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1925. NEW ZEALAND.
MENTAL HOSPITALS OF THE DOMINION (REPORT ON) FOR 1924.
Presented to both Houses of the General Assembly by Command of His Excellency.
The Hon. the Minister in Charge op Department for the Care op Mental Defectives t° His Excellency the Governor-General. Sir, — Wellington, 31st August, 1925. I have the honour to submit to Your Excellency the report for the year 1924 of the Acting Inspector-General of Mental Defectives. I have, &c., M. Pomare, Minister in Charge of Department for the Care of Mental Defectives.
The Acting Inspector-General to the Hon. Sir Maui Pomare, the Minister in Charge of the Department for the Care of Mental Defectives. Sir, — Wellington, Ist July, 1925. I have the honour to present my report for the year 1924, embracing also matters to date bearing on the further development and organization of the Mental Hospitals service. Since the close of 1924 it has become increasingly apparent, month by month, that active measures needed to keep the institutions and service of the Mental Hospitals Department up to a satisfactory standard of efficiency and progress could not justifiably be staved off until the return of the Inspector-General. Though a very sick man, Dr. Hay stuck devotedly to his post until the middle of last year, in spite of the fact that he had been seriously ill long before he finally gave in and left the Dominion on a year's leave of absence —since extended to next October, by which time it is hoped that the Inspector-General will be fit to resume his duties. The Great War and its aftermath (conjoined latterly with Dr. Hay's failing health) naturally affected the maintenance of the standard previously arrived at by the Department in certain directions, and retarded due progress in other directions. The Inspector-General realized these things himself, and I aril satisfied that no one will appreciate more than he will the measures which you have instituted, as Minister, to place matters on a better basis before his return. In view of the demands on my time all over the Dominion as Director of Child Welfare, and my work as a member of the Board of Inquiry into Mental Defectives and Sexual Offenders, it was fortunately neither required nor expected that I should do more, for a time, than look in at the institutions in passing, and act as interim Inspector-General, referee, and adviser to yourself — Dr. Prins being given charge at the Head Office in Wellington, with a thoroughly competent office stall. However, under your special instructions, given towards the end of 1924, I undertook to visit the whole of the mental hospitals of the Dominion (public and private) in order to look into matters thoroughly, with a view to maintaining and improving the standard of the service as a whole, and
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of the various institutions in particular. Your own visits to all the mental hospitals (mostly made in company with myself), in which you spared no pains to make yourself personally and professionally conversant with the whole situation, resulted in the decision to take steps in the following directions, viz. : — (a.) To afford the fullest opportunities for persons in a state of nervous and mental instability to obtain early and reliable advice, so as to facilitate prompt recognition and suitable treatment in the incipient stages of mental breakdown. (b.) To ensure the provision and use of improved methods of handling and dealing with mental patients, prior to and at the time of committal as insane, and to do away with temporary lodgment in prison, pending decision. (c.) To ensure the provision and better use of facilities for classification, care, and treatment —especially in the case of the more recent, impressionable, sensitive, and curable patients. Practical Undertakings. 1. The establishment of out-patient clinics, to be conducted at the general hospitals by two Doctors— one drawn from the general hospital and one from the mental hospital. Such clinics to be held weekly under the title " Clinic for nervous affections," without any implication of insanity, mental breakdown, or so-called " border-line " trouble. This project was first brought before a meeting of the Wellington Hospital authorities early in the present year, and was most favourably and sympathetically received both by the trustees and Dr. Wilson, the Medical Superintendent. Indeed, Dr. Wilson said the clinic would be heartily welcomed by himself and his colleagues, because they would benefit by a weekly conference with a mental specialist concerning such of their hospital inmates as might present mental problems : he frankly recognized that the advantages would be mutual. Similar overtures made in Auckland and Dunedin were received in the same spirit, and the Hospital Board for North Canterbury (centred at Christchurch) wrote expressing the desire to co-operate. It may be pointed out that one of the most important advantages of the clinic to the public will be the opportunity afforded of learning authoritatively at first hand — (a.) What kind of quarters and treatment would be available, at the moment, in the mental hospitals. (b.) What the doctors might feel it desirable to communicate in the particular case as to diagnosis, prospects of improvement or recovery, and the pros and cons of accommodation and care outside an institution, compared with the quarters and treatment available at the time in one of the mental hospitals, local or elsewhere, public or private. (c.) Frank advice as to the best course to pursue, taking everything into account, and giving precedence to the steps likely to afford the patient the best chance of recovery, rather than subordinating this to mere immediate saving of expense, or the desire of relations to prevent any member of the family becoming an inmate of a mental hospital, even as a voluntary boarder, lest this should be held to reflect on the family stability. 2. The safeguarding of persons alleged to be of unsound mind from the indignity, distress, and humiliation of being treated as delinquents or criminals, and lodged in prison pending decision as to their sanity or insanity ; further, in case of committal to a mental hospital, the ensuring of proper and humane lodgment, care, and treatment of the patient until taken charge of by the mental hospital authorities. Arrangements are being made for ensuring the provision of suitable rooms in the general hospitals where mental patients can be suitably lodged and properly cared for pending medico-legal examination and up to the time of despatch to a mental hospital -if committed as insane—instead of their being kept temporarily in police quarters. In order to facilitate the provision and equipment of, say, three or four rooms in each cf the four main centres, the Government has voted a sum of £2,000 — viz., £500 for each of the general hospitals concerned. 3. Preventing new patients, as far as possible, from being brought within sight of the main asylum, buildings or of the inmates, or into any kind of contact or association with ordinary chronic patients, unless it has been ascertained by careful medical examination, made immediately on arrival at a simple, attractive, homelike, entry lodge, or other suitable place out of sight of the main institution, that the particular patient is at the moment unsuitable for curative treatment at a seaside sanatorium, or in a special cottage or small villa on the main estate, and would not be harmed, at any rate in the meantime, by being associated with some of the chronic patients in a suitable ward of the central institution. Under this heading may be emphasized the need for much greater care than is generally shown in mental hospitals, in this or other countries, to ensure that the railway-station or other depot at which patients usually arrive, and the ways leading therefrom to the institution, are made as attractive as possible by means of good well-kept roads, plantations of attractive trees, floweringshrubs, &c. ; also by making as presentable as possible the working patients who may have to attend at the stations, or who are likely to be met with on the way to the institution. Nothing conduces more to render mental hospitals repugnant to the public, and humiliating and distressing to the saner and more self-respecting patients, than the obtrusion of untidy, obviously imbecile or demented patients of either sex,
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Referring to the out-patient clinics, one need scarcely point out that the doctors in attendance would appreciate being able to assure incipient or border-line cases that they need have no anxiety as to being confronted with painful or humiliating sights on their way to the institution ; that they would find the approaches and surroundings attractive ; that on arrival they would receive immediate professional care and attention at a private cottage ; that they would be well lodged, well looked after, and treated with every care and consideration, according to their requirements —e.g., rest in bed, or such occupation, recreation, associations, and treatment as might be deemed most conducive to their comfort and recovery. 4. The provision of private entry-lodges for preliminary examination, away from the main mental hospitals, as referred to in the previous section. 5. In addition to such residential cottages or small villas as may now exist on the main mental hospital estate, it is intended to erect small, simple, private, comfortable, homelike, and attractive buildings, capable of accommodating not more than a dozen men or women each. These have been designed on a kind of sanatorium or picnicking basis, and will be located at least several miles from the parent institution, so as to avoid any so-called " asylum association," but to suggest rather a holiday resort, sanatorium, or convalescent home —not only in location, design, and structure, but also in surroundings and accessories such as walks, plantations, and gardens, and, if bathing and boating be possible, the provision of suitable sheds, &c. It need scarcely be said that these places are intended to serve for much more than mere idling or recreation —they will provide in addition useful interesting outdoor and indoor occupations for patients of both sexes, with a view to establishing proper discipline, normal daily habits, and the power of self-direction needed for the independent regulation of their own lives and conduct before being discharged. 6. Systematic adjustment and improvement of diet to meet varying requirements in mental hospitals. As great advances have been made of late in the science, practice, and economics of dietetics (especially as applied to feeding during infancy and early childhood, and the catering for armies and persons boarded in schools, sanatoria, hospitals, &c.), it is gradually coming to be recognized that trained experts will have to be appointed in order to supervise and direct the feeding of all hospital patients, whether the evidences of ill health manifest themselves mainly on the bodily or on the mental side. In either case —digestion and nutrition being always more or less impaired —suitable adjustment of food and feeding-habits must be provided for. With this in view a professional dietitian (Miss D'Auvergne) has been appointed by the Mental Hospitals Department to organize, supervise, and direct the feeding arrangements in all our mental hospitals, in conjunction with the Inspector-General and the local Medical Superintendents. This lady, after going through the threeyears course in domestic science at Otago University, further qualified herself by taking a special practical course of training as a Hospital Dietitian at one of the most advanced centres in the world for practical and progressive dietetics —viz., Johns Hopkins University, Baltimore. It is recognized that, while the scale of food and feeding in the general and mental hospitals of the Dominion, and throughout the British Empire, is liberal —indeed, generally somewhat beyond what is desirable, especially in regard to meat —systematic scientific adjustments to meet the needs and tastes of individuals ought to be provided, as one of the most essential features of all curative treatment of those sick in body (" medical " or " surgical " cases) or sick in body and mind (so-called " mental " cases). As a striking instance of the need that may arise in mental hospitals for the use of advanced dietetics, so as to keep pace with recent progress in the science of healing, the case of diabetes may be cited. This disease (long recognized as an occasional cause of insanity) has only recently come within the sphere of definite scientific medical control, through the introduction and employment of insulin, conjoined with highly specialized dietetic treatment. As a measure conducing to give the nursing staff of the mental hospitals the benefit of generalhospital practice, it is encouraging to record that several general-hospital nurses have been appointed recently to responsible positions in the mental hospitals ; and that on the men's side more and more use is being made of the services of our nurses, in the wards, in addition to the male staff. The effect of this on the amenities is always conspicuous. 7. Psycho-analysis and suggestive therapeutics. So much importance has come to be attached of late to these terms in the public mind, as indicating some new and potent means of curing insanity, that one feels bound to refer to the matter. An extraordinary credulity has arisen as to the applicability and efficacy of what is popularly understood by " psychiatric treatment." People have always been prone to pin their faith to the latest professional shibboleth, and it may do some good to quote from Max Nordau on this increasing tendency of our modern civilization —whether in art, science, or religion : — " The million, robbed of its leaders, knows not where to turn .... false prophets arise .... men look with longing for whatever new things are at hand . . . . So, where a market vendor sets up his booth and claims to give an answer . . . . or professes to practise his art otherwise than his predecessors and competitors, there gathers a great concourse, crowding around him to seek some meaning in what he has wrought, as in oracles of the Pythia And the more vague and insignificant [his works], the more they seem to convey to the poor gaping souls gasping for revelations."
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Knowing the good use made of analysis and suggestion for " shell-shock cases " (persons suffering from merely functional nervous and mental disturbances, due to " shock"), many people have jumped to the conclusion that the same kind of suggestion would convince an ordinary insane person that his irrational fears and suspicions, and even his delusions, were groundless ! Of course, no competent physician fails to make use of Ms powers of mental and emotional analysis, suggestion, and persuasion ; but the public ought to know that, after fair trial for forty years by the most eminent specialists, so-called " expert suggestion " and hypnosis have proved to be of comparatively little applicability or efficacy in the treatment and cure of the hereditary, nutritional, pathological, organie, and toxic deviations from the normal, such as ordinarily come under treatment for insanity or border-line mental affections. Indeed, Dr. Albert Moll, long the leading authority on hypnosis and " suggestion," states expressly that a main requisite for success is a fairly normal mentality, that the insane prove singularly difficult and unsuitable subjects, and that even ordinary hysteria is rarely amenable to beneficial suggestive therapeusis. Granted adequate provisions and facilities for proper classification, care, and treatment of the insane (such as are now being more fully established), the public may rest assured that the doctors at our mental hospitals will leave no stone unturned, in any direction, to promote the recovery of their patients —including the use of any reasonable therapeutic suggestion that may give an additional chance of success, however remote. Status and Sekvices of the Medical Staffs. New Zealand is fortunate at the present time in haying all its main mental hospitals under the charge of capable specialists who have had long and ample experience in the care and treatment of thousands of cases of insanity in its various stages and manifestations. What is most needed, in addition, is that full use be made of the services of these men. Each of them is keen to do what he can to render admission to mental hospitals unnecessary, or to bring about early voluntary admission, with a view to preventing complete mental breakdown, and in order to restore bodily and mental health as quickly as possible by means of suitable environment, congenial occupation, and other treatment. Unfortunately, the attitude of the public towards our mental specialists (the doctors who have qualified themselves by living constantly in touch with the insane, studying their needs and peculiarities, and dealing personally with more cases of mental alienation in a day than a general practitioner may see in a year) not infrequently resembles the distrustful attitude of the child towards the doctor or the dentist. As Robert Louis Stevenson says, " People are afraid of war and wounds and dentists, all with excellent reason " ; but we do our best as doctors and dentists to reassure children, and to allay their anxieties concerning our apparently sinister professional connection with pain and suffering. When a patient comes to a doctor with a dangerously wounded eye, or incipient cancer of the womb, it is customary to call in a surgical specialist in consultation without a moment's delay ; but the leading mental specialists in the Dominion have rarely seen the patients committed to their care until they arrive at the mental hospital, though they may have been suffering from manifest mental disease for months and sometimes for years. Yet, of all the tissues of the body, it is the higher brain - cells which degenerate and pass beyond repair most rapidly. Cells of our skin will live for many hours after we are dead, and will serve to patch and grow over another man's ulcer ; the tissues of most of our organs can be transplanted after death ; but mere deprivation of oxygen for only a few minutes (as when access of air ifo the lungs is stopped by suffocation or drowning) makes it impossible to restore the function of the thinking, feeling, and lugher controlling cells of the organism —they are already dead or dying. It remains with the medical profession and the public to avail themselves of the services of the mental hospital physicians, now freely offered by the Department, in connection with the weekly " clinics for nervous affections " at the general hospitals. The Department is prepared to go even a stage further than this. In any case where a doctor finds that his patient cannot be induced to attend the clinic, but would be willing to see the mental hospital doctor privately, in conjunction with the family doctor, arrangements will be made by the mental hospital authorities, on application, for a mutually convenient private interview and consultation, to be held on the da}' appointed for the weekly clinic. It has been suggested professionally that it would be wiser not to have a mental hospital doctor attending the weekly clinic, and that it would be better for the patients to be seen and advised only by members of the staff of the general hospitals —on account of the dread people have of facing an " asylum doctor." However, this is surely one of the strongest grounds for associating a professional member of the mental hospital staff with the clinic —if it were only in order to do away once and for all with such an absurd and unjustifiable prejudice, wherever it may happen to exist, by bringing patients and friends into intimate personal touch with one of our mental .specialists. The way to cure a child of his dread of doctors is to take him to see one —in the same way as we set about curing a horse of shying at a wheelbarrow. Half-way Houses. There has been a growing expression of opinion in the Dominion of late years in favour of the establishment by the Government of a number of entirely new institutions for the care and treatment of persons suffering from potentially curable mental affections, such institutions to be free from any association, either in name or locality, with the present mental hospitals, and to be run by medical and lay staffs not connected with them in any way.
