MENTAL HOSPITALS OF THE DOMINION (REPORT ON) FOR 1935.

Appendix to the Journals of the House of Representatives, 1936 Session I, H-07

H.—7.

1936. NEW ZEALAND.

MENTAL HOSPITALS OF THE DOMINION (REPORT ON) FOR 1935.

Presented to both Houses of the General Assembly pursuant to Section 78 of the Mental Defectives Act, 1911.

The Director-General to the Hon. P. Fraser, Minister in Charge of the Department of Mental Hospitals. Sir, — Wellington, Ist June, 1936. I have the honour to present my annual report upon the work of the Department of Mental Hospitals for the year ending 31st December, 1935. At the end of the year there were 8,046 persons upon the registers of the mental hospitals of the Dominion, including 40 patients and boarders at Ashburn Hall Private Licensed Institution and 716 patients and boarders who were out on probation in the care of relatives and friends. In actual residence in Government institutions, there were 7,290 persons at the end of the year, an increase of 66 over the figure for the previous year, and of this number 6,975 were detained under a Magistrate's reception order, whilst 315 were under treatment as voluntary boarders at their own request. The total number of first admissions, including voluntary boarders, was 1,128 as against 1,049 for last year, an increase of 79, and 253 former patients and boarders sought readmission. We were able to discharge 647 patients and boarders during the year, or 46-85 per cent., calculated upon the admissions, but of these only 520 or 37-65 per cent, could be regarded as recovered, the remainder only being sufficiently well to live outside under some degree of supervision. The deaths during the year totalled 435 or 6-11 per cent, of the average number resident. In the result our mental hospital population increased to the extent of 232 inmates during the year. State of Accommodation. For many years most of our hospitals have been overcrowded, in some instances seriously so, and attention has been frequently called to the shortage of accommodation, but no effective long-range building programme has ever been evolved to meet the inevitable increase in our population. We have had to do our best with the annual appropriations from the Public Works Fund, but even when these appropriations have appeared to be sufficient for immediate needs, it has been found most difficult to get the money spent within the financial year, owing to the time occupied in drawing plans, calling for and accepting tenders, &c. The results of not building to meet our annual increase in numbers, are, of course, cumulative, and the position at the time of writing is that we have 935 patients in excess of proper accommodation. The extent and distribution of the overcrowding is set out in the following tables (compiled in May, 1936) : — (A) Accommodation. (B) Number of patients and boarders resident, I—H. 7,

2

Table A. Accommodation available.

Table B. Number of Patients and Boarders.

In addition to the 935 patients already surplus to our accommodation, we may anticipate an increase for the current year of about 250, so that there would normally be an excesS of 1,185 patients at the end of next year. To meet this, we have twelve villas being built at the various hospitals with a total accommodation for 600 men and women, so that the shortage will be reduced to 585 beds —a more favourable position than has existed for some years. Survey of the requirements at each Hospital. Auckland. —In 1925, following upon much public uneasiness in regard to conditions at Auckland, the Government of the day undertook to remove this institution within ten years, and to accommodate the patients in a new hospital to be erected near Papakura. The present position is that the new institution —Kingseat —has already 441 patients, whilst at Auckland there are 1,294, or 132 more than in 1927, when the land at Kingseat was acquired. I am quite definitely not in favour of vacating the Auckland institution, even if such a course were feasible. Since 1927, conditions at the institution have been greatly improved, and there is not now any public demand for its removal, nor, in my opinion, any justification for such a step. The facilities at Auckland for the treatment of recent and recoverable cases are excellent. Kingseat (near Papakura).—This property was acquired in 1927, since when eight villas and farm buildings have been erected. Towards the end of last year, tenders were let for four additional villas, and by December next the population of Kingseat will be about 640 patients. The main store is in the course of erection, and we hope to begin the laundry, the hospital admission ward, and administration block at an early date. I estimate that two villas a year in addition to the gradual erection of administrative units and officers' houses will meet the needs of the Auckland Province for some years. Tokanui.—Tokanui is, I think, a very badly planned institution so far as the main building is concerned, but there are three good female villas and one male, plus two in course of erection. The site of the main building was badly chosen, and there is little room for expansion in its neighbourhood, but I think that we should erect a hospital admission block and a number of villas at some distance from the present institution and dedicate them to recent and recoverable cases. The time is approaching when a good deal of reconstruction must take place at Tokanui to provide better laundry, entertainment, and administrative facilities. Overcrowding is not a serious problem at Tokanui,

2

I j Mental Hospital. Male. j Female. Total. • Deficiency, j Surplus. : I j Auckland .. .. .. 628 559 1,187 107 Kingseat .. .. .. 248 200 448 .. 7 Tokanui .. .. .. 285 279 564 16 Porirua .. .. .. 710 574 1,284 319 Christclmrch .. .. 604 492 1,096 266 Nelson .. .. .. 466 199 665 25 Hokitika .. .. .. 234 194 428 .. 17 Seacliff .. .. .. 543 461 1,004 226 Totals .. .. 3,718 | 2,958 6,676 959 24 Net deficiency—935.

Resident. Mental Hospital. Total. On Register. Probation Male. Female. Auckland .. .. 704 590 1,294 1,414 120 Kingseat .. .. 242 199 441 452 11 Tokanui .. .. .. 313 267 580 630 50 Porirua .. .. .. 896 707 1,603 1,700 97 Christcliurch .. .. 703 659 1,362 1,502 140 Nelson .. .. .. 484 206 690 720 30 Hokitika .. .. 225 186 411 419 8 Seacliff .. .. .. 711 519 1,230 1,273 43 Totals .. .. 4,278 3,333 7,611 8,110 499

