 15 2 23,224 15 11 65,172 5 10 9,387 17 8 6,504 5 6 17,472 9 3 10,935 18 2 97,354 16 11 * Outstanding accounts as at 31st March, 1939.

Mental Hospital. Average Number resident (inclusive of Boarders). Salaries. Bedding and Clothing. Buildings and Repairs. Farm. Fuel, Light, Water, and Cleaning. Provisions. Avondale, Auckland Kingseat, Papakura Raventhorpe, Papakura Tokanni, Te Awamutu Levin Farm, Levin Porirua.. Nelson .. Seaview, Hokitika Sunnyside, Christchurch Seacliff Head Office, Wellington Total average cost .. 1,314 849 230 799 138 1,255 979 515 1,357 987 8,423 £ s. d. 70 15 4 56 7 2 50 13 . 4 62 1 3 73 13 0 76 7 5 65 13 8 82 4 5 82 6 3 92 1 2 1 10 8 £ s. d. 8 15 0 12 11 3 13 9 7 6 3 4 32 6 3 18 2 0 10 1 11 17 8 10 7 10 8 11 16 9 £ s. d. 1. 14 0 1 12 1 10 4 2 5 8 1 15 3 0 7 11 0 12 2 0 18 4 1 15 0 0 19 8 £ s. d. 1 12 3 2 9 5 0 6 1 8 0 0 1 19 5 3 5 4 2 2 4 2 9 1 2 2 10 3 14 8 £ s. d. 7 15 3 6 12 11 7 111 7 6 6 11 16 5 9 19 7 12 1 6 13 3 9 9 8 9 17 9 0 0 4 £ s. d. 21 0 8 19 10 6 30 7 11 13 6 6 27 10 4 24 8 4 19 0 0 22 3 0 17 14 7 23 11 9 8.423 74 16 5 11 13 0 15 8 2 19 4 8 6 2 20 12 4 Surgery and Dispensary. 1 Miscellaneous. Total Cost per Patient (a). Repayments (6). Net Cost per Patient (6). Net Cost previous Year. Decrease in 1947-48. Increase in 1947-48. Avondale, Auckland Kingseat, Papakura Raventhorpe, Papakura Tokanni, Te Awamutu Levin Farm, Levin Porirua .. Nelson Seaview, Hokitika Sunnyside, Christchurch Seacliff Head Office, Wellington Total average cost.. £ s. d. 1 7 10 15 9 1 12 11 1 3 10 0 18 5 1 18 6 13 3 119 0 18 (5 13 8 0 0 1 £ s. d. 24 6 0 31 1 3 27 17 0 24 16 9 45 6 6 34 17 11 22 8 5 18 12 4 16 15 11 33 6 3 0 6 8 £ s. d. 137 6 4 131 10 4 132 9 1 125 3 10 195 5 7 168 9 2 128 13 10 151 11 0 138 13 5 176 11 8 1 17 9 £ s. d. 8 1 11 8 10 7 6 5 9 13 0 9 6 12 2 9 15 2 9 5 0 10 4 3 11 15 4 15 4 3 0 0 6 £ s. d. 129 4 5 122 19 9 126 3 4 112 3 1 188 13 5 158 14 0 119 8 10 141 6 9 126 18 1 161 7 5 1 17 3 £ s. d. 110 1 7 91 7 1 90 4 1 98 19 1 163 8 8 141 11 0 106 18 5 119 10 8 116 3 11 138 13 8 2 0 6 £ s. d. 0 3 3 £ s. d. 19 2 10 31 12 8 35 19 3 13 4 0 25 4 9 17 3 0 12 10 5 21 16 1 10 14 2 22 13 9 19 0 11 16 0 26 13 4 147 12 3 10 9 11 137 2 4 118 1 5 Notes. —(a) Cost does not include interest and depreciation on land, buildings, &c. (6) Receipts from maintenance shown in Table XlA not included.

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Table XIII—Expenditure of Public Works Fund on Mental Hospitals Buildings, Etc., during the Financial Year ended 31st March, 1948

27

Net Expenditure Mental Hospitals. for Year ended 31st March, 1948. Avondale, Auckland Sramyside, Christchurch Seaview, Hokitika Nelson and Stoke Porirua Kingseat Seacliff Tokanui Marton Levin Raventhorpe £ 10,938 4,369 509 1,518 58,335 8,936 25,752 8,065 56,007 10,234 10,925 195,588

H—7

Table XIV. —Total Expenditure of Public Works Fund for Building and Equipment at each Mental Hospital from 1st July, 1877, to 31st March, 1948

Approximate Cost of Paper.—Preparation, not given; printing (633 copies), £B2.

By Authority: E. Y. Paul Government Printer, Wellington.—l94B. Price &£.]

28

Mental Hospitals. 1877-1938, 1938-39. 1939-40. 1940-41. 1941-42. 1942-43. £ £ £ £ £ £ Avondale, Auckland 240,622 907 7,118 2,659 885 327 Sunnyside, Christchuroh 383,680 6,784 17,252 13,326 6,815 1,885 The Camp, Dunedin 4,891 Seaview, Hokitika 102,164 i ',140 26^793 233 23^944 3,842 Hornby 11,102 Motuihi Tsland 561 Napier 147 Nelson and Stoke 207,881 15,458 39 j 469 34 j 119 11,957 1,010 Kingseat, Puhitahi 247,372 71,149 62,896 45,095 25,052 3,569 Seacliff 315,676 2,527 1,082 707 1,855 1,301 Tokanui 261,337 6,903 9,922 13,662 2,128 112 Waitati 32,321 Wellington 29,641 Porirua, Wellington 373,541 23,948 10*894 M43 7,191 3,485 Marton Levin Raventliorpe Totals 2,210,936 128,816 175,426 126,644 79,827 15,531 Total Net Expenditure Mental Hospitals. 1943-44. 1944-45. 1945-40. 1946-47. 1947-48. 1st July, 1877, to 31st March, 1948. £ £ £ £ £ £ Avondale, Auckland 1,983 2,504 7,307 10,972 10,938 286,222 Sunnyside, Christchurch 2,210 766 701 2,683 4,369 440,471 The Camp, Dunedin 4,891 Seaview, Hokitika 125 180 43 1,250 509 170,223 Hornby 11,102 Motuihi Island 561 Napier 147 Nelson and Stoke 4 37 1 5,840 1,518 317,294 Kingseat, Puhitahi 637 424 1,487 3,985 8,936 470.602 Seacliff 6,526 24,918 16,155 25,752 396,499 Tokanui 1 1 1 8,065 302,132 Waitati 32,321 Wellington 29,641 Porirua, Wellington 83,253 20,623 45,866 67,503 58j 335 701,482 Marton 519 6,680 44,696 •48,276 56,007 156,178 Levin 83,967 239 10,234 94,440 Raventhorpe 107,567 10,925 118,492 Totals 88,732 37,741 208,987 264,470 195,588 3,532,698