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The proposal to duplicate our institutions for the care and treatment of the insane is founded largely on the erroneous assumption that persons in early or incipient stages of insanity should never be allowed to come into close contact and be associated with any chronic or incurable cases, on account of the depressing and humilating influence which it is gratuitously assumed the latter would have on the former : but the facts are quite the other way. Nothing could be more depressing and dispiriting than a fortuitously assembled group of patients (male or female) isolated as a small community and compelled to live together on the mere ground of their manifestations of insanity being recent and being deemed curable. Such patients tend to be self-centred, depressed, and (for a time at least) more or less uncompanionable ; and one of the best practical means of overcoming their anxieties, suspicions, and preoccupations, and winning them back to friendliness and sociability, is to place among them a small leaven of bright, capable, chronic patients, chosen on account of their cheerfulness and good-fellowship. In a large mental hospital there are always some such patients available, who gladly welcome the opportunity to make life for the time being more enjoyable for themselves and their fellows. The very fact that they themselves go through periods of more or less deep depression from time to time forms a strong bond of sympathy with those in similar distress ; they are as popular among the staff as they are among their fellow-patients ; they set the best example, and tend to lead both in work and play. An evening which would otherwise be dull and uninteresting is often made enjoyable by playing, singing, dancing, or card-playing set going by some such chronic patients. Without them a mental hospital would be a much duller, more trying, place for all concerned. Another fact left out of account by the advocates of separation is the need for a large staff of competent nurses and attendants to draw from, in order that fairly frequent changes may be made, so as to prevent a group of people brought into enforced daily contact wearying of one another; besides which, careful selection should always be made in order to suit the nurse or attendant to the special temperaments and tendencies of difficult cases. The great importance of this was recognized in old Rome nearly two thousand years ago. Soranus, the most prominent Roman physician who specialized in insanity, and whose detailed practical instructions for the humane care and treatment of the insane have never been surpassed in certain directions, said, for instance, concerning the exertion involved in unduly prolonged conversation : — " This kind of work, and also that of assiduous reading, causes as great lassitude as excessive bodily exercise. ... At a more advanced stage of treatment the patients ought to be occupied in more serious discussions to restore to the mind all its capacity. . . . . With regard to those who are illiterate, only questions referring to their conditions in life can be discussed with them. Thus, to the labourer one must talk of agriculture; to the sailor, of navigation. In dealing with a man who is ignorant of everything, you can only offer him very general subjects. ... In short, food [mental pabulum] may be found applicable to every sort of mind ; but it is specially important to introduce it [the subject] in a pleasant way." In no mental hospital is there ever a surplus of capable, tactful attendants and nurses who can adapt themselves to the infinitely varied personalities, tendencies, and moods of all sorts and conditions of patients, and win their interest, confidence, respect, and friendship, in spite of the depression of incipient insanity. The more curable the class of patients, the more imperative is the need for a large, varied, and competent staff from which to select suitable sympathetic guardians and companions. Last, but not least, is the need for the most capable and experienced doctors in a mental-hospital service to arrange such difficult and delicate matters as the foregoing, and to supervise the carryingout of the whole line of treatment most conducive to recovery. To make almost no use of the professional services of the present Medical Superintendents from the curative standpoint would be as wrong to them as it would be unfair to the potentially curable mental patients of the Dominion. Personally, I see no reason whatever for preferring the name " half-way house " to " mental hospital " : one would just as soon be accused of being " half seas over " as of being " drunk " — both mean loss of proper control over body and mind—so does "insanity," whether incipient or established. This is not said lightly, but with all seriousness and sense of responsibility. Which of us would not feel resentful and insulted at the seeming compliment of being declared too sane for a mental hospital, but suitable for a half-way house—if these institutions are to serve amongst their other functions as residential refuges for incurable sexual degenerates, as taken for granted in some quarters ? Several recent admissions to our asylums have been accompanied by medical certificates such as the following : — Illustrative Case.—A well-nourished, well-set-up youth of seventeen. Height, 5 ft. 8 in. ; weight, 9 st. 5 lb. Described by the Medical Superintendent, on admission, as an imbecile, who had reached only the Third Standard at school. Extract from report by certifying doctor : " Memory poor ; does not remember when he left school, what standard he reached, or date of birthday. Mentality like boy of twelve. Uncontrollable masturbator ; imagines people watch and discuss him, gets the feeling he must attack somebody (chop off their heads) ; looked for an axe to cut up his mother, and got hold of a hammer to hit his father." Special memorandum by certifying doctor : " This case illustrates the defect of our treatment of the mentally deficient. This boy should not really be sent to a lunatic asylum. He is essentially a case for a half-way house. He is, however, not fit to be at large, and for want of anything better must be committed to an asylum for the insane," No one questions the need for better classification of mental patients, but the undertakings for which you have made yourself responsible, as Minister of the Department, will meet all reasonable
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requirements, by the simple common-sense means of further development and extension of the present mental-hospital service. Of course, it was by no means an unreasonable idea that entirely separate institutions might provide the best safeguard against the wrongful herding-together of patients with almost nothing in common ; but complete separation is neither necessary nor desirable. The responsible person who should be trusted to make fair and unbiassed discrimination and decision as to what is best for a mental patient (within the limits of available resources) is naturally the Medical Superintendent of the mental hospital which the patient enters, whether voluntarily or on committal as insane. The whole weight of responsibility to the patient and the community should rest on the Superintendent. If he proves incompetent or unsuitable he can be replaced ; but, so long as he makes the best and most beneficent use of his institution and tries to improve it, public money will be spent far better and more profitably in backing and encouraging him and his staff than by resorting to the extravagant and futile experiment of hiving off half a dozen small struggling independent colonies under new queen bees —colonies which it would take not merely a season, but many long years to bring to anything approaching the resources, amenities, comfort, and efficiency of the existing establishments and the further offshoots which will be run in conjunction with them. Indeed, small independent half-way houses would never catch up or prove as efficient and satisfactory as what has been indicated. Psychopathic Hospitals. For the last fifty years proposals have been made from time to time to establish hospitals for the insane, on lines more or less similai to general hospitals for bodily disease. The latest offshoot in this direction is the so-called " psychopathic hospital," where mental patients are kept for the most part either at rest in bed or engaged in specially regulated and systematized occupations, such as basketmaking, joinery, wood-carving, or fancy work—some form of recreation being, of course, also provided. Compared with mental hospitals located in the country or at the seaside, with ample grounds and full facilities for outdoor occupation and recreation afforded by farming, gardening, bathing, boating, &c., the city psychopathic hospital may prove professionally convenient and interesting, but most patients would find freer, open outdoor life far more exhilarating and enjoyable. The highest authority on the question of the " hospitalization " of the insane is still Sir Clifford Albutt—who was at once the most broadly enlightened and competent all-round English physician of his day, and a leading authority on the care and treatment of the insane, in whom he took a specially keen and active interest. The following extract needs no explanation : — Extract from the Evidence of Br. Sir T. Clifford Albutt, given thirty-five years ago, before the London County Council Committee which was instructed to inquire into and report to the Council on the advantages to be expected from the establishment, as a complement to the then existing asylum system, of a hospital with visiting medical staff for the study and curative treatment of insanity : — " I think the first tiling to do is to get rid of some of the connotations which the word ' hospital ' brings in. Ido not mean to say that the word is not a good one, and should not be used ; but it brings in the idea that you want something like a hospital for the treatment of the bodily sick. I think the two classes of institutions should be entirely different, especially in their system of organization, and that it is very important that one should get rid of any idea that such an institution as you are contemplating should be anything like St. George's Hospital or the London Hospital, or such hospitals for the sick in our towns. " I think that it would not be desirable to have a visiting staff, unless it be for professional purposes only. I found that opinion upon this consideration. The treatment of lunacy does not appear to me to be very much a matter of drugs or pharmaceutics. Ido not think that pharmacy will have a very large place in the treatment of the insane. That medicines may be of the utmost possible importance, and that they may be employed at times with the greatest possible advantage, no one, of course, would deny ; but that they are usually of primary importance, or that they are the treatment for mental disease, is, I think, not true. I think the true treatment is chiefly moral and humane, and not very much in the direction of drugs. I therefore think that the management of the place —and under ' management ' I include all the amenities of the place as well as the mere stewarding of the house —the personal qualities of the Medical Superintendent, the personal qualities of every member of the medical and nursing staff, is really ' the cure.' But in an ordinary London hospital the plan of conduct is somewhat of this nature : the physician comes at, say, 2 o'clock in the afternoon. He goes round with the house physician, and he examines the patients, who are usually in bed, and he endeavours to ascertain the bodily complaint, for which he prescribes mechanical appliances or drugs, and a special dietary ; and those directions can be fully carried out by the house physician or house surgeon. Now, I do not see much similarity in that to the treatment of the insane. " When the physician goes into an asylum he finds a person not in bed—a person who is open to all the influences of exercise in the fresh air, and many of the pleasures and diversions of life. These are indeed part of the physician's treatment. The patient, in nine case out of ten, is not especially in need of drugs. His dietary may need some adjustment, but it would in most cases be the wholesome dietary of the average Englishman or Englishwoman. Therefore, it appears to me that all those things which a visiting physician does in the London hospital you would have very little place for. But what it does appear to me that there is place for, and what is indeed of cardinal importance, is the intimate personal relation between the Superintendent and his staff and the individual patient —the study of the patient's character and peculiarities, the ascertaining of his fears and his delusions, his dreads, his
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suspicions, what are his hallucinations, and everything of that kind ; and then the dealing, as tender-hearted, open-minded, sympathetic, humane people, with those mental conditions, as mind with mind. That system, you see, makes your Superintendent everything, and, subject to him, makes your staff everything also. The Superintendent is your medicine ; the staff is your medicine ; the nurses are your medicine ; your conservatory and your entertainments, your birds, your garden, and your farm are your medicine ; and these things cannot be prescribed by visiting physicians." Speaking to-day, there is remarkably little to add to Sir Clifford Albutt's masterful summary of essentials. True, he does not mention specifically the efficacy of ultra-violet rays, psycho-analysis, or psychopathy—but they are largely implied or provided for, not artifically, but naturally, in the form of sunlight, the personal interest and intimacy needed to bring the doctors and staff into close touch and sympathy with the patients as individuals, and the open-air country life, which provides the most natural, healthful, and enjoyable of all forms of occupation and recreation—besides being the best of sedatives for restoring rest and sleep. Sir Clifford Albutt in England was the professional counterpart of Sir Thomas Clouston in Edinburgh —both preached the gospel of open-air occupation and useful work for the insane, and the paramount need of normal healthy nutrition, in order to re-establish the mens soma in corpore sano. New Works, Alterations, and other Improvements. The following summary of the main new works (involving an expenditure of about £100,000), arranged for by the Inspector-General before leaving for Home, which have been carried out during the year or are nearing completion, gives a fair indication of the progressive policy which has been pursued. It must be understood that these additions and improvements do not include the large amount of work done and money expended annually in alterations, improvements, and maintenance at the various institutions, effected by the permanent local staffs of artisans and the patients : — Auckland : Installation of electric light, &c. Tokanui : Completion of reception ward for twenty-seven women ; completion of dormitory for thirty men ; completion of new stores and administrative block ; water-supply from Te Awamutu ; extensions to laundry ; installation of electric lighting (hydro). Ponrua : Additions to main building, providing infirmary wards for men and women; erection of two villas for sixty-eight women (now ready for occupation) ; erection of three villas for 102 men (approaching completion) ; accommodation for artisans (releasing equivalent accommodation for attendants) ; new kitchen at male auxiliary. Nelson : Completion of new store ; additions to boys' ward. Stoke : Villa for forty-two men (under construction). Hokitika : Completion of Medical Superintendent's residence ; completion of central block ; villa for thirty-eight men (almost ready for occupation). Christchurch : Completion of quarters for male attendants (releasing single-room accommodation for patients) new lavatories ; extension of laundry. Seacliff: Completion of single-room block for men ; new lavatories. During the last few months steps have been taken in the direction of reducing the size of unduly large dormitories. These rooms, constructed upwards of fifteen years ago to accommodate from sixty to eighty patients, are being completely subdivided into four small dormitories ; and at the same time the smaller resulting units are being systematically ventilated so as to provide an aggregate of many times the original air-supply. By the end of the present year at least £15,000 will have been expended in thus bringing the ventilation of close, stuffy bedrooms and dormitories up to a proper hygienic standard, so as to provide an additional supply of some millions of cubic feet of air an hour. There is now before the Government an important programme providing, among other things, for the erection of new buildings, and for extensive additions to existing premises, with the object of bringing the mental hospitals of the Dominion up to a high standard of efficiency and comfort. The programme includes — (1.) The purchase of necessary additional land. (2.) New buildings : — (a.) Receiving cottages. (b.) Units for the more sensitive and recoverable cases, mainly recent admissions, (c.) For chronic patients. (d.) For the sick and infirm. (3.) Ventilation and other hygienic provisions needed for existing premises. (4.) Structural additions and alterations (other than the above) needed to make existing premises suitable for continued use. Certain large items of expenditure are necessary because of faulty designing and the lack of proper provision for ventilation and sanitation in the buildings erected many years ago. These primary defects and shortcomings have not been completely remedied hitherto. In addition it has become necessary, in order to bring about further improvement and progress in our methods of treatment and accommodation, to make provision for — (a.) Out-patient clinics in connection with the general hospitals in the four main centres. (6.) The avoidance of lodgment in prison of persons alleged to be insane, pending medical examination and diagnosis.
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(c.) The provision of comfortable homelike admission cottages where new arrivals can be medically examined immediately by the doctors of the mental hospital,- so as to ascertain whether they would be likely to benefit by treatment at a seaside sanatorium, or in a special small villa on the estate, but remote from the main central building ; or whether, on the other hand, it would be better in the meantime to send them to a ward in the main building suited to their particular mental state and tendencies.* Provision has already been made for the expenditure necessary under the headings (a) and (b). Another departure making for the more humane treatment of sensitive and curable cases is the proposed establishment of hostels or sanatoria for persons suffering from nervous affections. The foregoing is an outline of what is required generally. With reference to the Auckland District, it is proposed that the Avondale Institution should be moved to another site, and it is proposed to acquire an area of land, mainly arable, within an easy distance of Auckland City for this purpose. The acquisition of this land would be the first step, and the erection of units accommodating male pioneer patients would follow. The transfer of the patients to the proposed new institution would of necessity have to be done gradually over a period of, say, ten years. Included in the programme before the Government is provision for adequate and comfortable housing for nurses. I have, &c., F. Tkuby King. The Hon. Sir Maui Pomare, K.8.E., C.M.G., M.D.
* I may here point out that this matter of allocating patients at once to the available quarters best suited to the particular cases must always be one of the greatest possible delicacy and difficulty. In most cases not only do the relations and friends desire and expect that the new arrival shall be put straight into the best and most private quarter of the institution where there will be no association with any manifestly insane person, but this is sometimes implied in the committal order by the Magistrate, or has been suggested to the patient or his friends by the medical adviser. To carry out, anywhere in the world, the exacting and unreasonable expectations and demands for separation and classification would necessitate the provision of two or three times the number of widely scattered small cottages and a corresponding increase in the staff, and would in reality serve no good purpose. It must be left unreservedly to the medical staff of the institution to determine where each patient is to be located, and all other details of his treatment, as a person sick in body and mind, and possibly varying extremely from time to time. Thus a patient who is bright, cheerful, companionable, and fit for any company one day may become violently maniacal and dangerous, or may pass into a state of utter dejection and despondency—in either case he would exercise a risky and harmful influence on the saner inmates. The variability which characterizes many forms of insanity calls for consistent vigilance on the part of the staff and it needs resources of classification which can only be provided adequately and satisfactorily in a large institution. One of the worst features of small isolated institutions for the care of the insane is that the means are not at hand of meeting the daily difficulties and emergencies which arise in connection with insanity.