H.—7

Porirua. —It would be quite undesirable to erect more buildings at Porirua, where there are 1,603 patients, with shortage of accommodation for 186 males and 133 females. The land at Porirua is generally of very poor quality, and we have difficulty even now in producing sufficient vegetables and milk for our needs. The time is long overdue when a new institution should be built somewhere in the Marton area to receive patients from the Taranaki and Hawke's Bay areas and the northern part of the Wellington Province, reserving Porirua as a metropolitan mental hospital. It must be borne in mind that Porirua was built for a population of about 500, or less than a third of its present population, and that in addition to mere lack of bed space, we have to cope with bakehouse, laundry, stores, dining-halls, and kitchens which are quite insufficient for present-day requirements. I am glad to report that the plans for new stores, kitchen, and boiler-house are nearing completion, and that many administrative difficulties at Porirua will soon be of the past. Christchurch. —Besides the main hospital at Christchurcli we have two entirely detached institutions, Hornby Lodge (for recent and recoverable cases) about three miles from the city and Templeton Farm Colony about five miles distant. Overcrowding does not affect these auxiliary institutions, but in the main institution there is a deficiency of accommodation equivalent to 266 patients. We have so far kept the numbers down by transferring patients to Hokitika, but the space there for further building is very limited, and another institution is needed in the South Island to take the growing surplus from Christchurch and Seacliff. Seacliff. —Overcrowding at Seaclifl has been accentuated, by the fact that part of the institution was originally built upon moving ground, and the effect of the movement upon the female side —about 8 ft. in thirty-five years —has been so pronounced that one wing has had to be evacuated and is now being demolished. Another wing is involved and cannot much longer be used for patients. Our excess population is 226, of whom 168 are males and 58 females. We have until now had an outlet at Waitati Auxiliary—about seven miles distant, but possibilities in this direction are exhausted. Between Seaclifl and Christchurch, we have, overcrowding to the extent of 492 patients, or the equivalent of ten villas in a new modern mental hospital, which should be built in the Timaru-Oamaru area. The most pressing need at Seacliff is an admission hospital, and plans have been prepared for additions and alterations to Clifton House, So as to adapt it for this purpose. Hokitika. —This institution is not overcrowded and is never likely to be, as direct admissions from the West Coast are few in number. The institution has for many years been used- to relieve the larger places, but it has almost reached its limit. There is room for three more villas to accommodate about 150 patients. A certain rearrangement of the administrative offices is necessary. Nelson. —There are two institutions in Nelson —the old mental hospital in the city —which was built in 1874 of timber —and Ngawhatu, near Stoke, about five miles distant. We acquired Ngawhatu from the Department of Education in 1923 in order to erect a villa mental hospital and to begin the separation of the mental patients proper from the congenitally defective children, who have since been housed in the old city building. Ngawhatu is a good villa hospital, but the classification could be vastly improved by the erection of two male " closed" villas for the accommodation of our worst cases, who are now housed in the main building, which is quite unsuited for this purpose. The main building could then be remodelled so as to provide entertainment-hall, stores, offices, and assistant medical officer's quarters. There is no great pressure on our space at Nelson. Consideration must soon be given to the policy to be pursued in regard to the old institution in Nelson. The buildings are sixty-two years old and are almost beyond the stage of being further preserved. We must shortly decide to rebuild on the site or to go elsewhere. Alterations, Additions, and Improvements. Capital expenditure on new buildings, additions, and improvements effected during the year amounted to £69,858 16s. and the following summary shows the principal items making up the total; — Auckland (£307). Improvements were made in the fire-fighting service and a new boiler was installed. A grant was made towards building the library. Kingseat (£21,973). Four new villas were completed and occupied during the year and a commencement has been made with four others. Two residences have been completed—one for a medical officer and one for a chief clerk. A commencement was made with the building of the main store. Road-making, sewerage construction, lighting, and drainage have all been carried forward.

3

H.—7

Tokanui (£12,682). One new villa has been completed and two otters are in course of erection. A complete reorganization of the sewerage system has been carried out. Ngawhatu (£18,307). The new laundry and boiler-house were completed, and three new villas for females were erected. Hokitika (£2,739). Two new villas were completed and a commencement was made with the erection of another. Christchurch (£12,397). Two new villas were completed ; a new kitchen was installed in the Reception House ; and a new granary was built. At Templeton Farm Colony, a new villa was completed for adult males and another one for juveniles; a tennis - court was constructed for ,the use of the staff; . a new water-tower was erected to serve the needs of the adult section of the colony. Seacliff (£1,453). Additions were made to the Nurses' Home and to the boiler-house ; a new shower-room was added to the male side ; and a commencement was made with the demolition of an unsafe part of the main building. Clinics. The clinics held by our medical officers at the general hospitals continue to do good work, and during the year we have tentatively extended the work to Palmerston North, at the request of the local medical men. This clinic will be held once a month in the meantime. During the year, 305 new cases were seen at Auckland, 163 at Wellington, 134 at Dunedin, and 39 at Invercargill. The Medical Superintendents of Seacliff and Porirua have been appointed to the honorary staffs of Dunedin and Wellington hospitals, respectively, to take charge of psychiatric cases, and I am satisfied that the co-operative and progressive spirit thus shown by the Boards concerned will be of great assistance to the clinics in carrying out their function in giving assistance to early and recoverable cases. I trust that the Auckland and Canterbury Boards will soon come into line. Medical Superintendents' Confer,ence. After an interval of some years, a conference of medical superintendents took place recently in Wellington, and your attendance and encouraging address were greatly appreciated by all present. Whilst the agenda paper contained many matters of great interest which stimulated full, frank, and most helpful discussions, I can refer here to only two of them : — Staff Working Hours. It was agreed that the hours worked by our nurses and attendants are too long, and that some scheme be devised which would give more time for staff relaxation and at the same time, if possible, gain advantages for the patients committed to our care. With your concurrence one of our head attendants is co-operating with the Secretary of the Public Service Association to formulate a plan acceptable to every one concerned. The matter is rather complex, involving as it does the matter of increased accommodation for the extra staff required ; but as there is an entire agreement as to principles, I hope in the near future to be in a position to submit concrete proposals. Supervision of Cooking and Distribution of Food. 1 am satisfied beyond any doubt as to the excellent quality and the sufficient quantity of the meals provided in our mental hospitals, but that there is room for improvement in the general supervision of the kitchen and the distribution of the food was the opinion held by all the superintendents. This distribution is relatively a simple matter in the new villa hospitals, where we are doing away with central kitchens and cooking and dining small numbers in the villas as in a private house, but in the larger institutions serving over a thousand patients and staff, the supervision of the kitchen and distribution of meals is a task which can no longer be regarded as one of the matron's subsidiary duties. This is a full-time occupation, which could only be done efficiently by a highly trained competent woman, who should receive a good salary. Appreciation. In conclusion, I desire to acknowledge the unfailing loyalty and generous support which I have received at all times from my colleague, Dr. John Russell, the medical superintendents, and the other officers of the service. To Mr. Sinclair, Chief Clerk, and the head office staff I return my thanks for good work carried out during the year. I have, &c., Theo. G. Gray.

4

H.—7.

MEDICAL SUPERINTENDENTS' REPORTS.

AUCKLAND MENTAL HOSPITAL. Db. Buchanan reports : — I have the honour to present my annual report for the year ended 31st December, 1935. The total number of cases under care during the year was 1,576, with a weekly average of 1,170. The admissions numbered 303 (145 males, 158 females). Of this number, 223 were admitted for the first time. Under section Bof the Mental Defectives Amendment Act, 165 patients were admitted. Ninety-four voluntary boarders were admitted during the year, making a total of 212 under care, and of these 82 were discharged. At the end of the year 186 patients were on probation, 140 on full parole, and 198 on limited parole. Generally the health of the patients has been good throughout the year. Deaths totalled 110 (54 males, 56 females). The hospital was honoured by the visit of His Excellency the Governor-General on the Bth July. I left Auckland in April to take up six months' temporary duty at Porirua. Dr. B. D. Hart took my place as Superintendent during this period. The actual constructive work carried out has been small; most of our energies have been directed towards maintenance. The new hot-water supply and additional boiler-capacity were completed and now give satisfaction. A library has been built on to the bowling-green pavilion,, and promises to be a bright and interesting centre for parole patients. Extra covered cow-bails were built on to the byres, and provided much desired shelter during inclement weather. On the male side the increasing number of recent cases and convalescents is taxing our accommodation the utmost. The admission ward, Wolfe Home, and hospital wards are generally full. The admission of new patients frequently requires a lot of juggling among these wards in an endeavour to prevent long-period recoverable cases (such as mild melancholia, of whom we have many) being sent into main building wards. Unfortunately, we cannot- always prevent this. Existing main building wards are not altogether suitable for such patients. I hope to put forward concrete proposals to you for an additional observation ward. It is a difficult question to solve without entailing new building, but it may be possible to transform a part of the auxiliary building into such a ward. This will necessitate increased staff, which, I think, under the circumstances would be justifiable. A separate institution for children now seems indicated. As you are aware, many parents living around and in Auckland are averse to sending their children to Nelson or Templeton. We have, in consequence, a growing number of defective children in our several wards who would be better segregated. Such a ward may be made available when the next lot of female patients is transferred to the new villas at Kingseat, now under construction. Criminal inmates and dangerous patients are yet another problem, and I hope that your recommendation for the separation of these cases will bear fruit. The Psychiatric Clinic remains a very active centre. The relative figures are : Tuesdays. Total. (1) Number of separate persons seen .. M. 235 56 291 F. 36 36 72 271 92 363 (2) Number of — («) First visits .. .. .. .. 234 71 305 (b) Subsequent consultations .. .. 676 653 1,329 910 724 1,634 (3) Sources of reference Tuesdays. Thursdays. Pensions Department .. .. .. 191 12 203 Medical practitioners .. .. ..52 61 113 Voluntary calls.. .. .. ..9 19 28 Prisons Department .. .. ..16 .. 10 Psychological Clinic .. .. 2 .. 2 Porirua Mental Hospital .. 1 ~ i 271 92 363 .(4) of the 363 persons who attended the clinic, 13 became voluntary boarders and 10 were committed to the Mental Hospital. Of the 13 voluntary boarders, 2 were discharged " recovered," 7 " relieved," and 1 died. Of the 10 committed cases, 1 was discharged on probation. Monthly visits were paid to the Inebriates' Homes on Rotoroa and Pakatoa Islands. The annual picnic, unfortunately, had to be cancelled owing to stormy weather. In its place a special entertainment was held in the institution, which all seemed to enjoy thoroughly.

