11

H.—7.

MEDICAL SUPERINTENDENT'S REPORTS. AUCKLAND MENTAL HOSPITAL. Dk. Beattie reports — The total number of patients under our care duringjthe year was 1,306 -782 males and 521 females. The number admitted was 245—129 males and 11.6 females. Njne males and 15 females were admitted as a consequence of the influenza epidemic. The other chief causes were senility, congenital and hereditary conditions, and syphilis. The recovery-rate was -14-22 per cent. In addition to those discharged recovered .1.1 patients were discharged unrecovered and were placed under the care, of responsible relatives. The death-rate was much heavier than usual, being 13-20 per cent, of the average number of patients resident during the year. This is accounted for by the large number due to senile decay (28), chronic brain-disease (28), phthisis (20), and general paralysis (14). A large number of influenza cases were treated with only one death. In this case, too, influenza was a secondary rather than a primary cause. Although our drainage system is now apparently quite satisfactory we still have occasional attacks of enteric fever : one death occurred from this cause during the year. As our Maori patients have in many cases been found to be carriers, we are unable to attribute the attacks to any other source of infection. The general work of the Hospital has progressed with varying degrees of efficiency. With few exceptions the best of our young men left on active service, and we have unfortunately been unable to replace them. We are still unable to do so, and one cannot but feel dissatisfied with the general condition of affairs. 1 cannot dissociate myself from the impression that part of the lack of discipline and the general air of disinterestedness, if not actual negligence, at present existing is to be accounted for by the operation of the Public Service Act, which, in its application to a mental hospital, where the conditions obtaining are so totally different from those, in any other public; institution, leads to a subordination of the authority of the, controlling officers, and is consequently prejudicial to the recovery and general well-being of the patients, Where patients are so mentally helpless and therefore so entirely dependent upon those in charge, of them, and when their evidence is almost invariably totally discounted in a Court of law, it is surely necessary to provide us with a staff whose natural qualifications justify their tenure of office. Any conditions which hamper the superior authorities in the proper regulation and control of the staff is bound to be reflected sooner or later in the decline of the patients' interests and the, rude awakening of the public; mind to the gravity of the position. I have to thank Dr. Tizard and the senior officers, chiefly, for their loyal service to myself and to the Hospital, also the District Inspector and the Official Visitors for their interest and readiness to help at all times. We have to thank the Herald for newspapers supplied daily, and Miss Fleming and various city bands for continued generosity. SUNNYSIDE MENTAL HOSPITAL. Dit. GiuBBEN reports:— At the beginning of the year 1918 there were 748 patients on the register, of whom 362 were males and 356 females. During the year there were admitted 59 males and 63 females, and at the, end of the year there were remaining 744 patients, a decrease of 4 for the year. There were 58 deaths (32 males and 26 females), giving a death-rate of 8-17 per cent, on the average number resident. There were 29 recoveries (15 males and 14 females), giving a rate of 2397 per cent, on the admissions. The health of the patients on the whole was good. The difficulties consequent upon the committal of persons who are suffering from physiological senile changes are in no way diminished, and in this connection I would like to repeat the suggestion in my report of last year that some, definite action should be taken in amending the law so that these unfortunate old people could be cared for under conditions specially adapted to their needs. The matter of repairs and renovation in the buildings generally, which it has not been possible to effectively deal with during the war, is now one of urgency, and it will be necessary to put in hand a general scheme throughout practically all the wards, at all events of the old buildings. There is also inimodiate need of extension to improve the accommodation and conditions of patients at present resident and to. make necessary provision for increases. The work on the farm has gone on satisfactorily, and the season promises to be a fruitful one. Another year's experience in the killing of our own meat has still further convinced me of the advisability of adopting this system where it is at all possible. For the year the cost of beef was 5-25 d. per pound and that of mutton 4-87 d. per pound. Apart from the economy of the system, the quality of the meat that it is possible to secure, combined with the opportunity given by variations in the patients' dietary, strongly commends this system. The shortage of staff and the increased proportion of junior members incidental to the war have combined to increase the responsibilities of the seniors, whose loyalty and enthusiasm have done much to case the difficulties consequent upon the situation. The patients' entertainments have been continued as before, and the acquisition of a picture outfit of our own will now enable us to give entertainments for odd hours during the winter evenings PORIRUA MENTAL HOSPITAL. Dr. Hassell reports : —■ In referring to the statistical tables for the year 19 L 8 it will be noted that the total number of patients under care at this mental hospital was 1,240 (697 males and 543 females), while the average number resident was 1,012. 251 were admitted, of whom 46 were readmissions, and 100 died (66 males