Statistical. The patients on the register at the end of the year numbered 5,131 (m., 2,873 ; f., 2,258), or 135 (m., 34 ; f., 101) more than at the beginning, and the daily average under treatment during the year was 4,954 (in., 2,808 ; f., 2,146), or 86 (m., 19 ; f., 67) more than in the previous year, while the total under care was 5,819. Patients belonging to the Native face numbered 72 (m., 37 ; f., 35) at the end of the year. The admissions numbered 823 (m., 446 ; f. 377), or 15 (m. 4 ; f., 11) more than in the previous year. Of these 133 (including 4 Maoris) had been previously under care, making the proportion of readmissions 16-16 per cent., and 690 patients (including 9 Maoris) were admitted for the first time. The ratio to population of all admissions (exclusive of Maoris) was 6-24 (m., 6-62 ; f. 5-84) to 10,000, and of first admissions 5-24 (m., 5-76 ; f., 4-71), so that 1,603 persons in the general population contributed one patient, and 1,907 contributed a patient admitted for the first time. These figures, the index of " occurring mental disorder," disclose an unusually low ratio. The discharges (excluding transfers) numbered 372, or 47 less than in 1923. Ninety-two, or 8 fewer harmless unrecovered persons were returned to the care of friends, and 280 (m., 152 ; f., 128) recovered, 39 fewer than last year, representing a percentage of 34-02 (m., 34-08 ; f., 33-95) on the total admitted. With voluntary boarders added the percentage rises to 39-00. Altogether 48-77 per cent, of the inmates admitted were able to leave institutional care. Of a total of 5,819 patients under care, 316 (m., 221 ; f., 95) died, or 5-43 per cent. An inquest is held in the case of every death, whatever the cause. The causes are detailed in Table XII, and the following is the percentage of causes mainly contributing : Senile decay, 27-85 ; disease of the brain and nervous system group, 32-28 ; heart-disease, 9-18 ; tuberculosis, 7-28. In Table XIII the principal causes assigned for the mental breakdown in the admissions are stated ; but as a matter of fact they are merely approximations, and these, with the small numbers with which we have to deal, show such divergencies from year to year that the proportion assigned to anv one cause in any one year cannot be assumed to be our average incidence. Causation is always
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complex, and the most potent factor is the individual. Hereunder the assigned causations in the table referred to are grouped and shown in their relative proportions : — Males. Females. Total. Heredity.. .. .. .. .. .. 15-70 15-38 15-55 Congenital .. .. . . . . .. 17-04 9-28 13-49 Predisposed by previous attack .. ~ .. 6-95 16-71 11-42 Critical periods .. .. .. .. .. 20-40 20-95 20-66 Child-bearing (puerperal, non-septic, and lactation) .. .. 5-84 2-67 Mental stress .. .. .. .. .. 4-93 6-90 5-83 Physiological defect and error .. .. .. 2-70 5-04 3-77 Toxic, including— m. f. t. Syphilis .. .. 8-74 1-06 5-22\ ?] ... Alcohol .. .. 8-74 2-92 6-07/ Traumatic . . .. .. .. .. 1-35 0-53 0-97 Disorder of nervous system, including— M. F. t. Epilepsy .. .. 4-03 3-97 4-01 6-27 6-90 6-56 Other bodily affections .. .. .. .. 1-80 2-12 1-94 No definite cause assigned .. .. .. .. 5-15 5-84- 5-47 100-00 100-00 100-00
Voluntary Boarders.
It will be noted that there were 118 voluntary admissions in the year under review, that 87 were discharged, and that 12 boarders, representing only 4-95 per cent, of the total under care, had to be transferred to the register of patients (having shown mental disorder in degree sufficiently pronounced and sustained to render it improper for them to be continued as voluntary boarders), while the proportion of deaths was 3-71 per cent. The column devoted to " Not First Admissions " records readmissions on a return of illness in those previously treated to recovery as voluntary boarders. The figures above are an indication of public confidence and of good work being done. The average daily number of voluntary boarders in 1924 was 126 (m., 57 ; f., 69). Mental Nurses. In December the usual examination was held for the registration of mental nurses, when the following passed : — Auckland : First Grade —Emily Broome, Frederick William Fades, Mary Isobel Laurenson, Grace Rosetta Warder; Second Grade —Maud Ruth Elizabeth Seymour, Hannah Walker. Christchurch : First Grade —John Daniel Hillary; Second Grade —Mary Alice Gilpin, Alice Pearson. Dunedin : First Grade —Eli Brighton, Muriel Adela Laurent, Allan Mclnnes, Mary Ellen Stewart; Second Grade—Thomas Ashworth. Hokitika : First Grade—James Joseph Lincoln ; Second Grade—Charlotte Bradley, Patrick Bernard Kirwan, Julia Theresa Noonan, Andrew Wright. Nelson : First Grade —Mary Elizabeth Hampton, Alfred George Hurst, James William Longworth. Porirua : First Grade —George Frederick Joseph Colley, Murdoch Mac Lean, Albert Sayers, Herbert Victor Tregoning, Rebecca Wasson ; Second Grade—Alfred Gurwood Clark, Frank Morrison Dick, Thomas Henry Jones Hardie, Eugene Bernard Riordan, Robert Walker Struthers, Henry Dixon Tyrer, Bedelia Elizabeth O'Brien. Tokanui: First Grade —Mary McMillan, Albert Charles Martin, Norman Gordon Topp ; Second Grade —Marintha Winifred Clifford, Leonard Wilmot Rogers.
First i Not First Total Transferred ' Remaining I Admission, j WSL j AdESL. ; | I 131st December. I I | j I J | M. F. T. M. F. T. I M. F. T. M. F. T. M. F. T. M. F. T. M. F. T. 1912 .. . . 6 17 23 0 0 0 ! 6 17 23 1 3 4 0 0 0 4 3 7 1 11 12 1913 .. .. 18 19 37 0 2 2 j 18 21 39 2 5 7 0 1 1 12 12 24 5 14 19 1914 .. .. 17 19 36 3 2 5 ! 20 21 41 7 5 12 1 1 2 11 15 26 6 14 20 1916 .. .. 15 17 32 1 2 3 16 19 35 3 4 7 0 1 1 8 14 22 11 14 25 1916 .. 13 23 36 5 8 13 18 31 49 4 4 8 1 2 3 14 14 28 10 15 25 1917 . . .. 14 21 35 1 13 14 15 34 49 6 6 12 0 1 1 10 23 33 9 19 28 1918 . . .. 23 38 61 5 11 10 28 49 77 1 4 5 2 2 4 15 30 45 19 32 51 1919 . . .. 31 39 70 5 19 24 36 58 94 3 3 6 0 2 2 26 42 68 26 43 69 1920 .. .. 26 38 64 16 12 281 42 50 92 3 4 7 1 2 3 33 33 66 31 54 85 1921 .. . . 39 39 78 11 15 26 50 54 104 2 3 5 5 1 6 38 41 79 36 63 99 1922 .. .. 47 38 85 10 16 26 57 54 111 6 5 11 4 4 8 40 48 88 43 60 103 1923 .. ..44 50 94 15 21 36 59 71 130 3 6 9 3 3 6 47 47 94 49 75 124 1924 .. .. 38 44 82 16 20 36 54 64 118 4 8 12 6 3 9 39 48 87 54 80 134 i <
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MEDICAL SUPERINTENDENTS' REPORTS. TOKANUI MENTAL HOSPITAL. Dr. Macpherson reports I have the honour to forward you my report on the Tokanui Mental Hospital for the year ending 31st December, 1924. The total number of patients under care during the year was 301, the average number resident being 265. The admissions, including 2 transfers, numbered 37 —viz., 20 male and 17 female patients. During the year there were 11 deaths —an unusually large number for this institution ; and I am afraid that, owing to the large preponderance of old people among our population, there will be an increased mortality for some years to come. Five of the deaths were due to senile decay. Three patients were transferred to other institutions, thus leaving on the register on 31st December a total of 270 patients —viz., 164 males and 106 female patients. During the period under review 8 voluntary boarders were receiving treatment. One female boarder was certified, and male boarder discharged, thus leaving 2 male and 4 female voluntary boarders under treatment at the end of the year. The bodily health of our population has been satisfactory, and their amusement has been catered for by occasional concerts kindly provided by the musical people of Te Awamutu, by bi-monthly dances during the winter, and by visits to the cinema-theatre in Te Awamutu. I think the time has now come when the institution should be provided with a cinematograph. As we are now linked up with the hydro-electric system we would have no difficulty about the current, and I am sure that a picture-show at regular intervals would be greatly appreciated by the patients. Eeligious services have been conducted thrice monthly. The Official Visitor, Mr. Brabyn, has paid regular visits to this institution, and has shown great interest in the patients' welfare. The whole of the estate with the exception of about 300 acres has now been brought under cultivation, and no new country has been dealt with during the year. Owing to lack of labour we had difficulty in keeping down the new growth of scrub and fern, and some parts of the property were in danger of reverting to its original state. During the present year, acting under instructions from the Acting Inspector-General, Sir F. Truby King, we have reopened No. 2 camp, and this has proved a step in the right direction. Twentysix patients are now in residence there, and are doing good work ploughing and clearing the country of scrub and noxious weeds. A similar establishment somewhere in the vicinity of No. 1 camp would enable us to work the whole property to advantage and dispense entirely with labour from the Waikeria Borstal Institution. As most of the " spade " work has now>been done, the farm should show, in the near future, increased returns for fat stock and sheep if present prices hold. In conclusion, I may say that the new female reception ward is now completed, and, as soon as furnished, will be ready for the reception of patients. Owing to the absence of the Medical Superintendent the compilation of this report has devolved on me, and I am sure that he would wish me to say that, throughout the year, he has had the loyal and hearty co-operation of the entire staff of the institution. PORIRUA MENTAL HOSPITAL. Dr. Jeffreys reports :— The total number of patients under care during the year was 1,383 (782 males and 601 females), the average number resident being 1,110 (631 males and 4-79 females). On the 31st December there were 1,194 remaining in the hospital, inclusive of 59 absent on trial. These figures do not include voluntary boarders, of whom there were 71 (33 males and 38 females) under treatment during the year. There were 239 patients (127 males and 112 females) admitted during the year, and of these 26 (11 males and 15 females) were readmissions. Of the 84 patients discharged, 66 were discharged recovered, making the recovery-rate only 27-6 per cent, on the number admitted ; but no doubt a number of the patients at present absent on trial will eventually be discharged recovered, so the recovery-rate for next year will probably be considerably higher ; but a very important factor in the recovery-rate is the type of cases admitted, as will be seen below. 1 ' The deaths during the year were 96 (67 males and 29 females), or 8-6 per cent, of the average number resident. This comparatively high death-rate is partly due to the fact that no fewer than 19 patients died within a month of admission. Six died within a week of, and one 3 hours after, admission. Five of these unfortunates were over seventy years of age, and five between sixty and seventy, and they were all in a more or less exhausted and dying state on admission, and although everything possible was done for them their condition was hopeless. Indeed, but for the unremitting care and attention given the death-rate for recent admissions would have been considerably higher. This deplorable state of things should not be, for, although many of these unfortunates must inevitably have died wherever they were, yet there can be no doubt that the long exhausting journey by train or car —in some cases by both —was responsible for a good many of the deaths, for this institution admits patients from as far north as New Plymouth on the one side and Gisborne on the other. One case, that of a young woman of twenty-one, was a particularly sad one. She contracted pneumonia on the journey here, and died in thirteen days, from " pneumonia and exhaustion." The principal causes of death were senile decay (22), cardiac disease (15), general paralysis (13), and phthisis (10). For several years past I have had to refer in my annual report to the overcrowding of this institution, but as two new wards in the main building and two villas are nearing completion, and as the excavation for the three remaining villas is well under way, one can begin to look forward to the time when the overcrowding will be but a dread memory, and this will be in truth a hospital for
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the care and treatment of the mentally afflicted. But we cannot shut our eyes to the fact that these new villas will be sufficient to accommodate only the patients we already have ; and as we have the highest admission-rate of any mental hospital in the Dominion, within a very few years the same problem will have to be faced again unless other provision is made. The excavation for the new villas—no mean work —has been carried out entirely by patients and attendants, and great credit is due to all for the way this work has been done, and it has been of great benefit to the patients, who have taken a keen interest in it. During the past year there have been 250 male patients usefully occupied outside on the farm, garden, and excavating—more than ever before. In addition to the weekly pictures and the dances, there have been numerous concert parties from Wellington, and I desire to thank the Victoria College Social Service Club and others who have helped to brighten the lives of the patients in this way, and I should like to place on record my appreciation of Mr. Prosser's generosity in issuing free passes to the pictures in the village. Our thanks are also due to the ministers of religion who have visited the patients and conducted services, and also to Mrs. Fraser and Mr. Bothainley, Official Visitors, for their interest in the institution and its inmates. I also desire to thank my colleagues, Drs. Blair, Cox, and Bydder, and the Matron and Head Attendant, for their loyal co-operation in carrying on the work of the institution. NELSON MENTAL HOSPITAL. Dr. Gray reports : — At the beginning of 1924 there were 330 patients in residence, and this number had increased to 348 by 31st December. The general health of the patients has been good, but El Nido, the boys' villa, was visited by an epidemic of measles in the latter part of the year. Verandas have been added to the male hospital ward, and greatly enhance the utility of this important part of the institution. The new closed villa at Stoke is nearing completion, and its occupation by the less amenable type of patient should enable us to add greatly to the comfort and well-being of the many workers who are able to appreciate and benefit by the large measure of parole allowed. The male admission ward at Nelson is now staffed by nurses, and the results amply confirm my previously expressed opinion that we should replace attendants by nurses to the utmost possible extent. A considerable amount of maintenance work has been done, including the repairing and painting of Toitoi Ward. It is most pleasant to put on record the generous sympathy and interest maintained in the institution by the people of Nelson. We have free passes to all football matches, races, and cinema-theatres, while the Operatic Society annually extends an invitation to their dress rehearsals. The school-children during the year inaugurated a " sunshine fund " to provide picnics for our boys at El Nido, and the citizens provided us with three gramaphones. The Sick and Wounded Soldiers' Committee donate £5 monthly for much appreciated drives for ex-service patients, while other agencies, including the Mail, have given us much encouragement. I have to acknowledge the loyalty and devoted interest shown by my staff. HOKITIKA MENTAL HOSPITAL. Dr. Buchanan reports : — At the beginning of the year there were 236 patients on the register. At the end of the year there remained 172 males and 64 females, making up a total of 236. Admissions numbered 23 ordinary patients and 2 voluntary boarders. Discharges were 12, and deaths 11. The majority of the deaths are accounted for by senile decay and heart-failure. The general health of the patients has been good. There have been several changes effected in the buildings and grounds since my last report. Much, however, remains to be done. As far as Hokitika is concerned, the villa system of housing is eminently successful. In acute cases a feeling of being in a hospital is engendered, and the popular idea of incarceration removed. This, of course, is most beneficial. Even in the case of chronic patients the opportunity afforded to change their immediate surroundings by transferring them from one house to another varies the monotony of their existence, adds some interest to their lives, and is most decidedly conducive to better behaviour. I find that many who never did a day's work, but sat and moped all day, have on their transfer seemed to waken up and proved themselves quite valuable workers. The most important change that has occurred during the last year is the replacing of attendants by nurses in two male wards. We have now 50 male cases under the charge of nurses. The results are most gratifying. Many of these patients, who previously were apt to be recalcitrant with male attendants and impulsive towards their fellow-patients, have under female influence become quieter, better behaved, and have in many cases evinced a willingness to work. These patients are undoubtedly cleaner, more smartly clothed, and better served with meals. Ido not intend to cast any aspersions on the male staff : these changes are subtle, and entirely due to the gentler influence of women. The addition of a sister to the staff who has undergone training in both a mental and a general hospital has greatly improved the nursing of the sick and new admissions. The training of the staff is better and made more interesting for those participating in it, and there is an atmosphere of an ordinary hospital produced. A new ward to contain 38 patients and 5 attendants is well under way, and should be ready for occupation in July. When completed the demolition of F ward —the worst feature of the institution — can be commenced. A new night nurses' cottage and the Superintendent's residence are now completed.