5

H.—7

The Official Visitors paid many visits, and took a live interest in the patients' condition and welfare. The Mental Hospital Branch of the Auckland Hospital Auxiliary has been active throughout the year. A library has now been established, for which my thanks are due chiefly to the ladies of the branch and to Mr. Hooker, who maintains his interest in the supply of reading-matter for the patients. Many varied entertainments for patients were held during the year, and I wish to thank all concerned for their kind assistance. Mr. Sinclair, our head clerk, left us in April in order to take up duties as Chief Clerk at Head Office. All our best wishes go to him in his promotion. I desire to express my appreciation for the great help tendered to me by medical officers, the matron, the clerk, the head attendant, and all the staff.

KINGSEAT MENTAL HOSPITAL. Dr. Buchanan reports : — I have the honour to submit my annual report for the year ended 31st December, 1935. The total number of cases under care during the year was 470 (260 males, 210 females), with a weekly average of 397. Three voluntary boarders were admitted during the year. At the end of the year 13 patients (8 males, 5 females) were on probation, and 5 patients (2 males, 3 females) were finally discharged. Deaths totalled 6 (4 males, 2 females). This year, like the preceding years, has been one of continuous activity. Not only has there been Public Works construction carried out, but steady work has gone on in laying out and improving the grounds. Villas 11 and 14 were completed and occupied in April, and at the end of the year excavations had been commenced for the construction of four additional buildings. Two residences are well on the way to completion and should be ready for use at the end of January, 1936. Additional tennis-courts were built, and are used by both the patients and the staff. A canteen has been erected, and proved itself to be a convenient and useful adjunct. Electric street lighting was installed, thus facilitating the work of the night staff. The old farm cottage, which has been used as quarters for patients, was renovated and made suitable for the accommodation of the Farm Overseer. The careful and painstaking work put into the design and building of the main drive has well justified the time and trouble expended on it. It looks spacious and dignified, and will be a fit setting for the new mental hospital. There is still much planting to be done, and though we are raising much stock in the nurseries, I am asking for a grant to enable us to purchase special decorative shelter trees, &c. The time, I think,, has come for the engagement of an all-time orchardist and gardener. The orchard consists of five hundred trees which are coming rapidly into profit. Skilled and constant attention is becoming necessary if we are to reap full benefit from these. Another necessary appointment now, is that of an artisan, capable of attending to the many requirements of maintenance, &c. With the increasing size of the institution there is enough work to keep him fully occupied. The patients on the whole are happy and contented. They can be fully occupied by constructive work in the grounds, gardening, laundry, and sewing. Their amusements have not been neglected — football, tennis, and cricket being provided for them. I am most grateful to the following people, who have done mu'ch for the entertainment of the patients : — Misa McArthur, of Pukekohe, who generously provided greatly appreciated concerts. The Pukekohe Municipal Band for their delightful recitals. The Divisions of the Women Farmers' Union of Waiuku and Pukeoware for their most acceptable Christmas gifts. The Auckland Hospital Auxiliary for regular donations for the benefit of the patients. The several local branches of the Returned Soldiers' Association for looking after ex-soldier patients. Finally, I wish to thank the matron, head attendant, and all the staff for their very helpful and encouraging services.

TOKANUI MENTAL HOSPITAL. Dr. Prins reports : — I have the honour to submit my annual report for the year ending 31st December, 1935. The total number of cases under care has been 684, with a weekly average of 574. Admissions were 78 (male 44, female 34), 65 of these (male 39, female 26) being admitted for the first time. The general health of the hospital has been good, except for an outbreak of influenza m August, when a large number of patients and staff were ill for a few days.

6

H.—7

Deaths numbered 32 (males 18, females 14), senile decay being the principal cause. Forty cases were discharged, 29 (male 12 and female 17) being recovered, 6 taken out by relatives, and 5 were transferred. Voluntary boarders under treatment numbered 14 men and 6 women, 7 being new admissions. Six men were discharged recovered. No major works have been completed during the year. At present the sewerage system is being renewed, a digester built, and parts of the water-main from Te Awamutu are being replaced. A new refrigerating plant has been installed, and two new villas are in course of construction. The painting gang has been at work throughout the year. The usual recreations —tennis, bowls, cricket, swimming, &c. —have been carried on, and for the second year in succession the hospital team won the district championship at table tennis. The weekly talking-picture entertainment is much appreciated. The Te Awamutu Band have given several enjoyable recitals and Mr. Findlay, Official Visitor, has brought several excellent concert parties. The various church services have been regularly held. One attendant and five nurses passed the senior examination. In conclusion I have to express my thanks to all the staff for their co-operation and help during the year.

