H.—7.

4

(m., 186; f., 97) died. Had last year's relation of discharges and deaths to the total numbei under care been maintained, there would have been 22 more discharges and 65 fewer deaths. -A careful analysis shows the difference to be due to the quality of the admissions and the increasing age of the permanent inmates, a factor which some years ago was pointed oui us likely in the future to raise the low death-rate. Added to these is a non-recurring item of 11 deaths from influenza, against 1 in the previous year. The epidemic was at the Nelson Mental Hospital, and was commented upon in the last report. The percentage of deaths calculated on the average number resident was B'ls (m., 917; f., 671), ;i;_'ii ; nst 6*05 (m.. 0 !i(); t'., 484) in 1909. Contrasting the proportions per cent, on the total number of cases under care, the figures are respectively 62 and 4/8. The percentage of the principal contributing factors calculated on the total number of deaths is hereunder contrasted with the returns of the previous year : — General diseases ... ... ... ... ... 2084 against 22*06 Including tuberculosis ... ... ... ... B"l.'i ~ 13"23 Diseased of the nervous system .. ... ... 'M' 24 .. ■'}3"33 Including general paralysis ... ... ... 1414 ~ L3'23 Senile decay ... ... ... ... ... 219] .. 18"63 It will be seen that the above causes account for three-fourths of the deaths. Table XII, giving the causes of death, should be read in conjunction with Table VI, giving the ages at death, and Table X, giving the length of residence at death. In 1909 the patients over s'xty years of age who died numbered 80; last year they numbered 121, one being a centenarian Again, as giving an indication of the quality of admissions with respect to general health and condition, in 1909 the patients who died after a residence of nine months and under numbered 62; last year they numbered 98. Apart from the proportion of deaths contributed by the number of senile patients admitted, many of whom were little other than " indigent faint souls past corporal toil," three being over ninety, and one over a hundred years of age (vide Table III), that the death of permanent residents of increasing age is beginning to tell may be inferred from the fact that 48 of the patients who died had been in resilience over fifteen years, against 28 in the year previous. The deaths due: to accident or violence were investigated at the time, and members of the staff fully exonerated from blame. Of the patients discharged, 327 (m., 182; f., 145) were classed as recovered, and 278 (m., 194 ; f., 84) unrecovered, 222 of which number (m. 165 ; f., 57) were transfers. The large number of transfers is accounted for by the closing of the Wellington Mental Hospital, familiarly known ac " Mount View," which formed a subject of comment in the last report. The quality of admissions touched upon above as tending to increase the death-rate also tends to reduce the recovery-rate, and there are other factors which influence the latter without markedly interfering with the expectancy of life. The percentage of recoveries calculated on admissions was 41-50 (m., 3840; f., 46-18), against 4874 (m.. 42"72; f., 57"24) in the previous year, the actual number of persons discharged recovered being 327 and 349 respectively. In the summary of total admissions since the year 1876, the percentage of recovery works out at 4023 (m., 38-05; f., 43-49). The Mental Defectives Bill, before referred to, has a provision, adapted from the procedure in Great Britain, for medical officers to send a yearly certificate regarding patients under their care, stating that their further detention is necessary for their own good or in the public interest, and thus the reception order, now current till discharge, is to be kept alive. A similar procedure, though not statutory, has been in operation for some years : the medical officers divide the patients into "curable" and " incurable," and further divide the "curable" into those for whom there is a chance of recovery, which they estimate as over or under a 40-per-cent. chance. This estimate is made as soon after admission as possible, and is reviewed at the end of each year. The results will be found embodied in the following table, which is a better guide to the value of treatment than percentage ratios on admissions, which vary with the quality of the admissions, whereas, in the table, patients deemed to be incurable are excluded.

Of 3,548 Patients resident iof 1,010 Patients admitted on 1st January, 1910. ' during 1910. Totals. ihowinB as on 31st December, 1910. the Dis- A - The ' .t 01 *? 8 C ' The charges, Deaths, and Length of Residence , Remainder, Rem a '"to. of those remainine, after the Exclusion pectedtobe ft peetedtobe: f^ of all Otu. deemed incurable on 1st Janu- a ' r 8 e C r h o a ; e ! r e e d d a8 excluding excluding ary, 1910, or on Admission in Csscs ad- recovered. , recovered. Incurable 1. mittnil during tbe Yrar. m. r. t. Iμ. f. I t. |m. I f. j t. |m. J f. t. D. ider, Of Classes . Of Classes i - , r A and C. B and D. ! <*««*»>• ing ales. T. M. F. T. M. P. T. M. P. T. Discharged recovered „ unrecovered Died Remaining, residence 1 month »r less Ditto 2 to 3 months ., 3 to 6 „ „ 6 to 9 „ 9 to 12 „ „ over 12 ,, j 71 j 69 57 49 j±l 140 93 106 30 .. Iβ I 3 M 37 7 7 189 I Hi 123 67 SO 46 23 1 3 10 .. .. .. 10 17 .. 18 18 .. 16 15 .. 14 18 ..7 6 JJ9 .. .. 89 65 74 269 I2(i 4 27 36 31 32 13 97 I I r> 2 d 1!) 82 i 13 \i 170 1 1!) 36 30 32 24 137 1 1(1 18 16 14 7 14 217 192 !!.-, 3 1 17 18 g 409 ! 232 1 27 36 31 : 32 Hi 33 190»178 45 50 22 9 _3 8 lT 8 19; 16 14 16 18 13 11 13 II 16 1181111 368! 13 la 36 30 32 24 89j 407j370 777 182145:i27 l>:! 12 36 5 9 14 ' 21 2r, 46 37 34 71 30 81 61 33 31 64 I 18 l<1 37 68 04122 197 2(14 401 '.'. '.'. .. .... _»_,!> 14 19 ;; ;; 33 44 33 44 i 45; •• .. • • Total remaining .. 45 I 139 74 79 I I 93 I 172 22!) <iti 140