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Tile farming-ground, is of very poor quality and limited in extent. Now that new buildings are encroaching on the hitherto available farming-land it is necessary for us to seek elsewhere for a farm. This is a really urgent matter. It now costs approximately £1,500 per annum for produce that should be grown by ourselves. I would recommend that 300 to 400 acres be purchased in the Kokatahi or Arahura Valley, and farmed by the patients for the benefit of the institution. At present prices for farming-land on the West Coast are moderate, but they are hardening every year. We are dependent on the town for our water-supply. The water is excellent, but the pipes carrying the water from Lake Kanieri are most defective, and are the causes of our being frequently shut off. We have had as many as three days without water, and very frequently two days. We are charged the exorbitant sum of Is. 3d. per 1,000 gallons by the Borough Council. We have sunk a well on our own grounds, and a plan is being prepared by the Public Works Department for pumping and storage. We have now procured from the well good potable water in sufficient quantities to make us independent of the Borough Council if the scheme is carried through. It is with regret that I now cease my superintendency at Hokitika. The work that has been carried out and the changes effected in the last four years could never have been accomplished were it not for the helpfulness and loyalty of all my staff : to them I owe a debt of gratitude. CHRISTCHURCH MENTAL HOSPITAL. Dr. Crosby reports : — At the beginning of the year there were 806 patients on the register (359 male, 447 female) and at its close 822 (366 male, 456 female). The admissions during the year number 127 (68 male, 59 female). Sixty-five patients were discharged, comprising 28 men and 37 women. Twenty-three voluntary boarders were admitted, and 20 (some from the previous year) were discharged. Twentytwo cases were remanded for observation by the Magistrates, and 8 were discharged uncertifiable. Forty-six deaths took place during the year, 33 men and 13 women, giving a death-rate of 5-8 per cent. The death-rate in the female division, on average number resident, was unusually low, being barely 3 per cent. Last July the committee investigating the social problem presented by the feeble-minded and sexual offenders visited Christchurch. Being asked to appear before this committee, in connection with mental-hospital work, I strongly urged the establishment of separate wards in mental hospitals for the treatment of epileptics, or, better still, epileptic colonies. The long periods of apparent sanity that epileptics often enjoy makes their residence among the insane very irksome to them, whilst, on the other hand, the witnessing of the grotesque contortions of an epileptic in a fit has a terrifying and often injurious effect on the more refined psycho-neurotic type of insane. The other point that I brought up for the consideration of the committee was the desirability of incorporating the English definition of the moral imbecile in the New Zealand Mental Defectives Act. The moral imbecile is a fertile source of recidivism, illegitimacy, and venereal disease. The Medical Superintendent of the Christchurch Public Hospital has emphasized the last point in a striking manner. Referring to the spread of venereal disease, in his annual report to his Board he writes : "We have no difficulty with men —they are the victims of unscrupulous women, and they faithfully attend to their treatment with every desire to get well; they are not degenerates or morally depraved. The women, on the other hand, are totally different. They are morally the cause of all the venereal troubles, and have little or no sense of moral responsibility. As a rule they are casual workers, never staying any length of time anywhere." If moraHmbecility were recognized as a form of insanity, and the English definition included in the Mental Defectives Act, then power to segregate women of the class referred to would be available, provided there was full and strict compliance with the terms of the definition. The accommodation for patients has remained the same as last year. Increased accommodation for both the male and female infirmary wards is a truly pressing need. Fortunately, more accommodation for male wards other than the infirmary is now available, owing to the completion of quarters for unmarried attendants. This new building will release twenty-four " single rooms " for the use of patients. The building itself is compact and neat, and with its roomy billiard-room will provide rest and recreation for those of the staff who do not wish to spend all their " days off " away from the institution. Another new building, which will greatly modernize the sanitation of the institution, is nearing completion : I allude to the separate block for lavatories which has been built in connection with A and D wards. The farm continues to be a sane and healthy interest for the male patients, and work on it is of great therapeutic value, even to those men hitherto unaccustomed to farm-work. Our area of land has been increased during the year by the lease of a further 100 acres from the Church Property Trustees. This additional land will doubtless soon be brought to the high level of productivity that has been reached by the rest of the Sunnyside farm under the capable direction of our Farm-manager. In this connection I am glad to be able to report that a start has been made with the new stables so long urgently needed. The farm returns again show a substantial credit balance. The religious needs of the community have again been met by much appreciated Church services held by the visiting chaplains, and by their frequent visits. The outdoor and indoor games and recreations have gone on as in the past. Our thanks are greatly due to the Fuller Proprietary for their permission—given through the kindly offices of Mr. Souter, Patients' Friend —for many of the patients to attend Saturday matinees. I would like also to express our gratitude to Mr. Brandon, Works Overseer, who is now retiring, for the work he has done during many years in organizing entertainments for the patients. Both Mr. 11. D. Acland, District Inspector, and Mr. H. H. Hanna, Official Visitor, have made frequent inspections of the institution, and have examined various patients from a legal standpoint. Mrs. Williams, the other Official Visitor, has also been assiduous in her visits and has arranged many tennis and bridge parties for the patients throughout the year.
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In reviewing the past year I am made very cognisant of the substantial and valuable help given by Dr. Beale and Dr. Roberts, as well as by the officers and members of the staff. I ask them to accept my sincere thanks. SEACLIFF MENTAL HOSPITAL. Dr. McKillop reports : — On the Ist January there were 1,100 patients oh the register. During the year we had 150 admissions (80 men and 70 women). Sixty patients were discharged, and 7 transferred to other institutions. The total number of committed cases under care was 1,250, and 1,128 (inclusive of 16 males and 15 females absent on probation) remained on the 31st December. Forty-five voluntary boarders received treatment, 10 males and 7 females were discharged recovered, 1 female was committed, leaving 14 men and 13 women under this section. The general health of the patients has been very satisfactory. There were 55 deaths (38 men and 17 women) —less than 5 per cent, of the number resident. Twenty-four of the deaths were due to senile decay. Very considerable structural alterations have been carried on during the year, and important works are still being carried out. On the female side, the ceilings in No. 1 ward have been renewed, and the interior of the ward, and the main corridor have been entirely painted and renovated. The large tables in the dining-room have been replaced by small tables, each to accommodate four patients. The alterations have given the ward a brighter and more homely aspect. The fence round the new park for Ward 2 (female) has been erected, and all sanitary arrangements are now completed. During the present year the park will be graded and paths laid down. The main female park fence is being renewed in sections, and an asphalt path is being laid from the Nurses' Home to the main kitchen. All single rooms in Male B and the dining-room for refractory patients have been replaced by up-to-date rooms and a new dining-room, and the former objectionable features removed. G Ward, Clifton House, and the interior and exterior of Simla, have been painted and renovated. A new bathroom and boiler-house has been erected at D Ward. The high fence surrounding the airing-court has been removed, and replaced by a low picket fence, enclosing an extensive area of lawns and gardens. The slate roofs all over the main building have been placed in repair. Electric lighting has been carried out along the back road as far as the railway-crossing. This has been a long-felt want, and the change has been much appreciated by visitors and members of the staff. Although much has been done during the year, very much still requires to be done. Plans have been prepared for new laundry, new kitchen, bakery, stores, farm buildings, and a building to replace D Ward. For a number of years the kitchen and laundry facilities have been inadequate, and lam pleased to note that the prospects of getting matters remedied is having your favourable consideration. When the new kitchen is an accomplished fact I hope the suggestion I made to Dr. Hay three years ago, and approved of by him, will be carried out —viz., that this department be placed under the control of a qualified dietitian. The advantages to be gained by doing so are very great. The electric lighting of Waitati is another matter that requires urgent attention, and the main building, the Retreat, and Female No. 1 Building require painting and renovating. During the year a considerable amount of research work has been carried out in conjunction with the Medical School, and I am deeply indebted to Professor Hercus, Drs. Lynch and D'Ath, for their valuable co-operation. The malarial treatment for general paralysis of the insane has been carried out in three cases with rather remarkable results. The malarial treatment was followed up by assiduous antisyphilitic treatment, and the salvarsanized serum was injected directly into the cisterna magna. In all three cases the disease has been arrested ; one patient was discharged well nine months ago, and has taken up his usual occupation ; the other two cases are very much improved, and are able to do a satisfactory day's work without untoward symptoms. In all cases the Wasserman reaction became negative after treatment. Owing to the difficulty in getting malarial inoculation, a further case was tried with tuberculin injection followed by antisyphilitic remedies. The results in this case were also beneficial. The mental symptoms have to a great extent cleared up, and he will, for a time at least, be able to resume his occupation. To secure the maximum benefits, whatever treatment is used, an early attack must be made on the agents of the disease, as, if treatment is not commenced early, organic degenerative charges are already present, and although the disease may be brought to a standstill, irreparable damage has already been done. The patients' recreation has been arranged on the usual lines : the weekly picture-show is very much appreciated. I consider it would be advisable to install a hydrant near the cinematograph machine to ensure adequate fire protection. The development of the farm has been steadily proceeded with, and the dairy herd has been augmented. The fences on the estate require a great deal of attention, and the farm buildings require extensive repairs. The fishing-station has not met with the same measure of success as in recent years. The fresh fish has proved a very welcome change to the patients, and if an institution of this nature only pays its way it fulfills a worthy object; at the same time I consider that we should be able not only to satisfy our own requirements, but also that of other mental hospitals. To Mr. Galloway, District Inspector ; to the Official Visitors (Miss Monson, Mr. Slater, the Rev. H. McLean); to Mr. Cumming, Patients' Friend, I tender my sincere thanks for their regular visits and for their attention to our inmates. I desire to record my thanks to Drs. Lee, Williams, Hart, and Mayfield for the help they have always accorded me in the medical and general work of the institution. I have also to thank Mr. Hughes and office staff, the Matron, Head Attendant, and other heads of departments for their loyal and efficient assistance, and the stafi as a whole for the satisfactory manner in which its work has been performed.
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APPENDIX.
Table I.—Showing the Admissions, Readmissions, Discharges, and Deaths in Mental Hospitals during the Year 1924.
Table II.—Admissions, Discharges, and Deaths, with the Mean Annual Mortality and Proportion of Recoveries, etc., per Cent, on the Admissions, etc., during the Year 1924.
M. P. T. M. F. T. In mental hospitals, 1st January, 1924 .. .. .. .. 2,839 2,157 4,996 Admitted for the first time .. .. .. .. 385 305 690 \ 000 Readmitted 61 72 133 / Ub 377 823 Total under care during the year .. .. .. 3,285 2,534 5,819 Discharged and died—Recovered .. .. .. .. .. .. 152 128 280 Relieved .. .. .. .. .. .. 30 42 72 Not improved .. .. .. .. .. 9 11 20 Died .. .. .. .. .. .. 221 95 316 (Not including transfers —Males 35, females 13.) 412 276 688 Remaining in mental hospitals, 31st December, 1924.. .. .. 2,873 2,258 5,131 Increase over 31st December, 1923 .. -. .. .. 34 101 135 Average number resident d uring the year .. ., .. .. 2,808 2,146 4,954
In Mental Hos- | Admissions in 1924. Total Number Mental Hospitals. pitals on i I p„ f ■ . 1st January, 1924. j Admitted for the Not First i Transfers under rare j First Time. | Admission. j Jransrers. under care. M. F. T. M. F. T. M. F. T. M. F. T. M. F. T. Auckland .. .. 637 441 1,078 90 87 177 19 13 32 (3 3 6) 749 544 1,293 Christchurch .. .. 359 447 806 56 38 94 10 17 27 (2 4 6) 427 506 933 Dunedin (Seacliff) .. 625 475 1,100 68 51 119 11 19 30 (1 .. 1) 705 545 1,250 Hokitika .. .. 171 65 236 16 4 20 2 1 3 (1 .. 1) 190 70 260 Nelson .. . . 212 118 330 25 10 35 3 5 8 (22 1 23) 262 134 396 Porirua .. .. 653 487 1,140 115 97 212 11 15 26 (3 2 5) 782 601 1,383 Tokanui .. .. 163 101 264 14 15 29 4 2 6 (2 .. 2) 183 118 301 Askburn Hall (private 19 23 42 1 3 4 1 1 (1 3 4) 22 29 51 mental hospital) Totals .. 2,839 2,157 4,996 385 305 690 61 72 133 (35 13 48) 3,285 2,534 5,819 Patients discharged, transferred, and died. Mental Hos Mental Hospitals. Discharged Discharged I I Total discharged, 31st P December, ?™!d j not recovfred. j Transferred. ! Died. tmn.ferred, 1924. M. F. T. M. F. T. M. F. T. M. F. T. | M. F. T. M. F. T. Auckland .. . . 53 43 96 4 7 11 20 .. 20 53 24 77 1 130 74 204 619 470 1,089 Christchurch .. 17 14 31 10 21 31 1 2 3 33 13 46 j 61 50 111 366 456 822 Dunedin (Seacliff) .. 27 19 46 7 7 14 1 6 7 38 17 55 | 73 49 122 632 496 1,128 Hokitika .. .. 4 4 8 3 1 4 1 .. 1 10 1 11 I 18 6 24 172 64 236 Nelson .. .. 9 12 21 3 4 7 2 1 3 11 6 17 i 25 23 48 237 111 348 Porirua .. .. 34 32 66 8 10 18 7 2 9 67 29 96 116 73 189 666 528 1,194 Tokanui .. 8 3 11 3 3 6 1 2 3 7 4 11 19 12 31 164 106 270 Ashburn Hall (private ..1 1 1.. 1 2.. 2 213 5 2 7 17 27 44 mental hospital) -— i Totals .. 152 128 280 39 53 92 35 13 48 221 95 316 j 447 289 736 2,873 2,258 5,131 Avbi ubb Niimhnr I Percentage Percentage of Mental Hospitals. j residjntduring | ] during the Year. j during the Year. M. F. T. M. F. T. M. F. T. Auckland .. .. .. .. .. 620 444 1,064 47-70 43-00 45-45 8-54 5-40 7-23 Christchurch .. .. .. .. .. 354 440 794 25-75 25-45 25-62 9-32 2-95 5-79 Dunedin (Seacliff) .. .. .. .. 623 481 1,104 34-07 27-14 30-87 6-09 3-53 4-98 Hokitika .. .. .. .. .. 171 62 233 22-22 80'00 3 4-78 5-84 1-61 4-72 Nelson .. .. .. .. .. 227 114 341 32-14 80-00 48-83 4-84 5-26 4-98 Porirua .. .. .. .. .. 631 479 1,110 26-70 28-57 27-73 10-61 6-05 8-06 Tokanui .. .. .. .. 164 101 265 44.44 17-64 31-42 4-26 3-96 4-15 Ashburn Hall (private mental hospital) .. .. 18 25 43 .. 33-33 25-00 11-11 4-00 6.97 Totals .. .. .. .. 2,808 2,146 4,954 34-08 33-95 34-02 7-87 4-42 6-37
H.—7
Table III.-Ages of Admissions.
Table IV.-Duration of Disorder on Admission.