PORIRUA MENTAL HOSPITAL. Dr. Hart reports : — I have the honour to submit my annual report for the year ending 31st December, 1935. The total number of persons under care during the year was 2,054, of whom 1,827 were committed patients, 215 voluntary boarders, and 12 were remanded for observation. Admissions number 389 —295 under certification and 94 as voluntary boarders. During the year 79 voluntary boarders and 84 patients under certification were discharged, and an additional 88 patients following treatment were sufficiently improved to go on probation to the care of relatives or friends. Deaths number 107, and 86 patients were transferred to other hospitals. The Psychiatric Clinic at the Wellington Public Hospital continues to function satisfactorily. Consultations and attendances for treatment numbered 694, and of these 163 were new cases. As additional equipment a vibrator was purchased for the physio-therapy department at Rauta. As an adjunct to psycho-therapy this unit with its trained staff and equipment provides for massage, light therapy, radiant heat, exercises and organized recreations, and has been of very material help in the treatment of recent and recoverable cases. Porirua has the largest resident population of our hospitals, and one feels that the stage has now been reached when the erection and equipment of a modern laboratory and the addition of a trained pathologist to the medical staff can be considered as a necessary and justifiable expenditure. This hospital, being centrally situated, as well as carrying out our own X-ray, bacteriological and pathological examinations, a considerable proportion of the laboratory work for the other mental hospitals in New Zealand could conveniently be undertaken. This unit would provide opportunities for research, greatly assist in investigation of that ever-important relationship between mental and physical disorders, and place this hospital on an equal footing with the more modern and advanced pyschiatric hospitals of overseas. Patient accommodation during the year was somewhat relieved by the transfer of 65 patients to the new villas at Kingseat, but the accommodation is still overtaxed to the extent of 185 men and 124 women. The office and store accommodation has for some time been very unsatisfactory. Plans have been prepared for a reorganization of the administration block and the erection of a new store. When completed the new facilities should allow for an efficient administration of this section of the hospital. The kitchen in the main building has to cook for approximately one thousand persons, and one of the more urgent needs is a new or an enlarged kitchen with the addition of modern appliances to cope efficiently with this task. The steam-boilers at the main building will have to be replaced within a year if the cooking, laundry, and central-heating facilities are to be maintained at a reasonable level of efficiency. No major structural changes to buildings have been undertaken during the year, but the artisan staff have been constantly employed at maintenance work and at minor alterations and improvements to existing buildings. Some of the latter were alterations to the hot-water service in M. 8, extension of urinals in M. 7, renewal of slates, roofs (main building), renovations of six staff cottages and renovations to roofs of five villas. The farm returns for the year were satisfactory, but the absence of sufficient land for herd grazing makes it impossible for the farm to supply the hospital the whole year round with milk. Additional acreage has been set aside for vegetable growing. The water catchment area was fenced and some 12,000 trees were planted in the high country. Patients' recreation has been well provided for in the way of golf, tennis, concerts, fortnightly dances, and weekly cinema. I am indebted to many people and certain societies for their contribution of books and magazines to the library, donations of money and goods to the Christmas Fund. The Rev. Mr. Harding continues to visit frequently, and his enthusiasm and untiring efforts in arranging concerts, picnics, and the donation of wireless sets are much appreciated by all. The official visitors have visited frequently during the year. In conclusion I must thank all the staff for their assistance in the work of the hospital,

7

H.—7

NELSON MENTAL HOSPITAL. Dr. Williams reports : — I have the honour to present my annual report for the year ending 31st December, 1935. The total number of persons under care during the year was 792, of whom 33 were voluntary boarders. Sixty-nine patients were admitted, 16 were discharged, 21 were transferred to other institutions, whilst 29 died. Twenty patients were admitted under section Bof the 1928 Amendment Act. The health of the patients generally was satisfactory, though there was the usual fairly large amount of sickness amongst the children during the winter and spring months. No serious accidents occurred. The number of deaths (29) was larger than that of the previous year, but it is to be noted that 11 of these were due purely to senile causes. During the past year, the construction of two new female villas was commenced, and this work is nearing completion. The contract has been let for a sixth female villa. The laundry and powerhouse have been completed, and have been in full working order for the latter half of the year. The laundry is proving most efficient, and the amount of work done and the quality of this is infinitely better than under the conditions obtaining with the old laundry. The power-house, which is in operation for the full twenty-four hours daily, and provides the power for laundry and generates all the electricity required for Ngawhatu, is proving also most efficient and the quality of the light is very much better than that supplied previously. There are ample reserves of power and electricity for any future contingencies. A good deal of roading work has been carried out and is continuing, as is the case with the layingout of the grounds in Yorks Valley. The painting party has been very busy, and much work has been done in the wards generally, more particularly at Nelson, and with pleasing results. The sun-porch in male ward at Nelson has been glassed in. A tentative plan of building at Ngawhatu for the coming year has been proposed and should this be carried out as outlined the conditions then obtaining should challenge favourable comparison with those at any mental hospital. The erection, in addition, of another villa for male workers is the only further necessity I can suggest at Ngawhatu. Anti-flv measures have been carried out with some considerable measure of success. The usual activities have proceeded on the farm, vegetable gardens, and orchards, and returns generally have been considerably improved. An experimental tobacco-crop has been planted, but it is somewhat early to prognose results. The white butterfly has made its appearance, but arrangements have been made to secure parasites to combat this pest. The patients have been reasonably well catered for in the matter of recreation and amusements generally, and it is situation and difficulty of transport only which limit activities at all in this direction. The installation of a talking-machine at Ngawhatu would undoubtedly entertain many more than is at present possible, and in addition a very considerable saving would be made in cost of transport and admittance fees. My thanks are due to many individuals, business firms, and societies in Nelson for their continued support and interest, and for donations of money and goods for recreation purposes. Miss Cooksey and her party have been particularly good, and the Sunshine Fund organized by Mrs. Scantlebury for the provision of picnics for the children has been even more than usually successful this year. _ To the Official Visitors, to the visiting Ministers of Religion, and to the staff generally, for their co-operation and assistance during the year, I also wish to express my thanks.

HOKITIKA MENTAL HOSPITAL. Dr. Childs reports I have the honour to present my annual report for the year ended 31st December, 1935. At the beginning of the year the patients on the register numbered 427. The admissions proper for the year were 28, while 8 male patients were received on transfer. The discharges numbered 15, transfers to other hospitals 6, and deaths 24. The total number under treatment during the year was 463, the number remaining on the register at the end of the year being 418. There were 4 voluntary boarders on the register at the beginning of the year, and during the year 5 were admitted and 3 discharged. Except for two epidemics of influenza, one rather severe, the health of most of the patients has been good, the majority of the deaths being due to senility. A modern residence has been erected for the head attendant. A new morgue and a new tool-shed have been built, and the old morgue dismantled, while a new villa for female patients is in the course of construction. The usual routine of farming operations have been carried out; fourteen acres of land have been cleared and left fallow, and main drains cut so that future land can be taken in. Ten acres of last year's fallow land have been grassed, while the grounds around Porere have been drained, levelled, and lawns laid down. The vegetable-garden has also been increased considerably. The painting gang has been continuously employed throughout the year, and the usual maintenance work carried on. A monthly clinic has been held at Greymouth, and visits have been paid to the Westland Hospital.

8

H.—7

The usual games and recreations have been carried on, and again the Hokitika Municipal Band has made many visits, playing at most of the dances. Thanks are also due to others who have visited the hospital to entertain the patients, and to those who made gifts at Christmas time. The clergy have made frequent visits during the year, and I would also thank the Official Visitors for their support. I desire to thank the staff for their assistance during the year.

