9

H.~7

It is noteworthy that some higher-grade imbeciles and feeble-minded persons managed to get into military camps and the Expeditionary Forces before their condition was discovered. Class VI includes those epileptics who, on account of their mental condition, require oversight, care, and control. The mental condition of some patients of this class is at times the most disturbed, and dangerous of any, and at other times, or in other cases, the mental disturbance is relatively mild. With regard to accommodation, the usual transfers are in contemplation for adjusting balances, and certain works are in progress to make up the deficiencies and augment the resources in respect to classification. Auckland will be relieved by Tokanui; but the, increase of population in Auckland District has to be anticipated, and additions are planned for 60 males and 80 females, mostly to classify the semi-disturbed ; but one small ward on the female side will be for patients of faulty habits. At Tokanui another male unit for 50 has been opened, and a similar unit for females is nearing fitness for occupation. This unit, together with one for 20 working patients on a remote part of the estate, have been delayed by tin- workmen being lent to the Public Works Department because of the extreme urgency of providing accommodation at. Motuihi Quarantine Island. It has been decided to begin the, direct admission of patients at Tokanui, and for this purpose suitable blocks for 23 males and 27 females have been planned and approved. These buildings completed, patients from the Waikato district will be admitted here, instead of going to Auckland. Tokanui is also an outlet for the relief of Porirua. The extensions at Tokanui necessitate a properly equipped laundry : heretofore we have got on with hand washing and an improvised diying-chamber. At Porirua during the, current year the excess on the women's side will be met by transfer, and additions will need to be made next year. Tenders are, about to be called for a reception-house at Nelson suitably planned to meet local requirements, and to be an instalment in the rebuilding of this hospital. At the present time one of the women's wards is occupied by mentally deficient boys. At Hokitika provision has been made, for a Medical Superintendent's residence. The lay Superintendent's house will be adapted for patients, and I trust that a block for boiler-house, bakery, kitchen, and laundry will soon be started as a nucleus for the gradual rebuilding of the institution. At Christchurch the preparation of the Eeceiving and Hospital Block is proceeding. I reported to you the faulty plaster, and you visited the building and saw the work we had carried out since the building was handed over to us. I trust that it will soon be ready for occupation, and that there will bo an official opening, as was the case at Porirua, when a parliamentary party inspected buildings of similar general design. Plans have been prepared for extending the day-room and dining-room for the more disturbed women patients, who require as much space as possible in their living-rooms, which are cramped at present. Without material!}' adding to the cost these extensions will be. carried out. in a style architecturally fitting the main building, of which they will form a part. A small ward is also necessary for patients with faulty habits. At Seacliff accommodation has been added to take the patients from The Camp, who wore being maintained there at a high cost, with no compensating benefit, and a unit for 56 patients has been authorized and will be placed at Waitati. Taking generally the question of accommodation and classification, the main desiderata at present are the Segregation of juvenile deficients', and a small institution for the few patients we have or are likely to have of the criminal class. For the first the Nelson District would be the most convenient for our purpose, especially if the Stoke institution were handed over to us ; for the second some spot near the boundary of our Tokanui Estate with the Waikeria Reformatory property. This project I have discussed with the Inspector of Prisons, and he agrees that it would be a suitable site from his point of view also. Visits of Inspection. I am glad to have this opportunity to express my thanks to the District Inspectors and Official Visitors for their helpful co-operation in advancing the welfare of the patients ; to my colleagues Miss Maclean and Dr. Gow for their reports of visits, and to the latter especially for doing relief duty at Seacliff for five weeks, including February this year. Mr. Ewington, after long and faithful service, resigned his position as Official Visitor at Auckland Mental. Hospital. He wrote paying a tribute to the improvements that had been carried out, and thanking you, the Department, and the officers of the Hospital for the sympathy and support he had always received, stating that he relinquished the office on medical advice. Mr. Ewington's understanding of the patients, and his tact in dealing with them, acquired after many years of intimate association, and his willingness at all times to make special visits for his own satisfaction or at the instance of the Department, made his services particularly valuable and will make his loss the more felt. A serious loss to Sunnyside was sustained by the death in February last of Mr. Smail, who, as patients' friend, visited the institution for about three hours or so daily. He accepted his duties as a serious charge, and his joyous presence in the wards was looked forward to by the patients and staff. Every week I had a report from him of his visits—reports which exhibited his enthusiasm for the work in hand, the well-being of the patient. Talcing him all in all we shall not look on his like again. Auckland. Visited in February, March, August, 1918, and in January and June, 1919. The, male infirmary is now completed and in occupation. The main kitchen has been remodelled, and suitable mess-rooms Tor the staff an; ready for occupation. Shelter-sheds are about, to be erected in connection with the Women's Annexe, Renovations, repainting, and decorations, largely suspended during the war, are to be undertaken now, so as to restore as soon as possible the cheerful aspect of the wards. Questions regarding additional buildings, the influenza outbreak, and the staff difficulties have been mentioned in other sections of this report. The war depletion and the indifferent probationers was perhaps felt here more than elsewhere, but Dr. Beattie, in indifferent health, battled on with the assistance of Dr. Tizard and the senior staff, putting his outlook tersely in his last, report, thus : " We fully realize, the insignificance of our difficulties in the face of the immensity of our national crisis."

2—H. 7.