15
Dunedin i I i Ashburn Hall Ages. Auckland. | Christchurcb. fSeacliff) i Hokitika. ! Nelson. | Porirua. Tokanui. (Private Mental Total. 1 '• j I j Hospital). M. F. T. M. F. T. M. F. T. M. F. T. M. F. T. M. F. T. M. F. T. M. F. T. M. F. T. Under 5 years .. .. .. .. 303 .. .. .. 3 03 033 .. .. 639 From 5 to 10 years .. .. .. .. Oil .. .. 729 044 .. .. 77 14 „ 10 „ 15 „ .. .. .. 0 1 1 1 0 1 0 3 3 .. 4 0 4 0 3 3 .. .. 5 7 12 „ 15 „ 20 „ .. .. .. 3 6 9 2 3 5 2 2 4 2 1 3 3 0 3 8 3 11 1 0 1 .. 21 15 36 „ 20 „ 30 „ .. .. .. 20 12 32 16 10 26 13 8 21 1 1 2 1 6 7 2 7 24 51 3 5 8 .. 81 66 147 „ 30 „ 40 „ .. .. . . 14 22 36 15 14 29 17 18 35 5 0 5 4 2 6 .24 16 40 3 3 6 0 1 1 82 76 158 „ 40 „ 50 „ .. .. .. 16 27 43 10 17 27 12 16 28 1 1 2 2 3 5 .26 29 55 5 4 9 1 0 1 73 97 170 ,, 50 „ 60 „ .. .. .. 21 15 36 9 7 16 7 10 17 2 0 2 3 1 4 15 13 28 3 3 6 1 2 3 61 51 112 „ 60 „ 70 „ .. .. 14 7 21 7 1 8 15 7 22 1 0 ! .. 10 11 21 .. .. 47 26 73 „ 70 „ 80 „ .. .. .. 9 2 11 5 2 7 8 5 13 1 0 1 0 1 1 11 4 15 2 0 2 .. 36 14 50 „ 80 „ 90 „ .. .. .. | 3 6 9 1 0 1 5 1 6 3 2 5 1 0 1 4 1 5 1 2 3 .. 18 12 30 90 „ 100 „ .. .. .. ! 2 0 2 .. .. 1 0 1 .. .. .. . . 3 0 3 „ 100 „ 105 „ .. .. .. ; .. .. .. .. j .. 10 1 .. .. 10 1 Unknown .. .. .. .. i 4 2 6 .. .. 1 0 1 .. 011 .. .. 538 Transfers .. .. .. .. ! 3 3 6 2 4 6 1 0 1 I O I 22 I 23 3 2 5 2 0 2 1 3 4 35 13 48 Totals .. .. .. j 112 103 215 68 59 127 80 70 150 19 5 24 50 16 66 129 114 243 20 17 37 3 6 9 481 390 871
I j Dnnpflni ! Asliburn Hall j Auckland. Christchurch. Hokitika. Nelson. Porirua. Tokanui. (Private Mental Total. (beaciin). , i Hospital). I I | | I M. F. T. M. F. T. M. F. T. M. F. T. M. F. T. M. F. T. M. F. T. M. F. T. M. F. T. First Class (first attack and within 3 months 66 78 144 31 21 52 36 25 61 7 2 9 3 4 7 81 63 144 12 11 23 1 3 4 237 207 444 on admission) Second Class (first attack above 3 months and 8 4 12 7 4 11 13 6 19 3 0 3 1 2 3 26 26 52 1 1 2 .. 59 43 102 within 12 months on admission) Third Class (not first attack, and within 21 11 32 20 23 43 9 26 35 5 2 7 1 6 7 5 4 9 4 3 7 .. 65 75 140 12 months on admission) Fourth Class (first attack or not, but of more 14 7 21 8 7 15 21 13 34 3 1 4 23 3 26 14 19 33 1 2 3 1 0 1 85 52 137 than 12 months on admission) Transfers .. .. .. .. 3 3 6 2 4 6 1 0 1 1 0 1 22 1 23 3 2 5 2 0 2 1 3 4 35 13 48 Totals .. .. .. 112 103 215 68 59 127 80 70 150 19 5 24 50 16 66 129 114 243 20 17 37 3 6 9 481 390 871
H,—7
16
Table V.-Ages of Patients discharged "Recovered" and "Not Recovered" during the Year 1924.
Table VI.-Ages of Patients who died.
Auckland. Christehurch. Dunedin (Seacliff). Hokitika. Nelson. Poriiua. Tokanui. (Private JJTH 1 ) Total. Age6 ' Ee- Not re- Be- j Not re- j Re- Not re- Be- Not re- I Re- Not re- He- Not re- Be- Not re- j Be- Not re- Becnvprpd Not covered, covered. covered, j covered. | covered, covered, covered, covered, covered. covered, covered, covered, covered, covered, j covered, covered. - recovered. M. F. T. M. P. T. M. F. T. 1 M. F. T. M. F. T. M. F. T. M. F. T. M. F. T. M. F. T. M. F. T.| M. F. T. M. F. T. M. F. T. M. F. T. M. F. T. M. F. T. M. F. T. M. F. T. Under 5 years .. . ■ •• •• •• • * •• 101 .. ! .. .. .. .. .. .. 101 From 5 to 10 years .. .. Oil .. Oil .. Oil .. .. .. .. .. 022 .. .. .. .. .. 055 " is" 20 " " o 'i i i '6 i 2 "o 2 o 'i i o 'i i i "o i .. .. .. .. 112 .. 1 '0 1 " " '' 4 3 7 2 'i 3 " 20 30 9 10 19 1 1 2 3 2 5 1 6 7 4 4 8 2 1 3 .. 1 0 1 1 5 6 0 1 110 7 17 2 2 4 1 1 2 2 1 3 .. .. 28 29 57 9 12 21 " 30 " 40 " 8 10 18 1 1 2 6 7 13 0 7 7 4 6 10 2 0 2 1 1 2 ] 0 1 0 2 2 1 1 2 5 7 12 1 3 4 1 0 1 .. .. 1 0 1 25 33 58 7 12 19 " 40 " 50 " 14 13 27 1 4 5 4 2 6 3 1 4 7 3 10 1 1 2 0 1 1 .. 3 3 611 29 11 20 4 1 54 1 51 1 2 .. .. 41 34 75 11 9 20 50 " 60 " 9 8 17 . 1 2 3 3 4 7 4 3 7 0 3 3 1 1 2 1 1 2 3 1 4 0 1 1 4 3 7 1 2 3 1 1 2 0 1 1 0 1 1 .. 23 20 43 5 12 17 " 60 " 70 " 6 1 7 .. 1 1 2 2 1 3 6 2 8 1 1 2 0 1 1 .. 1 0 1 .. 5 3 8 .. .. .. . . . . 19 8 27 3 2 5 " 70 " 80 " . 2 0 2 .. .. ] 0 1 2 0 2 .. .. .. .. .. .. .. .. .. .. .. 4 0 4 1 0 1 " 80 „ 90 „ .. 1 0 1 1 0 1.. .. 1 0 1 2 0 2 1 0 1 „ 90 „ 100 „ .. 1 0 1 .. •• •• •• - ■ ■■ •• •• •• ■• •• •• • ■ •• 10 1 Unknown .. ..303 .. .. •• 101 .. 01] .. .. .. .. .. .. .. 415 Transfers .. .. .. 20 0 20 .. 1 2 3 .. 167 .. 101 .. 21 3 .. 729 .. 123 .. 202 .. 35 13 48 Totals .. 53 43 9624 7 3117 14 31 11 23 3427 19 46 8 13 21 4 4 8 4 1 5 9 12 21 5 5 1034 32 66 15 12 27 8 3 11 4 5 9 0 1 1 3 0 3 152 128 280 74 66 140
Ages. Auckland. Christchurch. Dunedin (Seacliff). J Hokitika. Nelson. Porirua. Tokanui. J Total. M. F. T. M. F. T. M. F. T. M. F. T. M. F. T. M. F. T. M. F. T.' M. F. T. M. F. T. Under 5 years .. .. .. .. •• •• •• 101 .. .. .. 101 From 5 to 10 years .. .. .. •• •• ■■ •• 101 .. .. .. 101 TO 15 .. Oil .. 2 0 2 0 1 1 .. .. 2 2 4 ;; is;; 20 ;; :: :: :: 0 2 2 .. .. .. .. 022 .. .. 0 4 4 20 „ 30 „ 2 1 3 1 0 1 1 0 1 . . .. 4 5 9 .. .. 8 6 14 30 40 5 1 6 224 213 101 202 819 .. .. 20 5 25 " 40 " 50 " 1! 5 16 5 3 8 3 2 5 .. .. 14 2 16 Oil .. 33 13 46 " 50 " 60 " 4 7 11 11 0 11 9 4 13 .. .. 6 4 10 2 0 2 1 1 2 33 16 49 60 " 70 " 13 2 15 10 3 13 10 3 13 7 0 7 2 5 7 12 10 22 Oil .. 54 24 78 " 70 " 80 " ' 9 3 12 2 3 5 8 3 11 1 1 2 3 1 4 20 3 23 3 2 5 .. 46 16 62 80 " 90 " ' 437 224 437 .. .. 303 202 101 16 8 24 ;; 90" ioo " 1 o 1 ... 1 o 1 1 o 1 .. o 1 1 .. .. 314 Unknown .. .. .. .. 404 •• •• •• •• •• •• 404 Totals .. .. j 53 24 77 33 13 46 38 17 55 10 1 11 11 6 17 67 29 96 7 4 11 2 1 3 221 95 316
17
H.—7
Table VII. —Condition as to Marriage.
3—H. 7.
j I ; Admissions. Discharges. j Deaths. Auckland— m. it. t. m. f. t. m. f. t. Single .. .. .. .. .. .. 55 37 92 32 22 54 28 10 38 Married .. .. .. .. .. 46 48 94 23 25 48 21 10 31 Widowed .. .. .. .. .. 7 15 22 235 448 Unknown .. .. .. .. 1 1 Transfers .. .. .. .. .. 3 3 6 20 0 20 Totals.. .. .. .. .. 112 103 215 77 50 127 53 24 77 Cheistchubch— Single .. .. .. .. .. .. 40 32 72 17 16 33 10 5 15 Married .. .. .. .. .. 24 20 44 9 19 28 19 5 24 Widowed .. .. .. .. .. 235 101 437 Unknown Transfers .. .. .. .. .. 246 123 Totals .. .. .. .. .. 68 59 127 28 37 65 33 13 46 Dunedin (Seaoliff) — Single'.. .. .. .. .. .. 44 33 77 21 10 31 23 8 31 Married .. .. .. .. .. 25 26 51 11 14 25 9 7 16 Widowed .. .. .. .. .. 10 11 21 2 2 4 6 2 8 Unknown Transfers .. .. .. .. .. 101 167 Totals .. .. .. .. .. 80 70 150 35 32 67 38 17 55 Hokitika— Single .. .. .. .. .. .. 12 2 14 4 0 4 8 0 8 Married .. .. .. .. .. 5 16 145 Widowed .. .. .. .. .. 123 213 213 Unknown Transfers .. .. .. .. .. 101 101 Totals .. .. .. .. .. 19 5 24 8 5 13 10 1 11 Nelson— Single .. .. .. .. .. .. 25 5 30 7 3 10 6 1 7 Married .. .. .. .. .. 1 10 11 3 12 15 3 2 5 Widowed .. .. .. .. .. 202 213 235 Unknown Transfers .. .. .. .. .. 22 1 23 2 1 3 Totals.. .. .. .. .. 50 16 66. 14 17 31 11 6 17 POBIEIIA Single .. .. .. .. .. .. 69 44 113 26 18 44 30 11 47 Married .. .. .. .. .. 44 51 95 16 21 37 24 11 35 Widowed .. .. .. .. .. 13 17 30 0 3 3 7 7 14 Unknown .. .. .. .... Transfers .. .. .. .. .. 325 729 Totals.. .. .. .. .. 129 114 243 49 44 93 67 29 96 Tokanui — Single .. .. .. .. .. .. 10 6 16 8 2 10 2 2 4 Married .. .. .. .. .. 7 10 17 3 4 7 1 1 2 Widowed .. .. .. .. .. 112 .. 415 Unknown . Transfers .. .. .. .. .. 2 0 2 1 2 3 Totals .. .. .. .. .. 20 17 37 12 ' 8 20 7 4 11 ASHBTJKN 11 ALL — Single .. .. .. .. .. .. 123 01 1 Married .. .. .. .. .. 011 101 011 Widowed .. .. .. .. .. 101 .. 202 Unknown Transfers .. .. .. .. .. 134 202 Totals .. .. .. .. .. 369 314 213 Totals — Single.. .. .. .. .. .. 256 161 417 115 72 187 113 37 150 Married .. .. .. .. .. 152 167 319 67 99 166 77 37 114 Widowed .. .. .. .. .. 37 49 86 9 10 19 31 21 52 Unknown .. .. .. .. .. 101 Transfers .. .. .. .. .. 35 13 48 35 13 48 Totals .. .. .. .. .. 481 390 871 226 194 420 221 95 316
H.—7
18
Table IX.-Ages of Patients on 31st December, 1924.
Table VIII.-Native Countries.
Countries. Auckland.! Christchurch. Dune c iffl)! Sea " Hokitika. Nelson. Porirua. Tokanui. (Prfvate^H. 1 ). TotaL M Jf T. M. F. T. M. F. T. M. F. T. M. F. T. M. F. T. ! M. F. T. M. F. T. M. F. T. Frwland and Wales 119 76 195 76 94 170 96 56 152 30 9 39 18 10 28 148 86 234 36 13 49 4 2 6 527 346 873 SnH " 28 15 43 19 19 38 81 63 144 6 6 12 14 5 19 35 19 54 10 6 16 2 1 3 195 134 329 rrekirul " " " 54 43 97 31 33 64 48 45 93 24 10 34 9 3 12 50 50 100 13 15 28 .. 229 199 428 New TealfmH " " " 289 272 561 206 282 488 367 307 674 76 37 113 148 49 197 355 322 677 86 68 154 11 22 33 1,538 1,359 2,897 Wml^n States 43 21 64 13 11 24 19 22 41 14 1 15 9 5 14 32 21 53 7 3 10 0 2 2 137 86 223 France " 10 1 • • • • 10 110 1 . . . . . . 3 0 3 3 1 4 4 2 6 1 1 2 3 0 3 1 0 1 7 8 15 1 0 1 .. 20 12 32 AustHjT : 20 1 21 123 10 1 .. 202 11 2 202 .. 27 4 31 Norway " " ..3 1 4 .. 4 0 4 1 0 1 .. 3 1 4 1 0 1 .. 12 2 14 • '' 516303 3 0 3 5 0 5 202314 .. .. 21 2 23 Denmark " 2 0 2 2 1 3 2 1 3 .. 1 0 1 3 2 5 1 0 1 .. 11 4 15 i;, " 314 .. 303 1013 1 4101 .. 11 2 13 p. i 4 " " " 1 0 1 1 0 1 808 303 .. 10 1 .. .. 14 0 14 " " " 17 22 39 1 0 1 2 0 2 1 0 1 4 2 6 10 11 21 2 0 2 .. 37 35 72 Othercountries " 29 10 39 4 8 12 0 1 1 5 1 6 1 0 1 15 5 20 4 1 5 .. 58 26 84 Unknown " " .. 2 6 8 5 4 9 .. 26 37 63 „ .. 33 47 80 Tota]g .. .. 619 470 1,089 366 456 822 632 496 1,128 172 64 236 237 111348 666 528 1,194 164 106 270 17 27 44 2,873 2,258 5,131
I ! Ages. Auckland. Ohristohuroh. ' S6a ~ ! Hokitika. Nelson. Porlrua. Tokanui. (Private'lFH) Total. I ' M. F. T. M. F. T. M. F. T. ; M. F. T. M. F. T. M. F. T. M. F. T. M. F. T. M. F. T. From 1 to 5 year? .. .. .. 0 2 2 1 0 1 .. 9 1 10 0 2 2 .. .. 10 5 15 „ 5 „ 10 .. .. .. 0 1 1 1 6 7 2 1 3 | .. 29 3 32 0 10 10 .. .. 32 21 ' 53 ■„ 10 „ 15 .. .. 2 5 7:4 2 6 3 9 12 .. 28 4 32 0 14 14 .. .. 37 34 71 „ 15 „ 20 .. .. 10 8 18 i 6 9 15 27 10 37 3 2 5 20 3 23 11 5 16 I 1 0 1 .. 78 37 115 „ 20 „ 30 ,. .. .. 72 40 112 40 34 74 65 36 101 9 3 12 20 14 34 82 65 147 8 7 15 1 0 1 297 199 496 „ 30 „ 40 „ .. .. 124 97 221 66 71 137 111 90 201 .33 10 43 31 11 42 126 107 233 24 19 43 2 5 7 517 410 927 „ 40 „ 50 .. .. .. 154 122 276 ' 97 126 223 153 120 273 : 47 16 63 32 19 51 182 119 301 48 27 75 2 2 4 715 551 1,266 „ 50 „ 60 .. .. .. Ill 96 207 60 95 155 119 117 236 46 20 66 29 29 58 127 95 222 44 23 67 4 10 14 540 485 1,025 .. 60 „ 70 .. .. .. 93 58 151 43 70 113 80 65 145 17 5 22 26 13 39 80 67 147 24 18 42 7 6 13 370 302 672 „ 70 „ 80 .. .. .. 22 19 41 34 31 65 51 39 90 11 3 14 10 8 18 45 30 75 9 11 20 1 2 3 183 143 326 „ 80 „ 90 „ .. .. 11 7 18 13 8 21 12 6 18 6 5 11 3 3 6 12 12 24 1 1 2 0 2 2 58 44 102 Upwards of 90 vears .. .. .. 101 .. .. .. 112: .. .. 213 Unknown .. " .. .. 20 17 37 I 2 3 8 3 11 .. 0 3 3 0 1 1 5 0 5 .. 34 26 60 Totals .. .. .. 619 470 1,089 366 456 822 632 496 1,128, 172 64 236 237 111348 666 528 1,194 164 106 270 17 27 44 2,873 2,258 5,131 I I j |
H.—7
19
Table XI.-Length of Residence of Patients discharged "Recovered" during 1924.