CHRISTCHURCH MENTAL HOSPITAL, Dr. McKillop reports :— I have the honour to forward my report for the year ending 31st December, 1935. On the Ist January, 1935, there were 1,310 patients on the register. During the year, 244 patients were admitted, 69 were discharged, and 17 were transferred to other institutions. At the end of the year, 1,411 patients were on the register, inclusive of 95 males and 102 females who were absent on probation, and 3 males and 1 female on escape. The number of voluntary boarders who received treatment was 107 of whom 43 were discharged, 3 were committed, and 2 died ; 59 remaining for further treatment. The general health of the patients has been very good. There were 57 deaths, more than half being the result of old age. It is interesting to note that there were only two deaths from general paralysis, which has been responsible in the past for a considerably higher percentage. The progressive decrease in the death-rate from this disease can be considered due to two reasons (a) the advance in treatment of the disease itself, and (b) the regulations now in force for the treatment of the causal agent. The increase in the number of admissions is more apparent than real, and is due to the opening of new villas at Jenkins's Farm and at Templeton. The provision of the villa at Jenkins's has enabled us to transfer many young men there, and the villa is fully occupied. The inmates do very useful work on the farm and in the gardens. Workshops are in the course of erection, and when completed will afford opportunity for training lads in congenial trades. Contracts have been let for two further villas there, and boys on reaching adolescence will be transferred from Templeton Farm School —the adjoining property. I cannot speak too highly of the work of Miss Findlay, Matron, at Templeton and Jenkins's, and of the staff under her control. At Sunnyside, the new kitchen at the Reception House has been completed : work is about to be commenced to ensure a satisfactory water-supply, and provision has been made to build a new bathhouse. General maintenance work has been carried out by the artisan staff, and several wards have been renovated. We have had a very good year on. the farm, and prospects for the present harvest are much above the average. The patients' recreation has been carried out on the usual lines. Many concert parties have visited the institution, and I have to thank them and the companies who have supplied picture programmes throughout the year. Mr. Acland, District Inspector, and the Official Visitors — Mrs. Williams and Mr. Hanna—• have visited the institution at frequent intervals and have 'taken their usual keen interest in the welfare of the patients. I have to thank Drs. Lewis, Bellringer, and Couston for the great help they have given me. Mr. Thomas and the office staff, the matrons, head attendants, and other heads of departments have given very efficient service, and I thank them and the staff as a whole for the manner in which the work of the hospital has been carried out.

SEACLIFF MENTAL HOSPITAL. Dr. Hates reports : — I have the honour to present my annual report for the year ended 31st December, 1935. The total number of patients under care during the year was 1,352 (760 male, 592 female). Of these 112 were first admissions, 19 readmissions, and 3 transfers, the admission totalling 134 (76 male, 58 female). Discharges were 50 (31 male, 19 female), of which 24 were " recovered " and 9 were transfers. There were 66 deaths (32 male, 34 female), the principal assigned cause of death being senile decay. Voluntary boarders under care numbered 84 (46 male, 38 female) of whom 43 (24 male, 19 female) were admitted during the year. The number of voluntary boarders discharged was 42 (22 male, 20 female), of whom 20 were " recovered." There were 4 voluntary boarders committed, and 7 died. At the beginning of the year there were 1,218 patients and 41 boarders, and at the end 1,236 patients and 31 boarders. Overcrowding, despite the reduction of 11 in the resident population, is still evident to the extent of 197 (138 males, and 59 females). A new wing has been added to the Nurses' Home providing accommodation for 21 nurses and dining accommodation for junior and charge nurses. Various maintenance works have been attended to, and new coal and coke bunkers provided for Seaclif! and Waitati respectively. At the end of the year a new shower bathroom for the male side was started, and it will be a welcome and needed 2—H. 7.

9

H.—7

addition to the bathing facilities. Alterations to the hot-water service and dormitory accommodation of the female cottage were in progress, now enabling this unit to deal more effectively with new admissions. The Dunedin Clinic continues bi-weekly, and about the same number of new cases were seen this year as last. The details are : — Source : Wards, 81 ; practitioners, 30 ; spontaneous, 7 ; otherwise, 16 : Total, 134. Disposal : Committed, 27 ; voluntary boarders, 15 ; treated and discharged, 39 ; referred to other hospitals or institutions, 5 ; report or opinion supplied, 28 ; advice not followed, 11 ; under treatment at end of year, 9 : Total, 134. Classification: G.P.I, and cerebral syphilis, 6 ; organic dementias, 8 ; other organic mental disorders, 16 ; adolescent instability, 2 ; hysteria, 22 ; schizophrenia, 18; paranoid states, 4; anxiety states, 16 ; manic depressive insanity, 7 ; reactive depression, 7 ; involutional melancholia, 6 ; congenital mental defect, 11 ; other conditions, 11 : Total, 134. These figures are for new cases only. The Invercargill Clinic has been conducted by Dr. Brown, who submits the following figures : New cases numbered 39, of whom 7 were recommended by practitioners, and 4 were from the Eiverton Hospital, the remainder being seen in Southland Hospital. Of these 39 cases, 6 were committed, and 1 admitted as a voluntary boarder. There were four cases under treatment at the end of the year. A number of cases on probation in the Southland district also were glad to attend the clinic during their period of trial. While the clinics perform useful functions in treating the neurotics and inducing mild psychotics to seek mental-hospital treatment early, there is a definite difficulty in treating these cases at Seacliff. I refer to the insufficient suitable accommodation for recoverable male admissions. Clifton House with 13 beds caters for perhaps half of such cases, but it could be enlarged to accommodate twice that number, as well as a number of convalescents. Such a proposal is contemplated for next year. Another difficulty is the number of dangerous male criminal cases of all types. It is inevitable in these circumstances that the custodial aspect of the nursing duties receives undue emphasis. When your proposed separate institution for dangerous defectives removes such cases from this hospital, then considerable improvements in the treatment, particularly with regard to airing court conditions, could be effected. Concerts have been given to the patients by the Justices of the Peace, Royal Male Choir, and other bodies, to whom we are deeply indebted. I have also to thank the visiting clergy for their interestin the institution, and also the Official Visitor, Mr. Louden. Mr. Cummings, the the Patient's Friend, has visited the hospital- during the year, and his long association with both staff and patients is reflected in the appreciation of his visits. The Patients' and Prisoners' Aid Society, whose activities form a very useful link between hospital and community, has performed much useful work for us, including assisting patients when discharged, arranging probations, and also in providing entertainment for the hospital generally. The Society's Agent and Chaplain, Mr. A. Steven, pays a weekly visit and also conducts religious services as well. I must express our thanks, both patients' and staff, to this society for the services rendered through its chaplain. I have to thank my colleagues for their loyal co-operation during the year. In February Dr. Hay was transferred from Auckland, and so terminated a period of short staffing during which Dr. Brown and Dr. Bowell carried out many extra duties willingly. In conclusion, I wish to thank the matrons, head attendants, the various executive officers, and the staff generally, for their work and loyal support during the year.

STATISTICAL. The patients on the register at the end of the year numbered 7,687 (m. 4,282, f. 3,405), or 254 (m. 149, f. 105) more than at the beginning ; and the daily average under treatment during the year was 7,114 (m. 4,003, f. 3,111), or 176 (m. 104, f. 72) more than in the previous year ; while the total under care was 8,502. Patients belonging to the Native race numbered 118 (in. 75, f. 43) at the end of the year. The admissions numbered 1,069 (m. 567, f. 502), or 86 more than in the previous year. Of these 158 had been previously under care, making the proportion of readmissions 14-78 per cent., and 911 patients were admitted for the first time. The ratio to population of all admissions (exclusive of Maoris) was 7-07 (m ; 7-34, f. 6-79) to 10,000, and of first admissions 6-03 (m. 648, f. 5-55), so that 1,413 persons in the general population contributed one patient, and 1,660 contributed a patient admitted for the first time. The discharges (excluding transfers) numbered 380, or 16 less than in 1934. 127 (or 9 less) harmless unrecovered persons were returned to the care of friends ; and 253 (m. 1.17, f. 136) recovered — 7 less than last year —representing a percentage of 23-67 (m. 20-63, f. 27-09) on the total admitted. With voluntary boarders added the percentage rises to 36-49. Altogether, 47 per cent, of the inmates admitted were able to leave institutional care. Of a total of 8,502 patients under care, 435 (m. 229, f. 206) died, or 6-11 per cent, on the average number resident. An inquest is held in the case of every death, whatever the cause. The causes are detailed in Table VI, and the following is the percentage of causes mainly contributing : Senile decay, 28-97 ; diseases of the brain and nervous system group, 22-53 ; heart-disease, 17-41 ; tuberculosis, 4-14. In Table YII 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 any one cause in any one year cannot be assumed to be our average incidence. Causation is always complex,

