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REPORT OF THE DIRECTOR, DIVISION OF MENTAL HYGIENE At the end of the year there were 9,500 persons on the registers of the Division, including 64 persons at Ashburn Hall, the only private institution licensed under the Mental Defectives Act. In addition, 902 patients were on probation in the care of relatives or friends. There were 8,543 persons in residence in Government mental hospitals on 31st December, 1949. This is an increase of 191 when compared with figures as at 31st December, 1948. Of the number in residence, 8,139 were subject to reception orders and 404 were voluntary boarders. Persons admitted for the first time totalled 1,722, an increase of 13 on the figures of the previous year. Voluntary boarders still form an increasing proportion of the total admissions to our hospitals. During the year ended 31st December, 1949, 1,532 persons were discharged, or 64-83 per cent, when calculated on the number admitted. Although it cannot be said that all such patients were discharged as fully recovered, it is believed that at least 47-15 per cent, of the 1,532 had recovered at the respective times of their discharge. It is of interest to record that- during the year 881 persons were admitted as voluntary boarders and 801 were discharged. These figures show clearly the advantages to be gained by early treatment and the exercise of volition by the individuals concerned in seeking that treatment. SENILES The admissions continue to include a considerable number of senile cases. One large hospital records that over 25 per cent, of their committed patients were sixty-five years of age or over. These cases tax our available accommodation and place an added strain on our nursing staff. It would seem that there are three main reasons for the continued increase in the senile admission rate : (1) The lack of available domestic help in the homes of relatives. (2) The reduction of beds available in public and private hospitals for these cases because of the shortage of available staff. (3) A change in the individual attitude towards responsibility and obligation in connection with the care of the aged. TREATMENT The various special treatments have continued during the year. Each has its uses, but none by itself is of any great value unless it is co-ordinated with psychotherapy, occupational and recreational therapies, and the general routine activities of hospital life. Electro-convulsive Therapy has been the most widely used of the physical treatments. Contrary to popular opinion, it is not suitable for every type of case. It is very important that discretion is exercised in its use. The neuro-surgical operation of leucotomy appears to have found a definite place in the treatment of certain types of psychotics whose mental condition has proved to be resistant to other methods of treatment. Most of this work has been carried out in association with the department of neuro-surgery at the Dunedin Public Hospital, although some operations have been performed at Auckland Public Hospital.

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