Table X.-Length of Residence of Patients who died during 1924.
Length of Residence. Auckland. j Christchurch. (SeaelM? Hokitika. Nelson. Porlrua. Tokanui. (Privat e 1 M V i' } I Total. M. F. T. M. F. T. sr. If. T. M. P. T. M. F. T. M. F. T. M. F. T. M. F. T. M. F. T. Under 1 month .. .. .. .. 639 12 3 437 101 101 77 14 101 101 22 15 37 From 1 to 3 months .. .. .. 505 314 505 .. .. 516 .. 011 18 3 21 „ 3 „ 6 „ .. .. .. 5 1 6 1 0 1 2 1 3 .. 1 0 1 7 4 11 2 0 2 .. 18 6 24 „ 6 „ 9 „ .. .. .. 426 202 101 .. 011 101 .. .. 83 11 „ 9 „ 12 „ .. .. .. 4 2 6 .. 2 1 3 .. .. 3 2 5 1 0 1 .. 10 5 15 „ 1 „ 2 years .. .. .. 3 25 112 314 101 505)75 12 101 .. 21 9 30 „ 2 ., 3 .. .. .. 2 1 3 5 3 8 2 2 4 .. 3 0 3 9 1 10 .. .. 21 7 28 „ 3 „ 5 „ .. .. .. 235 718 202 .. 011 639 .. .. 17 8 25 „ 5 ,, 7 „ .. .. .. .. 30 3 213 .. 011 437 011 .. 9 6 15 „ 7 „ 10 „ .. .. .. 2 1 3 3 1 4 3 1 4 1 0 1 .. 3 0 3 .. .. 12 3 15 „ 10 „ 12 „ .. .. .. 4 2 6 1 0 1 .. .. .. .. 1 1 2 .. 6 3 9 „ 12 „ 15 „ .. .. .. 0 2 2 1 1 2 1 2 3 .. 0 1 1 6 0 6 0 2 2 .. 8 8 16 Overyears .. .. .. .. 14 5 19 5 3 8 11 5 16 7 1 8 1 2 3 8 2 10 .. 1 0 1 47 18 65 Died while absent on trial .. .. 202 .. .. .. .. 112 101 .. 415 Totals .. .. .. 53 24 77 33 13 46 38 17 55 10 1 11 11 6 17 67 29 96 7 4 11 2 1 3 221 95 316~~
Length of Eesidence. Auckland. Christchurcc. (Seaclfff" Hokitika. Nelson. Porirua. Tokanui. (Private 1 !?!! 1 ) Total. M. F. T. | M. F. T. | M. F. T. M. F. T. M. F. T. M. F. T. M. F. T. \ M. F. T. M. F. X. Under 1 month .. .. .. .. 6 6 12 .. 1 0 1 .. 033 .. .. .. 7 9 16 From 1 to 3 months .. .. ..|12 9 21 ! 4 2 6 73 10 202 224 235 101 .. 30 19 49 3 „ 6 „ .. .. 15 10 25 6 2 8, 5 6 11 1 0 1 4 2 6 5 4 9 2 3 5 0 1 1 38 28 66 6 „ 9 „ .. .. .. I 11 8 19 2 3 5! 4 6 10 1 0 1 1 4 5 9 8 17 3 0 3 .. 31 29 60 „ 9 „ 12 „ .. .. .. 325 1 34 437 0 2 2 .. 2 4 6 .. .. 10 14 24 1 „ 2 years .. .. .. 1 4 5 i 2 1 3 I 2 0 2 .. .. 9 6 15 1 0 1 .. 15 11 26 „ 2 „ 3 „ .. .. 213 202 202 .. 101 123 101 93 12 „ 3 „ 5 „ .. .. .. 325 033 202 011 1 01 426 .. .. 10 8 18 „ 5 „ 7 „ .. .. .. .. .. .. .. .. 0 2 2 .. .. 0 2 2 „ 7 „ 10 „ .. .. .. 0 11 .. .. .. .. 0 11 „ 10 „ 12 „ „ 12 „ 15 „ .. .. .. | .. .. 0 11 .. ! .. 10 1 .. .. 112 Over 15 years .. .. .. .. 011 .. .. .. 0 11 112 .. .. 134 Totals .. .. .. 53 43 96 17 14 31 27 19 46 4 4 8 | 9 12 21 34 32 66 8 3 11 0 1 1 152 128 280
H.—7.
Table XII. —Causes of Death.
20
! i i . : . Mi Causes ® J*i . e* 'S I I I I s I I 1 I |!« * < ['■"• 8 j I fill £ £ -Sfei I I. General Diseases. Tuberculosis — m. f. m. f. m. f. m. f. m. f. m. f. m. f. m. f. m. f. General .. .. .. .. 31 .. .. .. .. .. .. 3] Of lungs .. .. ..30 .. 21 .. .. 55 .. .. 10 6 Acute miliary .. ..21 .. .. .. .. .. .. .. 21 Diabetes .. .. ..20 .. .. .. .. .. .. .. 20 Carcinoma .. .. .. .. 231010 .. 40 .. .. 83 Influenza .. .. .. .. .1010 .. .. .. 01 .. 21 Anaemia (pernicious) .. .. .. 10 .. .. .. 10 .. .. 20 Measles .. .. .. .. .. .. .. 2 0 .. .. .. 2 0 Septicaemia .. .. .. .. .. .. .. 0 1 .. .. .. 0 1 Toxaemia .. .. .. .. .. .. .. .. 10 .. .. 10 Erysipelas .. .. .. .. .. .. .. .. 10 .. .. 10 II. Diseases of the Nervous System. Melancholia, exhaustion from .. .. 1012 .. .. .. .. .. 22 Mania, exhaustion from ..01 .. 02 .. .. .. .. .. 03 Paralysis agitans .. .. .. .. .. .. .. 10 .. .. 10 General paralysis of insane 4 0 10 0 4 0 .. 10 13 0 .. .. 32 0 Chronic brain disease .. 12 12' .. .. .. .. .. .. .. 12 12 Organic brain disease .. ..12 .. 10 .. .. 1220 .. 54 Cerebral haemorrhage .. ..1111 .. .. 2024 .. .. 6 6 Epilepsy .. .. ..10 3121 10 10 42 .. " 12 4 Huntingdon's chorea .. .. .. .. .. .. .. 10 .. .. 10 III. Diseases of the Respiratory System. Pneumonia .. .. ..102320 .. 1022 10 .. 95 Bronchitis .. .. .. .. j ' .. 10 .. .. .. 10 IV. Diseases of the Circulatory System. Heart-disease .. ..30 42 01 20 11 11 4 .. .. 21 8 Valvular disease of the heart ..22 .. 73 .. 02 .. 01 .. 98 Cerebral thrombosis .. .. .. .. .. .. .. .. .. 0101 V. Diseases of the Digestive System. Gastro enteritis .. .. .. .. .. .. 01 .. .. .. 01 VI. Diseases of the Genitourinary System. Blight's disease .. .. .. 10 .. .. .. .. .. .. 10 Nephritis .. .. .. .. .. .. .. .. 03 .. 1013 VII. Diseases of the Bones. Acute mastoiditis .. .. 10 .. .. .. .. .. .. .. 10 VIII. Diseases of the Skin. Senile gangrene .. .. .. .. .. .. .. 10 .. .. 10 IX. Old Age. Senile decay .. .. .. 17 5 3 2 17 7 6 1 2 1 17 4 3 2 1 0 66 22 X. External Causes. Suicide (fracture of skull) ..10 .. .. .. .. .. .. .. 10 XI. Ill-defined. Exhaustion .. .. .. .. .. .. .. .. 12 .. .. 12 XII. Died while on Trial ..2010 .. .. .. 1110 .. 51 Totals .. .. 53 24 33 13 38 17 10 1 11 6 67 29 7 4 2 1 221 95
H.—7
21
4—H. 7.
Table XIII. —Principal Assigned Causes of Insanity
„ I I I I Causes. Auckland, (Seacliff? Hokitika.j Nelson. Porirua. Tokanui. JT all Totals. M. F. M. F. M. F. M. F. M. F. M. F. M. F. M. F. M. F. Heredity .. .. .. 13 8 15 14 9 lfi 4 0 1 4 28 16 .. .. 70 58 Congenital . . .. . . 23 8 7 5 9 3 2 0 16 2 19 15 0 2 .. 76 35 Previous attack .. 6 17 6 9 6 16 .. 2 1 9 19 2 1 .. 31 63 Puberty or adolescence ..41 .. 51 01 1045 41 .. 18 9 Climacteric .. .. .. 0 11 05 08 .. 02 02 .. .. 0 28 Menstrual .. .. .. .. .. .. .. .. 05 .. .. 0 5 Sexual .. .. . 13 .. .. .. .. .. .. .. 13 Senility .. .. 18 10 6 3 16 10 7 1 1 1 23 10 2 2 .. 73 37 Lactation .. .. .. .. .. .. .. 010201 .. 04 Puerperal .. .. .. 04020 4 .. 020402 .. 0 18 Mental stress — Sudden .. .. ..84 .. 10 .. .. .. .. 019 5 Prolonged.. .. 0 12 1 1 6 4 .. .. 6 3 0 1 .. 13 21 Solitude .. .. .. .. .. .. .. .. 20 .. 20 Alcohol . . . . .9 1 4 1 11 2 2 0 .. 10 6 1 0 2 1 39 11 Syphilis .. ... . . 6 0 5 0 10 1 .. 1 0 17 3 .. .. 39 4 Drug habit .. .. .. 01 .. .. .. 1010 .. 21 Post-operative .. 02 .. .. .. .. .. .. .. 02 Traumatic .. .. ..3012 .. .. 1010 .. .. 62 Epilepsy .. .. 2 3 6 5 4 5 .. .. 6 2 .. .. 18 15 Arteriosclerosis .. ..40 .. .. .. .. 01 .. .. 41 Privation .. .. ..01 .. .. .. .. .. .. .. 01 Asthma .. .. 10 .. .. .. .. .. .. .. 10 Tuberculosis .. .. . 0111 .. .. .. .. .. .. 12 111 health .. .. 32 .. .. 01200910 .. 6 12 Diabetes .. .. . .. 10 .. .. .. 01 .. .. 11 Influenza .. .. .110 1 .. .. .. .. .. .. 12 Cancer .. . . .. 10 .. .. .. .. .. .. 10 Heart-disease .. .10 .. .. .. .. 02 .. .. 12 Toxic .. .. ..01 .. .. .. .. 11 .. .. 12 Cerebral hemorrhage .. 101010 .. .. 0110 .. 41 Organic brain -disease .. .. .. .. .. .. .. 03 11 .. 14 Meningitis .. .. .. .. 10 .. .. 11 .. .. 21 Emotional excitement .. 11.. .. 0 1 .. .. .. .. 12 Exophthalmic goitre .. . . .. 0 1 .. .. .. 0 1 .. 0 10 3 Encephalitis .. .. .. .. .. .. .. 10 .. .. .. 10 Unknown .. .. 4 9 11 4 .. 3 1 2 2 .. 3 6 .. 23 22 Transfers .. .. .. 3 3 2 4 1 0 1 0 22 1 3 2 2 0 1 3 35 13 Totals .. ..112 103 68 59 80 70 19 5 50 16 129 114 20 17 3 6 481 390
H.—7.
Table XIV.—Former Occupations of Patients admitted during 1924.