10

H.—7

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 .. .. .. .. .. 11-64 7-17 9-54 Congenital .. .. .. .. .. 20-46 10*96 16-00 Predisposed by previous attack .. .. 10-41 13-15 11-70 Critical periods .. .. .. 10-23 20-12 14-88 Child-bearing (puerperal, non-septic, and lactation) .. 3-78 1-78 Mental stress .. .. .. .. 14-81 21-12 17-77 Toxic, including— m. f. Syphilis 3-88 i-oo\ Alcohol .. .. .. 2-82 0-20/ 74:1 17y 477 Traumatic .. . . . . . . . . 0-35 . . 0-18 Disorder of nervous system, including — m. f. Epilepsy .. .. .. 4-94 5-58 7-23 6-57 6-92 Other bodily afiections . .. .. 6-17 2-59 4-49 Senility .. .. .. .. 11-29 12-75 11-97 100-00 100-00 100-00

Voluntary Boarders.

It will be noted that there were 312 voluntary admissions in the year under review, that 267 were discharged, and that 38 boarders, representing 12 -18 per cent, of the admissions, 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 oil average number of resident was 7-63 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 average daily number of voluntary boarders in 1935 was 380.

MENTAL NURSES. In December the usual examination was held for the registration of mental nurses, when the following passed : — Passed top for Dominion : Nurse M. A. McFarlane (CJhristchurch). Auckland : Attendants —K. J. Brown, F. L. Irving, T. J. R. Trotter. Nurses —11. M. Hunter, M. E. Little,* I. K. 0. Lowe, I. P. Milton, D. Thomas, I. P. Tliomasen, C. E. Young. Te Awamutu: Attendant—C. E. Shanaghan. Nurses—A. G. Goddard, J. M. Gray, I. D. Haining, J. R. MacKenzie, H. P. Nicoll. Porirua: Attendants —B. W. Fisk, M. A. Lucas. Nurses —A. M. Brown,* J. B. Doyle, E. M. Harris, J. L. Harris,* M. A. Mcintosh, L. A. Scott,* M. P. Squire,* K. E. Woodcock. Nelson : Nurses —E. T. Lynch, M. T. McCluskey, B. A. McNamara, A. A. Walsh.* Hokitika: Nurses —M. C. Buckland, J. Masterson. Clyistchurch: Attendants —A. K. Asher, L. A. Mahoney, A. R. Rowe. Nurses—S. R. T. Aitcheson,* H. Clark, M. M. Depree, M. A. McFarlane,* B. M. Obery, R. M. Paijl, M. G. Shearer,* A. A. T. Spink, V. M. Stevens, I. M. V. Waters. Seacliff: Nurses —S. R. Allison, K. C. Cornish, E. I. Kay,* R. R. Kelly,* T. Sutherland.*

* Passed with distinction.

11

j j I ' ' j ; ( I First, I Not nw. Total Transferred Remaining Year - ! AdmSon. Admission, i AdmWons. J? 5a£S? ' Died ' I Discharged. on I I of Patients, i | j 31st December. 1 I j 1 . . .| J M. F. T. M. F. T. 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 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 1915 .. .. 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 16 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 28 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 1925 .. .. 64 59 123 15 34 49 79 93 172 10 15 25 6 3 9 60 63 123 57 92 149 1926 .. .. 71 60 131 11 29 40 82 89 171 10 11 21 7 2 9 49 71 120 73 97 170 1927 .. .. 70 70 140 25 32 57 95 102 197 8 6 14 5 12 17 75 58 133 80 123 203 1928 .. .. 120 94 214 ! 37 39 76 157 133 290 8 10 18 10 8 18 102 97 199 117 141 258 1929 .. .. 102 63 165 i 50 43 93 152 106 258 11 3 14 9 9 18 119 110 229 130 125 255 1930 .. .. 152 84 236 j 41 35 76 193 119 312 15 9 24 8 6 14 130 79 209 170 150 320 1931 .. .. 166 98 264 ! 43 36 79 209 134 343 11 14 25 11 7 18 159 102 261 198 161 359 1932 .. .. 1150 85 235 ! 50 40 90 200 125 325 24 32 56 14 5 19 190 108 298 170 141 311 1933 .. .. 112 109 221 53 52 85 165 141 306 11 14 25 5 4 9 121 107 228 198 157 3-55 1934 .. .. 132 90 221 56 33 89 188 123 311 7 11 18 10 6 16 152 99 251 217 164 381 1935 .. .. 1130 87 217 , 40 55 95 170 142 312 18 20 38 19 10 29 151 116 267 199 160 359 I

H.—7

APPENDIX.

Table I.—Showing the Admissions, Readmissions, Discharges, and Deaths in Mental Hospitals during the Year 1935.

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 1935.

12

M. F. T. M. !•'. T. In mental hospitals, 1st January, 1935 .. .. •• •• 4,133 3,300 7,433 Admitted for the first time .. .. .. . • 501 410 911 \ ] 039 Readmitted .. .. .. .. • • • • 66 92 158 f Total under care during the year .. .. .. 4,700 3,802 8,502 Discharged , died, and committed — Recovered .. .. .. . • •• •• 117 136 253 Not recovered .. .. • • • • - • 72 55 127 Died . .. .. .. .. • • 229 206 435 418 397 815 (Not including transfers —Males, 94 ; females, 138.) Remaining in mental hospitals, 31st December, 1935 . . . • 4,282 3,405 7,687 Increase over 31st December, 1934 .. .. .. .. 149 105 254 Average number resident during the year .. .. .. .. 4,003 3,111 7,114

