3

EL—7

Other factors may be adduced to explain the selective, affinity, but undoubtedly the most potent is inherited mental instability. Hereunder Table XIII is restated in percentage proportions of the principal causes : — Male. Female. Total. Heredity .. .. .. .. .. 7-55 .11-19 9-29 Congenital and mental deficiency .. .. 9-39 13-18 11-20 Predisposed by previous attack ~ .. .. 6-87 12-19 9-43 Critical periods .. .. .. .. 4-12 7-71 5-84 Senility .. .. .. .. .. 12-13 11-19 11-68 Mental stress .. .. .. .. .. 11-90 9-20 10-61 Alcohol .. .. .. .. .. 9-61 2-49 6-20 Syphilis .. .. .. .. .. 10-07 0-75 5-60 Epilepsy .. .. .. .. .. 5-72 2-74- 4-29 Influenza .. .. .. .. .." 3-44 5-72 4-53 Other assigned causes .. .. .. .. 6-61 12-94 9-65 Unknown .. .. .. ..- .. 12-59 1.0-70 11-68 100-00 100-00 100-00 Such statistical returns tend to be fairly uniform, the ups and downs of one year being balanced by the figures of the next. The above, proportions, compared with the average, show a marked reduction in the incidence ascribed to heredity and alcohol, and an increase in congenital cases and to mental disorder associated with, syphilis. There is also an increase of about 2 per cent, in the incidence of mental stress, which is very little during a period of economic unrest and when it is remembered that this factor includes the special anxieties and worries incidental to the war, whether direct or indirect, and whether on the part of the soldier or the civilian. The influenza epidemic which visited the country towards the latter end of the year did not spare the mental hospitals. None escaped, but the epidemic manifested itself in varying extent and severity in different institutions. For easy reference .the facts are placed hereunder in tabular form, and in studying these, while, still a lively recollection exists of the visitation as a disturbing element in the general community, some conception may be possible of the anxieties of those controlling the smaller and special communities resident in mental hospitals. In this connection I wish to record my appreciation of the faithful services of the staffs during a very trying time.

Influenza. —Mental Hospitals. Table showing the Daily Average Number of Patients and Staff (respectively), the Number attacked, and the Proportion in which the Malady proved fatal.

Mental Hospital, Patients. Daily Average Number at i i 11 of Patients Number attacked by (and Boarders) resident Influenza, during Epidemic. Number died from Influenza. Percentage of Deaths of those attacked. Auckland Christchurch Seaclifi Hokitika Nelson Porirua Tokanui M. 657 319 617 195 97 578 114 P. T. 397 1,054 359 678 447 1,064 71 266 109 206 448 1,026 43 157 M. 46 52 153 2 0 306 41 F, 56 146 106 14 ] 104 0 T. 102 198 259 16 1 410 41 M, 0 1 10 F. I 0 8 T. 1 1 18' 1-00 0-5 6-95 16 4 6 0 22 4 5-36 9-75 Totals 2,577 1,874 4,451 600 427 1,027 31 15 46 4-47 Staff. Daily Average Number of Staff during ISpidomic. Auckland Cliristchurcli Seacliff Hokitika Nelson Porirua Tokanui.. M. 70 75 109 23 22 88 28 F. 37 54 70 12 19 52 11 T. 107 129 179 35 41 40 39 36 28 75 7 2 54 22 25 32 42 5 2 29 7 6.1 60 1.17 12 4 83 29 0 1 3 1 1 0 1 0 1 1 4 1 1-64 1-66 3-42 8-33 1 0 1 3-45 Totals 415 255 670 224 142 366 6 2 8 2-16