22
! wj tn I 5H S . 3 ■ fe .3 i ~ =3 ~ Occupations. j . S cc =2 Occupations. 2 02 "5 r° S ~ . ■ w ragrj . M 'S? J ■ !i P fl " S "3s9oaS-; s - La .a ® S S .s S ' 5 s SgoSoCgg's S 3 O © O O -5 P S |_j__gJ_QJ_a_Jg_S__g__j ■"lOQWKfcfH.SjB Males. Accountant .. 1 .. .. 1 Jeweller .. 1 .. 1 .. .. 1 Apprentice .. .. 1 1 Jockeys .. .. .. 1 ...... 1.. .. 2 Architect .. .. .. 1 1 Labourers .. .. 21 20 18 2 3 46 5 .. 115 Bakers .. .. .. 1 1 2 Laundrymen .. 2 2 Barman .. 1 1 Linesman .. 1 .. .. 1 Blacksmiths .. .. 2 1 I .. .. 4 Linotype operator .. ] .. .. ] Boilermaker .. .. .. 1 .... 1 Machinists .. 2 2 Bootmakers .. .. 2 2 1.... 5 Maoris .. .. 6 | 6 Builder .. 1 .. 1 Masons .. .. .. 2 2 Bushmen .. .. 2 .... 2.. 1.... 5 Meat-grader .. .. 1 j 1 Butchers .. 2 .... 2 Medical practitioners .. .. 1.. .. 1.. .. 1 3 Cable-operator .. 1 1 Merchants .. 2 .... 2 Carpenters .. .. 2 1 4.... 2 .... 9 Metal-worker .. .. 1 1 Carriers .. .. 1 1 1 .. .. 3 Mill hands .. 1 1.. 2 Civil Servants .. 1 2 2 1.. 6 Miners .. .. 1.. 2 4 7 Clergyman .. .. .. 1 1 Musician .. | .. 1 .. .. 1 Clerks .. .. 4.. 1.... 3.... 8 Orchardists .. .. 1.. 1 2 Commercial travellers .. 1 1.. .. 2 Painters .. .. 3 2 3 lj 9 Compositor .. 1 1 Pensioners .. .. .. 1 1 4.. 2 .... 8 Confectioner .. .. .. 1 1 Photographer.. .. 1 1 Contractor .. 1 1 Picture-framer 1 1 Cooks .. .. 2.. 1.... 2 .... 5 Plasterer .. .. 1 1 Cooper .. 1 1 Printer .. .. 1 1 Dealers .. 1 2 .... 3 Prisoners .. .. 5 5 Drivers .. .. 2 2 Rabbiter .. 1 1 Drover .. 1 .. .. 1 Salesman .. .. 1 1 Engineers .. .. 1.. 2.... 2 .... 5 Sawmiller .. 1 1 Factory employees .. 1 1 1.. .. 3 School-teachers 2 2 Farmers .. 18 9 6 1 4 14 7 .. 59 Seamen .. 2 .... 2 .... 4 Farm hands .. 4 1.. 5 Shepherds .. .. .. 2 2 Fireman .. 1 .. .. 1 Soldier .. 1 1 Fisherman .. 1 .. .. 1 Stewards .. 2 .... 2 Fishmonger .. 1 .. .. I Storekeepers .. .. .. 1 2 1.. 4 Fitters .. 1 .. .. I .... 2 Students .. .. .. 2 1.... 3 French-polisher 1 .. .. 1 Tailors .. . . .. I 1 .. .. ] .. .. 3 Gardeners .. .. 2 1 1 .... 1 I .. 6 Tea-blender .. .. .. 1 1 Grocers .. .. 2 1 1.. 4 Trader .. .. 1 1 Groom .. .. 1 1 Warehouseman 1 .. .. 1 Hairdressers .. 2 .... 2 No occupation .. 19 5 14 2 17 10 .... 67 Hawker .. 1 1 Unknown .. 1 1 Hotelkeepers .. .. .. 2 .... I 3 Transfers .. .. 3 2 1 1 22 3 2 1 35 Hotel assistants 21.. 1.... 4 — Indent agents.. .. 1 1 .. .. 2 Totals ,. 112 68 80 19 50129 20, 3 481 Inmates of special schools J .. .. 4 .. 4 Females. Civil Servant .. 1 1 Pensioners .. .. .. 1.. 1 2 Clerks .. 1 .. 2 .... 2 School-teachers .. 1 2 1.. 1 5 Domestic duties .. 80 43 65 4 12 94 12 2 317 Shop-assistant .. 1 1 Dressmakers .. .. 1 3 1 .. i ... .. 2.. 7 Student .. .. 1 1 Factory employee I .. 1 .. . . 1 Typist .. I .. .. 1 Maoris .. .. 4 j .. .. 1.. 5 No occupation .. 4 5 4.. 211 1.. 27 Milliner .. .. 1 j 1 Transfers .. .. 3 4.... 12.. 3 13 Mission worker .. 1 ! 1 - ! — Nurses .. .. 1 1....:.. 2 1.. 5 Totals .. 103! 59 70 5 16114 17 6 390
23
H.—7
Table XV.- Showing the Admissions, Discharges, and Deaths, with the Mean Annual Mortality and Proportion of Recoveries per Cent. of the Admissions, for each Year since 1st January, 1876.
1 I ' I j Discharged. Remaining, Average Numbers Percentage Percentage oi Deaths Year. \ Admitted. : : Died. 31st December in ) rSSrimt of Becoveries on on Average Numbers I -o „ , , , each Year. Admissions. resident. Recovered. Believed. Not Improved. M. F. T. M. F. T. M. F. T. M. ! F. T. M. F. T. M. I F. T. M. i F. T. M. F. T. M. F. T. 1875 .. j S 482 i 254 736 .. 1876 .. | 221 117 338 129 79 208 17 8 25 2 i 8 10 36 12 48 519' 264 783 491 257 748 54-53 66'01 57-56 8*21 3'58 6'70 1877 ..I 250 112 362 123 57 180 20 5 25 3 2 5 42 21 63 581 291 872 541! 277 818 49*20 50'80 49-72 7'76 7-58 7'70 1878 .. 247 131 378 121 68 189 14 14 28 4 4 8 51 17 68 638 319 957 601 303 904 48-98 51-90 50-00 8-48 5'61 7'52 1879 .. 248 151 399 112 76 188 15 13 28 9 4 13 55 16 71 695 361 1,056 666 337 1,003 45-16 50-33 47-11 8-25 4-74 7-07 1880 .. 229 T49 378 100 67 167 36 25 61 5 2 7 54 20 74 729 396j 1,125 703| 371 1,074 43-66 44-96 44-17 7*68 5-39 6-89 1881 .. 232 127 359 93 65 158 41 36 *77 9 2 11 49 14 63 769 406! 1,175 747 388 1,135 40-08 51-10 44-01 6-29 3-60 5-55 1882 .. 267 152 419 95 59 154 49 32 81 5 6 11 60 19 79 827 442! 1,269 796 ! 421 1,217 35-58 38-81 36-75 7-53 4-51 6-49 1883 .. 255 166 421 102 78 180 13 20 33 10 9 19 65 18 83 892 483! 1,375 860 475 1,335 40*00 46-98 42-75 7*55 3-78 6'21 1884 .. I 238 153 391 89 77 166 17 9 26 18 12 30 68 24 92 938. 514! 1,452 911 497 1,408 37'39 50'32 42-45 7*46 4-82 6'53 1885 .. . 246 133 379 95 76 171 10 5 15 25 2 27 73 22 95 981 r 542 1,523 965 528 1,493 38*62 57-14 45-12 7*56 4-16 6-36 1886 .. j 207 165 372 99 60 159 11 17 28 12 7 19 57 19 76 1,009 604 1,613 984 559 1,543 47*82 36-36 42*74 5*79 3*39 4*91 1887 .. j 255 161 416 103 78 181 34 17 51 74 27 101 1,053 643 1,696 1,034 613 1,647 40*39 48*75 43*61 7*15 4*40 6*13 1888 .. I 215 146 361 116 92 208 31 28 59 2 3 5 78 26 104 1,041 640 1,681 1,045 641 1,686 53*95 63*01 57*62 7*56 4*05 6-16 1889 .. 230 161 391 93 53 146 31 30 61 3 1 4 70 30 100 1,074 687 1,761 1,046 660 1,707 40-43 32*92 37*34 6*69 4*54 5*86 1890 .. ! 230 160 390 98 88 186 23 17 40 12 5 17 76 35 111 1,095 702 1,797 1,078 685 1,763 42*61 55*00 47*69 7*05 5-11 6-29 1891 .. 234 171 405 88 74 162 33 24 57 14 .. 14 79 41 I 120 1,115 734 1,849 1,089 699 1,789 37-61 43-27 40-00 7*25 5-86 6-71 1892 .. ! 231 158 389 89 76 165 21 17 38 8 2 10 74 34 108 1,154 763 1,917 1,125 714 1,839 38*53 48*10 42*42 6*58 4*76 5*87 1893 .. 281 179 460 101 89 190 17 12 29 10 8 18 78 23 | 101 1,229 810 2,039 1,172 758 1,930 35*94 49*72 41*30 6*66 3*03 5*23 1894 .. 270 176 446 107 76 183 15 11 26 5 4 9 64 35 j 99 1,308 860 2,168 1,241 812 2,053 39*63 43*13 41*03 5*16 4*31 4*82 1895 ,. ! 252 165 417 105 77 182 24 19 43 1 2 3 101 42 ! 143 1,329 885 2,214 1,313 849 2,162 41*67 46*66 43*64 7*69 4*94 6*61 1896 ..I 278 159 437 104 70 174 25 16 41 2 1 3 86 32 118 1,390 925 2,315 1,347 882 2,229 37*41 44*02 39*13 6*38 3*63 5*29 1897 .. 284 193 477 102 73 175 17 12 29 10 . • 10 105 43 148 1,440 990 2,430 1,411 944 2,355 35*92 37*82 36*69 7*44 4-55 6'28 1898 .. 254 212 466 114 110 224 13 23 '36 7 1 8 88 60 148 1,472 1,008 2,480 1,438 973 2,411 44-88 51-89 48-07 6-12 6-17 6-14 1899 .. 259 199 458 88 99 187 15 19 34 2 1 3 114 43 157 1,512 1,045 2,557 1,487 1,004 2,491 33*98 49*49 40*83 7*67 4*28 6*30 1900 .. 300 202 502 103 96 199 29 10 39 4 4 99 46 145 1,581 1,091 2,672 1,534 1,049 2,583 34*33 47*54 39*64 6*45 4*38 5*61 1901 .. j 320 223 543 125 104 229 20 17 37 2 2 102 72 174 1,654 1,119 2,773 1,622 1,094 2,716 39*06 46*64 42*17 6*29 6*58 6*41 1902 ..I 352 192 544 135 99 234 26 15 41 10 9 19 120 55 175 1,715 1,133 2,848 1,671 1,114 2,785 38*35 51*56 43*01 7*18 4*94 6*28 1903 .. j 355 226 581 144 101 245 26 24 50 2 2 129 44 173 1,771 1,188 2,959 1,741 1,160 2,901 40*56 44*69 42*17 7*41 3*79 5*96 1904 .. 332 236 568 157 106 263 24 11 35 1 1 120 70 190 1,801 1,237 3,038 1,780 1,198 2,978 47*59 44*91 46*30 6*74 5*84 6*38 1905 .. 360 251 611 149 121 270 29 24 53 147 67 214 1,836 1,276 3,112 1,796 1,232 3,028 41*39 48*21 44*19 8*18 5*44 7-07 1906 .. 395 264 659 157 126 283 28 22 50 1 1 146 85 231 1,900 1,306 3,206 1,823 1,265 3,088 39-75 47'73 42-94 8'01 6-71 7-48 1907 .. 359 241 600 160 139 299 22 13 35 168 64 232 1,909 1,331 3,240 1,851 1,285 3,136 44-29 57-68 49'84 9-08 4-98 7*39 1908 .. 426 318 744 180 146 326 9 12 21 1 .. 1 148 74 222 1,997 1,417 3,414 1,894 1,346 3,240 42*25 45*91 43*82 7*81 5*50 6*85 1909 .. 419 297 716 179 170 349 17 11 28 1 1 136 68 204 2,083 1,465 3,548 1,970 1,404 3,374 42*72 57*24 48*74 6*90 4*84 6*00 1910 .. 474 314 788 182 145 327 29 27 56 .. .. .. 186 97 283 2,160 1,510 3,670 2,028 1,445 3,473 38*40 46*18 41*50 9*17 6-71 8-15 1911 .. 448 317 765 163 168 331 23 16 39 4 2 6 198 105 303 2,220 1,536 3,756 2,105 1,496 3,601 36*38 53*00 43*27 9*41 7*02 8*41 1912 .. 458 381 839 184 141 325 17 44 61 11 5 16 193 87 280 2,273 1,640 3,913 2,146 1,551 3,697 40*17 37*01 38*74 8*99 5*61 7*57 1913 .. 466 318 784 175 162 337 35 48 83 1 5 6 196 111 307 2,332 1,632 3,964 2,252 1,597 3,849 37*55 50-94 42-98 8-70 6*96 7*98 1914 .. 509 359 868 207 162 369 27 29 56 6 9 15 193 88 281 2,408 1,703 4,111 2,309 1,641 3,950 40-67 45-12 42-51 8-36 5-36 7-11 1915 .. 450 361 811 202 157 359 26 32 58 10 11 21 172 112 284 2,448 1,752 4,200 2,391 1,703 4,094 44-89 43-21 44-88 7'19 6'58 6*94 1916 .. 518 361 879 160 171 331 ! 35 34 69 7 8 15 209 80 289 2,555 1,820 4,375 2,483 1,768 4,251 30*89 47*37 37*66 8*42 4*52 6*80 1917 .. 470 374 [ 844 171 152 323 j 32 20 52 6 5 11 205 113 ! 318 2,611 1,904 4,515 2,543 1,825 4,368 36*38 40*64 38*27 8*06 6*19 7*28 1918 .. 437 402! 839 142 141 283 17 36 53 12 12 24 274 174 448 2,603 1,943 4,546{ 2,602 1,89914,501 32*49 35*07 33 73 10*53 9*16 9*95 1919 .. 512 371 ! 883 190 147 337 37 44 81 9 13 22 212 130 342 2,667 1,980 4,647} 2,620 l,907i 4,527 37*11 39*62 38*17 8*09 6*82 7*55 1920 .. 455 418 I 873 162 148 310 27 37 64 6 10 16 210 166 376 2,717 2,037 4,754 2,674 1,980! 4,654 35*63 35*32 35*51 7*85 8*40 8*08 1921 ■ 479 402 881 178 193 371 30 21 51 15 9 24 201 117 318 2,772 2,099 4,871 2,723 2,031 4,754 37*23 47*88 42*11 7*38 5*76 6*69 1922 .. 453 386 839 156 157 313 32 20 52 10 8 18 211 184 395 2,816 2,116 4,932 2,747 2,06214,809 34*44 40-67 37*31 7-67 8-92 8-21 1923 ..: 442 366 808 168 151 319 42 38 80 15 5 20 194 131 325 2,839 2,157 4,996 2,789 2,079; 4,868 38-00 41-25 39-48 6'95 6.30 6.67 1924 ..; 446 377 823 152 128 280 30 42 72 9 11 20 221 95 316 2,873 2,258 5,131 2,808 2,146(4,953 34-08 33*95 34-02 7*87 4*42 6*37 16,548 11,753 28,301 6,547 5,348 11,895 1,211 1,076 2,287 312 217 529 6,087 3,108 9,195 ' ■ ■ . . 1 ■ ■ Excluding transfers between institutions —1,395 males, 993 females.
H.—7
24
Table XVI. —Showing the Admissions, Discharges, and Deaths from Ist January, 1876, to 31st December, 1924 (excluding Transfers). M. F. T. In hospitals, 31st December, 1875 .. .. .. .. 482 254 736 Admissions .. .. .. .. .. .. .. 16,548 11,753 28,301 17,030 12,007 29,037 Discharged— M. F. T. Recovered .. .. .. 6,547 5,348 11,895 Relieved .. .. .. 1,211 1,076 2,287 Not improved .. .. .. 312 217 529 Died .. .. .. .. 6,087 3,108 9,195 14,157 9,749 23,906 Remaining on 31st December, 1924 .. .. 2,873 2,258 5,131
Table XVII. —Summary of Total Admissions: Percentage of Cases since the Year 1876.
Males. Females. Both Sexes. Recovered . • .. . • • • • • 38-44 44-55 40-96 Relieved . . . . . • • • • 7-11 8-96 7-87 Not improved .. . . . . ■ • 1-83 1-80 1-82 Died .. .. .. .. .. • • 35-74 25-88 31-67 Remaining . . • • . • 16-88 18-81 17-68 100-00 100-00 100-00
25
11. 7.
Table XVIII.-Expenditure for Year ended 31st March, 1925.