Admissions in 1935. nw„i AT „„ , ! In Mental Hospitals : Total Number Mental Hospital. on I | 1st January, 1935. Admitted for the j Not First Transfers under Harp First Time. ! Admissions. iransiers. under I M. F. T. M. F. T. M. P. T. M. F. T. M. F. T, Auckland .. .. 679 594 1,273 107 116 223 22 32 54 16 10 26 824 752 1,576 Kingseat . . 239 99 338 . . 1 0 1 20 111 131 260 210 470 Tokanui .. .. 323 283 606 39 26 65 3 5 8 2 3 5 367 317 684 Porirua .. .. 830 702 1,532 126 110 236 17 27 44 11 4 15 984 843 1,827 Nelson .. .. 490 200 690 29 23 52 1 4 5 10 2 12 530 229 759 Hokitika .. 236 191 427 7 13 20 5 3 8 8 0 8 256 207 463 Christchurch .. .. 638 672 1,310 124 70 194 10 9 19 25 6 31 797 757 1,554 SeaclifE .. .. 684 534 1,218 67 45 112 7 12 19 2 1 3 760 592 1,352 Ashburn HaJl (private 14 25 39 2 7 9 . . 0 1 1 16 33 49 mental hospital) Totals .. 4,133 3,300 7,433 501 410 911 66 92 158 94 138 232 4.794 3,940 8,734 Patients discharged, transferred, and died. In Mental Hospitals Mental Hospitals. | I T t . j;.,,!,.,,™,! on Discharged Discharged ; Transferre(l nlert fransfem-d 3l8t December, 1935. recovered. ! not recovered. j "anslerred. Died. | transferred, M. F. T. M. F. T. M. F. T. M. F. T. M. F. T. M. F. T. Auckland .. .. 23 38 61 23 23 46 22 48 70 54 56 110 122 165 287 702 587 1,289 Kingseat .. .. 0 2 2 2 1 3 6 8 14 4 2 6 12 13 25 248 197 445 Tokanui . . .. 12 17 29 4 2 6 4 1 5 18 14 32 38 34 72 329 283 612 Porirua .. .. 29 34 63 10 11 21 15 71 86 60 47 107 114 163 277 870 680 1,550 Nelson .. . . 8 4 12 3 1 4 21 3 24 14 15 29 46 23 69 484 206 690 Hokitika .. .. 6 1 7 3 5 8 5 1 6 14 10 24 28 17 45 228 190 418 Christchurch .. 25 23 48 16 5 21 13 4 17 32 25 57 86 57 143 711 700 1,411 Seaclifl .. .. 13 11 24 10 7 17 8 1 9 32 34 66 63 53 116 697 539 1,236 Ashburn Hall (private 11 6 7 1 0 1 0 1 1 1 3 4 3 10 13 13 23 36 mental hospital) : Totals .. 117 136 253 72 55 127 94 138 232 229 206 435 512 535 1,047 4,282 3,405 7,687 Average Number Percentages Percentages of Mental Hosnitals resident duriti" of Recoveries 011 Deaths on Average Mental Hospitals. resiaent uuim B Admissions Number resident during the Year. during the Year. M. F. T. M. F. T. M. F. T. Auckland .. .. .. •• 645 525 1,170 17-83 25-68 22-02 8-37 10-67 9-40 Kingseat .. .. .. .. 242 155 397 .. 1-65 1-29 1-51 Tokanui .. . - •• •• 309 265 574 28-57 54-84 39-73 5-83 5-28 5-57 Porirua .. .. .. •• 796 622 1,418 20-28 24-82 22-50 7-54 7-56 7-55 Nelson .. 465 194 659 26-66 14-81 21-05 3-01 7-73 4-40 Hokitika .. .. .. ■■ 231 187 418 50-00 6-25 25-00 6-06 5-35 5-74 Christchurch .. •• 631 628 1,259 18-66 29-11 22-54 5-07 3-98 4-53 Seacliff .. . • • • •• 670 510 1,180 17-57 19-30 18-32 4-78 6-67 5-59 Ashburn Hall (private mental hospital) .. 14 25 39 50-00 85-71 77-77 7-14 12-00 .10-26 Totals.. .. .. .. 4,003 3,111 7,114 20-63 27-09 23-67 5-72 6-62 6-11

H.—7

Table IV.—Ages of Patients on 31st December, 1935.

Table III.— Native Countries.

13

Ashburn Hall Countries. Auckland. Kingseat. Tokanui. Porirua. Nelson. Hokitika. Christchurch. I Seacliff. ! (Private Mental Total. 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. M. F. T. England and Wales .. 107 81 188 43 38 81 51 36 87 143 100 243 52 15 67 32 17 49 63 60 123 65 38 103 3 2 5 559 387 946 Scotland .. 26 14 40 12 2 14 12 8 20 30 17 47 24 6 30 6 4 10 21 15 36 48 31 79 4 1 5 183 98 281 Ireland .. .. 28 24 52 12 11 23 20 17 37 43 28 71 17 2 19 16 7 23 15 23 38 j 29 28 57 1 0 1 181 140 321 New Zealand.. .. 405 380 785 118 116 234 199 190 389 548 4891,037 350 167 517 132 128 260 592 577 1,169 508 407 915: 4 18 22 2,856 2,472 5,328 Australian States .. 32 32 64 12 8 20 9 13 22 37 19 56 7 6 13 14 6 20 9 13 22 15 22 37 1 2 3 136 121 257 France .. ..011 .. 101 .. .. .. .. .. .. 112 Germany .. ..202 202 314 145 20 2 101 123 303 .. 15 7 22 Austria .. ..9110 11 0 11 404 .. 202 .. 011101 .. 27 2 29 Norway .. ..101303202213 ..101 .. .. .. 9 1 10 Sweden .. .. .. 12301120 2 101101101202 .. 8 3 11 Denmark .. .. .. 101202325404101 .. 112 .. 12 3 15 Italy .. ..213 .. 101202011404 .. .. .. 92 11 China .. ..3 0 3 .. 1 0 1 415 . . .. .. 101 .. 9 1 10 Maoris .. .. 14 15 29 5 0 5 10 12 22 33 12 45 7 2 9 1 1 2 5 1 6 .. .. 75 43 118 Other countries 39 16 55 13 4 17 14 5 19 22 7 29 5 1 6 5 1 6 4 8 12 6 4 10 .. 108 46 154 Unknown .. 34 22 56 15 16 31 .. . . 13 6 19 14 26 40 .. 18 8 26 .. 94 78 172 Totals .. 702 587 1,289 248 197 445 329 283 612 870 6801,550 484 206 690 | 228 190 418 I 711 7001,411 697 5391,236 13 23 36 4,282 3,405 7,687

j-xiujju x ! . xiuiau vr x io wxox xyjiucjiYix>xax\ij xt/tiy. ( Ashburn Hall Ages. Auckland. Kingseat. Tokanui. ! Porirua. i kelson. Hokitika. Christchurch. j Seacliff. j (Private Mental Total. j j. j Hospital). M. F. 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. From 1 to 5 years ..202 .. .. 0 2 2 9 1 10 0 11 8 9 17!3 0 3 ; .. 22 13 35 „ 5 „ 10 „ .. 7 6 13 .. 2 1 3 1 9 10 29 10 39 .. 33 10 43 ! 4 2 6 . . 76 38 114 „ 10 „ 15 „ .. 10 7 17 .. 3 3 6 2 4 6 46 9 55 1 1 2 68 46 114 10 4 14 . . 140 74 214 „ 15 „ 20 „ 23 19 42 3 0 3 10 9 19 29 30 59 65 19 84 ! 1 6 7 92 80 172 33 11 44 .. 256 174 430 „ 20 30 „ .. 97 62 159 21 20 41 53 30 83 124 83 207 85 36 121 ! 31 12 43 107 110 217 91 42 133 .. 609 395 1,004 „ 30 „ 40 „ .. 154 118 272 30 18 48 47 50 97 174 128 302 48 32 80 ! 25 21 46 106 92 198 133 67 200 2 0 2 719 526 1,245 „ 40 „ 50 „ .. 147 155 302 53 44 97 52 64 116 181 157 338 46 24 70 I 45 48 93 122 104 226 129 124 253 3 6 9 778 726 1,504 „ 50 „ 60 „ .. 138 123 261 64 63 127 76 58 134 193 148 341 | 54 29 83 65 64 129 97 138 235 139 123 262 1 7 8 827 753 1,580 „ 60 „ 70 „ .-. 62 60 122 55 32 87 58 47 105 114 70 184 56 26 82 ; 46 28 74 48 72 120 92 94 186 3 7 10 534 436 970 „ 70 „ 80 „ .. 31 23 54 16 10 26 20 15 35 40 40 80 32 14 46 10 4 14 23 33 56 48 55 103 3 1 4 223 195 418 „ 80 „ 90 „ .. 7 4 11 3 3 6 3 3 6 12 8 20 5 4 9 ; 1 1 2 6 6 12 9 13 22 1 1 2 47 43 90 Upwards of 90 „..202101 .. 011.. .. 101123011 5 4 9 Unknown .. 22 10 32 2 7 9 5 3 8 .. 9 2 11 3 4 7 .. 5 2 7 .. 46 28 74 Totals .. 702 587 1,289 248 197 445 329 283 680 1,550 484 206 190 418 711 7001,411 t 697 539 1,236 13 23 36 4,282 3,405 7,687

H.—7

Table V.—Length of Residence of Patients discharged "Recovered" during 1935.