Auckland. Chiistchurch. Hokitlka. Nelson. i'orirua. Tokanui. Head Office. Totals. £ s. d. £ s. d. £ s. d. £ s. d. £ s. d. £ s, d. £ s. d. £ s. d. £ s. d. Salaries .. .. .. .. .. .. 25,527 6 7 32,183 2 6 47,026 13 10 13,667 1111 14,067 11 6 38,819 10 3 12,703 7 4 4,737 3 11 188,732 7 10 Official Visitors .. .. .. .. .. 50 8 0 12 12 0 46 4 0 14 14 0 .. .. .. 2 2 0 126 0 0 Advertising, photographs, books, &c. .. .. 23 14 4 17 8 4 18 15 9 35 10 3 7 17 0 7 15 4 8 5 7 12 10 7 131 17 2 Bacteriological research .. .. .. .. .. .. 100 160 .. .. .. .. 260 Bedding and clothing .. .. .. .. 4,486 13 9 3,11115 4 6,150 6 7 939 13 10 1,527 10 11 5,393 7 11 920 11 5 .. 22,529 19 9 Buildings, including additions, &c. .. .. .. 483 13 2 344 8 4 1,101 5 2 408 10 9 89 1 1 1,036 2 8 318 6 3 .. 3,781 7 5 Compassionate allowance to ex-nurse .. .. .. .. 60 0 0 .. .. • • • • • - 60 0 0 Dental services .. .. .. .. .. 19 4 6 200 0 0 9 18 0 69 3 0 5 4 0 15 3 6 .. .. 318 13 0 Developmental work, &c. .. .. .. .. .. .. .. .. .. .. 934 0 0 .. 934 0 0 Farms, maintenance of .. .. . . .. 966 12 11 2,373 7 11 5,743 19 4 423 10 10 1,454 0 3 2,210 5 2 3,135 0 2 .. 16,306 16 7 Fencing, draining, and reading .. .. .. j 12 17 10 59 9 6 313 3 6 43 2 5 64 16 8 260 0 10 91 13 2 .. 845 3 11 Freight, cartage, and transport charges .. .. j 1 10 1 81 10 0 359 3 11 151 10 1 171 9 7 226 1 9 .. • .. 991 5 5 Fuel, light, power, water, &c. .. .. .. j 4,735 2 7 4,481 0 5 5,396 10 6 587 7 1 1,669 1 10 3,919 7 8 1,457 1 7 .. 22,245 11 8 Funerals, expenses of .. .. .. .. 114 7 0 44 0 0 30 0 0 5 5 0 61 15 0 73 12 9 20 13 0 .. 349 12 9 Furniture and fittings .. .. .. . . 93 14 6 141 6 10 160 12 10 68 13 7 69 7 0 73 12 4 71 17 0 .. 679 4 1 Gardens and shrubberies, expenses of .. . . 15 4 4 100 4 10 37 13 3 4 18 0 69 14 2 36 3 7 9 8 5 .. 273 6 7 Grant to Inspector-General .. .. . . .. .. .. .. .. .. .. .. 500 0 0 500 0 0 Laundry .. .. .. .. .. .. 566 6 1 845 6 11 1,900 5 7 940 4 8 169 13 0 587 4 11 214 18 6 .. 5,223 19 8 Law-costs .. .. .. .. .. 13 19 0 15 19 3 .. .. 1 1 0 7 13 10 .. .. 38 13 1 Machinery, repairs, and stores .. .. .. 87 13 5 234 1 7 184 2 3 15 17 4 34 6 9 193 6 5 206 15 9 .. 956 3 6 Maintenance fees overpaid, refund of .. .. 1 8 0 21 0 0 .. • • .. .. . • • • 22 8 0 Medical fees for certificates, &c. .. .. .. 574 3 6 343 10 0 303 11 6 68 7 0 69 3 0 534 1 0 67 13 0 .. 1,960 9 0 Motor-vehicles, purchase of .. .. .. .. .. .. .. .. .. 803 15 11 .. .. 803 15 11 Motor-vehicles, maintenance of .. .. .. .. 35 17 6 87 13 11 73 8 9 94 15 0 56 15 8 14 18 9 .. 363 9 7 Nursing staffEngagement of .. .. .. .. .. .. .. .. .. 0 8 0 14 16 0 0 7 6 .. 15 11 6 Uniforms, purchase of .. .. .. .. 473 11 6 387 14 7 141 12 3 194 19 8 155 14 11 461 16 7 141 15 10 .. 1,957 5 4 Office equipment .. .. .. .. .. 1 8 0 10 18 6 20 1 3 2 9 1 0 4 0 •• 115 10 7 150 11 5 Patients, expenses connected with — Gratuities .. .. .. .. . . 133 2 8 37 16 4 364 9 2 13 9 2 83 7 6 56 18 4 17 4 6 .. 706 7 8 " Patients' Friends" .. .. .. .. .. 100 0 0 100 0 0 .. .. .. .. •• 200 0 0 Recreation .. .. .. .. .. 992 1 4 1,434 14 1 2,022 19 10 507 18 3 463 6 9 1,536 5 6 476 4 11 .. 7,433 10 8 Transfer .. .. .. .. .. 85 3 5 6 15 1 8 16 8 20 8 1 12 10 0 93 18 8 10 13 9 .. 238 5 8 Payment of life-insurance premium (patient) .. .. . . .. .. .. .. 14 0 0 ■ ■ • • 14 0 0 Postage, telegrams, &c. .. .. .. .. 59 16 4 53 19 4 84 8 7 19 7 7 24 4 4 88 7 0 26 It) 3 140 0 10 496 14 3 Printing and stationery .. .. .. .. 103 14 6 165 13 2 139 1 9 49 18 3 57 13 4 172 16 8 39 3 7 112 12 1 840 13 4 Rations .. .. .. .. .. .. 17,06118 7 14,20116 8 19,572 7 2 3,993 19 1 4,340 16 2 16,741 3 2 2,05110 7 .. 77,963 11 5 Rents and rates .. .. .. .. .. .. 2,736 5 11 173 13 9 .. .. .. .. •• 2,909 19 8 Repatriation of two mental patients .. .. .. .. 99 11 6 .. .. 91 7 7 .. .. ■ • 190 19 1 Stores ' . .. .. .. .. .. 842 2 0 850 0 9 830 4 1 232' 17 6 441 15 6 679' 3 11 206 8 11 .. 4,082 12 8 Surgery and dispensary — Drugs and instruments .. .. .. .. 131 11 0 158 15 10 89 3 10 114 15 7 51 12 5 167 18 3 18 17 1 7 12 6 740 6 6 Wine, spirits, ale, and porter .. .. .. 25 7 0 .. 19 18 8 22 5 4 2 15 0 7 17 0 .. •• 78 3 0 Telephone services, &c. .. .. .. .. 47 8 1 67 9 6 163 2 0 20 10 2 40 12 9 97 8 4 44 9 5 57 16 11 538 17 2 Transfer and removal expenses .. .. .. 13 18 11 .. .. 2 14 3 39 2 6 .. .. 55 15 8 Travelling allowances and expenses .. .. .. 98 15 2 ! Ill 10 7 180 15 3 50 16 9 96 11 8 68 13 0 171 8 6 346 3 4 1,124 14 3 Treatment and maintenance in general hospitals — Patients .. .. .. .. .. .. 13 0 0 .. .. 1 .. 21 17 0 j 5 5 0 .. 40 2 0 Staff •• •• •• .. .. .. 2 0 6 96 16 0 10 16 0 ; 13 10 0 3 4 6 I 2 0 6 .. 128 7 6 Contingencies, including unforeseen expenditure, &c. .. 0 15 0 6 9 6 27 16 6 .. j' ' .. 14 12 6 5 8 0 .. 55 1 6 Total expenditure .. .. .. .. 57,844 13 1 I 65,090 13 1 92,966 6 8 22,775 19 3 ! 25,542 0 2 74,494 17 11 1 23,391 18 3 6,031 12 9 368,138 1 2 Credits .. .. .. .. .. 21,473 4 6:26,274 14 2 29,575 0 11 3,435 9 4 8,933 7 11 27,585 1 7 6,52119 0 7 15 10 123,806 13 3 Net expenditure .. .. .. .. 36,371 8 7 ; 38,815 18 11 63,391 5 9 19,340 9 11 ! 16,608 12 3 46,909 16 4 16,869 19 3 6,023 16 11 244,331 7 11
H.—7.
Table XVIIIa-Showing Details of Credits.
26
Credits. Auckland. ' Christchnrch. D and < W!iitatn' ff Hokitika. I Nelson. Porirua. | Tokanui. Head Office. Totals. £ s. d. | £ s. d. £ s. d. £ s. d. J £ s. d. i £ s. d. j £ s. d. £ s. d. £ s. d. Receipts for maintenance .. .. 19,951 9 8 I 19,467 4 2 22,842 11 8 1,965 3 11 j 6,518 19 3 : 24,190 0 9 [ 3,152 12 0 .. 98,088 1 5 Receipts for farm .. .. .. 662 14 0 3,904 12 1 2,547 5 0 81 19 5 1,829 4 6 ! 1,619 15 5 I 2,861 8 10 .. 13,506 19 3 Miscellaneous .. .. .. 859 0 10 | 2,902 17 11 4,185 4 3 1,388 6 0 j 585 4 2 1,775 5 5 507 18 2 7 15 10 12,211 12 7 Totals .. .. .. 21,473 4 6 i 26,274 14 2 29,575 0 11 3,435 9 4 ; 8,933 7 11 j 27,585 1 7 j 6,521 19 0 7 15 10 123,806 13 3 Table XIX. —Avebage Cost of each Patient pee Annum. Necessaries, "Rpmv Average Bedding Buildings Fuel, Light, Surgery Wines, Incidentals, Total Cost othprTfp Net Cost Net Cost Decrease Increase Mental Hospital. Number Salaries. and and Farm. Water, and Provisions. and Spirits, Ale, and per Main " per previous in in resident. Clothing. Repairs. Cleaning. Dispensary, and Porter. Miscel- Patient. fonon " Iy ! Patient. Year. 1924-25. 1924-25. i laneous. tenance. ~ — I : , j 7 7 ; j £ s. d. £ s. d. £ s. d. £ s. d. £ s. d. i £ s. d. £ s. d. £ s. d. £ s. d. £ s. d. £ d. s. £ s. d. £ s. d. £ s. d. £ s. d. £ s. d. Auckland .. .. 1,089 23 9 9 4 2 5 0 8 10$ 0 17 9 j 4 6 11$ 15 13 4 0 2 5 0 0 5$ 4 0 4$ 53 2 4 18 6 5 1 7 11 33 8 0 34 1 11$ 0 13 11$ Christchurch .. I 828 39 0 1 3 15 2 0 8 4 2 17 4 5 8 3 I 17 3 0$ 0 3 10 .. 9 16 2$ 78 12 2f 23 10 2$; 8 4 5$ 46 17 7 51 15 0$ 4 17 5| Dunedin (Seaciiff) ..1,129 41 15 8 5 8 11$ 0 19 6 5 1 9 4 15 7 17 6 8} 0 1 7 0 0 4$ 6 16 9 82 6 10$ 20 4 7jJ 5 19 3$ 56 2 11$ 62 0 8 5 17 8$ Hokitika .. .. 232 58 19 6$ 4 0 8 1 15 2$ 1 16 6$ 2 10 7$ 17 4 7$ 0 9 lOf 0 1 11$ 11 4 5$ 98 3 5$ 8 9 5 I 6 6 9 83 7 3$ 81 2 8 .. 2 4 7$ Nelson .. .. 351 40 1 6| 4 7 0$ 0 5 1 4 2 10$ 4 15 1$ 12 7 3 0 2 11$ 0 0 If 6 13 4J 72 15 4$ 18 11 5$j 6 17 7 47 6 4 52 13 4$ 5 7 0$ Porirua .. .. 1,158 33 10 5$ 4 13 If 0 17 11 1 18 2$ 3 7 8$ 14 9 1$ 0 2 10J 0 0 1$ 5 7 Of 64 6 7$ 20 17 9$j 2 18 7$ 40 10 2$ 42 11 9 2 1 6f Tokanui .. .. 269 47 4 5f 3 8 5$ 1 3 8 15 2 6$ 5 8 4 7 12 6$; 0 1 4f .. 6 17 9$ 86 19 2 11 14 4} 12 10 6 62 14 3$ 65 13 11 2 19 7f Averages .. 5,056 37 9 10 4 9 l$j 0 14 11$ 3 4 6 j 4 8 0 i 15 8 5 | 0 2 10$ 0 0 3$ 6 18 3 72 16 3 19 8 0 5 1 9 48 6 6 50 5 11$ 1 19 5$ Table XIXa. £ s. d. £ s. d. £ s. d. £ s. d. £ s. d. ■ £ s. d. £ s. d. s. d. £ s. d. £ s. d. £ s. d. £ s. d. £ s. d. £ s. d. £ s. d. £ s. d. Including Head Office | .. j . . .. .. j .. .. .. .. 74 0 lji .. .. 49 10 4 j 51 6 6 1 16 2 charges in Table j xviii i ; :
H.—7.
Table XXI.-Total Expenditure, out of Public Works Fund for Building and Equipment at each Hospital from 1st July, 1877, to 31st March, 1925.
Table XX.-Expenditure, out of Public Works Fund, on Mental Hospital Buildings, etc., during the Financial Year ended 31st March, 1925, and Liabilities at that Date.
Approximate Cost of Paper.—Preparation not given ; printing 625 copies), £49 12s. 6d.
By Authority: W. A. G. Skinner, Government Printer, Wellington.— 1925.
Price 9d .]
27
Date. Mpntnl HnsnitalK Net Expenditure for Tear Liabilities mental iiospitais. en(Jea fflgt Marchi 1925 on 31st Marchj 1925i £ £ Auckland .. .. .. .. .. .. 2,393 81 Christchurch (Sunnyside) .. .. .. .. .. 6,272 350 Hokitika.. .. .. .. .. .. 16,013 1,443 Nelson .. .. .. .. .. .. 2,389 79 Porirua .. .. .. .. .. .. .. 18,374 1,771 Seacliff .. .. .. .. .. .. .. 3,016 45 Stoke .. .. .. .. .. .. .. 3,905 778 Tokanui .. .. .. .. .. .. .. 16,076 1,270 Totals.. .. .. .. .. 68,438 5,817
| I j Total _ Mental Hospitals, 1877-1916. 1916-17. j 1917-18. 1918-19. 1919-20. 1920-21. 1921-22. 1922-23. | 1923-24. 1924-25. Ne £,® to 31st March, 1925, £ £ £ £ £ £ £ £ £ £ £ Auckland .. .. .. .. 144,348 76 1,048 1,171 543 8,040 9,013 777 5,188 2,393 172,597 Reoeption-house at Auckland .. .. 5,059 .. .. .. .. .. .. .. .. .. 5,059 Christchureh (Sunnyside) .. .. 149,613 24,346 7,647 1,238 2,490 5,139 3,494 2,245 1,497 6,272 203,981 Dunedin (The Gamp) .. .. .. 4,891 .. .. .. .. .. .. .. 4,891 Hokitika .. .. .. .. 3,727 .. .. .. .. .. 984 4,789 10,216 16,013 35,729 Hornby .. .. .. .. .. .. .. .. 7,370 928 2,682 122 .. .. 11,102 Motuihi Island .. .. .. .. 561 .. .. .. .. .. .. .. .. .. 561 Napier .. .. .. .. .. 147 .. .. .. .. .. .. .. • • • • 147 Nelson .. .. .. .. .. 23,512 1,798 535 200 208 3,496 3,316 1,929 1,429 2,389 38,812 Richmond .. .. .. .. 1,097 .. .. .. .. .. .. .. •• •• 1,097 Seaclifi .. .. .. .. 179,070 997 597 966 2,069 40 3,389 1,602 1,246 3,016 192,992 Stoke .. .. .. .. .. .. .. .. .. .. .. .. 337 1,450 3,095 5,692 Tokanui .. .. .. .. 56,297 5,639 6,188 8,105 4,111 5,381 9,774 515 2,743 16,076 114,829 Waitati .. .. .. .. 8,325 24 88 498 848 3,620 3,217 848 194 .. 17,662 Wellington .. .. .. .. 29,641 .. .. .. .. .. .. .. .. .. 29,641 Wellington (Porirua) .. .. .. 181,216 11,722 10,399 2,462 638 724 5,969 688 2,578 18,374 234,770 Totals .. .. .. .. 787,504 44,602 26,502 14,640 18,277 27,368 41,833 13,852 26,541 68,438 1,069,562
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https://paperspast.natlib.govt.nz/parliamentary/AJHR1925-I.2.3.4.8
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MENTAL HOSPITALS OF THE DOMINION (REPORT ON) FOR 1924., Appendix to the Journals of the House of Representatives, 1925 Session I, H-07
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20,874MENTAL HOSPITALS OF THE DOMINION (REPORT ON) FOR 1924. Appendix to the Journals of the House of Representatives, 1925 Session I, H-07
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