14

I I Ashburn Hall. Length of Residence. Auckland. Kingseat. Tokanui. Porirua. Nelson. Hokitika. Christchurcli. Seacliff. 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. M. F. T. Under 1 month .. 213 .. Oil .. .. , 'Ai t 'io nil i n l9 99 From 1 to 3 months .. 3 9 12 .. 4 0 4 1 1 2 .. 1 0 1 1 1 2 .. 0 1 1 10 12 22 or 178 .. 314 224 .. 101 10 7 17 213 033 19 21 40 6 " 9 76 13 .. 033 268 101 101 437 314 112 19 20 39 " t" it " " 4 3 7 .. 1 2 3 7 8 15 1 1 2 1 0 1 3 3 6 4 3 7 .. 21 20 41 ;; 1 ;; 2 year's .. 6 8 14 0 1 1 3 6 9 11 7 18 6 3 § 112 3 7 1 3 4 0 1 1 32 33 65 2 3 044 Oil 101437 .. 235 213 .. 9 12 21 <55' .. 033156 .. 101 101 112 .. 49 13 " 5 " 7 " ' ■ • 0 11 112 .. . • 0 11 0 11 . . 14 5 ;; ?;;io .. .. .. .. 0 i i .. .. 022 .. .. 033 „ 10 „ 12 „ .. .. ... •• •• •• •• •• •• •• „ 12 „ 15 „ .. .. . ■ i Over 15 years .. .. .. • • • • | • • • • ■ * * [J Totals .. .. 23 38 61 0 2 2 12 17 29 29 34 63 8 4 12 6 1 7 25 23 48 13 11 24 1 6 7 117 136 253

H.—7

Table VI.—Causes of Death, 1935.

Table VII.—Principal assigned Causes of Insanity, 1935.

15

' 4 lL T3 • a Causes. S g '3 -• . S 1 s . 1 I i I I I I I 1 III a ■ 1 _» |H Ph I S I J -S]£ ! H I. —General Diseases. Tuberculosis — M. F. M. E. M. E. M. E. . M. E. M. E. M. F. M. F. M. E, M F General .. .. .. ..0 1 .. .. .... .. 10 10 ..21 Of lungs .. .. .. ..2601 .. 1 0 .. .. 2010 .. 07 Of intestines .. .. .. .. .. 01 .. .. 01 02 Cancer . . .. .. ..9 0 1 0 .. 0 412 1 10 2 211 .. 16 8 Toxaemia .. .. .. .. .. .. .. 02 .. 20 .. .. .. 22 Furunculosis .. .. ..01 .. .. .. .. .. 0 Ī Diabetes .. .. .. .. .. 10 .. .... .. 10 Cellulitis .. .. .. .. .. .. .. | ,, _ 10 10 Asthenia .. .. .. .. .. .. .. .. .. 0101 II. Diseases oe the Nervous System. ! | Mania, exhaustion from .. .. .. . | .. j ., .. 10 jlO Melancholia, exhaustion from .. 34;.. 10 241 1 .. 02 711 Confusional insanity, exhaustion from .. J ..11 .. 01 .. . . " ! 1 2 General paralysis of insane .. .. 7 1 .. 2 0 5 1 10 01 1 1 10' .. I 17 4 Encephalitis .. .. ..02 .. .. , _ _ _ ; 02 Epilepsy .. .. .. .. 53 .. 2 0 j 4 3 10 .. 2 0 11 !! 15 7 Cerebral haemorrhage .. ..20 .. 02 33 .. 10 1303 7 11 Cerebral thrombosis .. .. ..05 .. .. 01 .. .. 06 Cerebral syphilis .. .. .. .. .. .. 11 .. .. .. Cerebral tumour .. .. ..10 .. .. .. .. .. 10 Meningitis .. .. .. . . .. .. | .. 10 .. . . !. 10 !. 2 0 Subacute combined degeneration of cord .. j .. .. .. 10 10 Huntingdon's chorea .. .. .. .. .. .. .. .. ., 0 1 0 1 III. Diseases oe the Respiatoky System. Pneumonia .. .. ..36 .. | .. 01 .. .. 2002 .. 5 9 Broncho-pneumonia .. .. ..01 .. 1 0 4 5 1 0 .. 10 76 Chronic bronchitis .. .. .. .. .. 1003 .. 01 10 24 Tonsillitis .. .. .. .. .. .. .. 01 .. .. 01 IV. Diseases oe the Cibculatoby System. Heart-disease .. .. .. 12 13 1 1 42 97 44 12 32 45 02 38 38 Arterio-sclerosis .. .. ..01 .. 1220 .. .. 21121076 Ansemia .. .. .. .. .. .. .. 01 .. .. . 01 V. Diseases of the Digestive System. Bacillary dysentery .. .. ..14 .. .. . . . . . . ., 14 Gastro enteritis •• 1 0 • • I •• • • •••.....10 Chronic colitis .. .. .. .. .. .. .. .. 01 01 VI. Diseases oe the Gentto-ubinary System. Nephritis .. .. .. ..11.. 0101.. 0113 27 Uramia .. .. .. .. .. .. io .. 01 .. .. .. .. ii VII. Old Age. Senile decay .. .. ..4 7 .. 4 5 22 7 3 8 8 4 10 11 18 15 .. 69 57 VIII. External Causes. Suicide .. .. .. .. | .. 20 .. 10 .. .. .. 30 IX. Died while oh escape .... 10.. .. .. .. 10 Died while on TEIAL .. ..3 0 .. 113 110 !. 2 0 12 !! 11 4 Totals ■ ■ .. 1 54 56 4 2 I 18 14 60 47 14 15 14 10 32 25 32 34 J 3 229 206

• r-j'S o -d g Causes. g « *p . S xs . ■a S 5 B a 3 -2 «g SS§< 1 " § 'C R r 1- ! o o o ft 2? "S «h ffl WHPMftWo^^flg M. F. M. F. M. P. M. F. M. F. M. F. M. F. M. F. M F M F Alcohol . . ..5 1 . . 1 0 2 0 1 0 .. 6 0 1 0 ..16 1 Arterio-sclerosis ..82 .. 1191 .. .. .. 42 22 6 Climacteric .. 0 26 .. 02 07 .. .. 017 06 0 58 Congenital .. .. 14 13 .. 8 2 28 12 7 11 .. 39 13 17 4 !! 113 55 Constitutional .. . . .. .. 3 0 . . .. .. .. 3 0 Encephalitis .. . . . . 10 .. . . 0 1 0 1 12 Epilepsy .. . . 11 15 .. 1 1 4 5 6 1 2 2 4 1 0 3 !.' 28 28 Gross brain lesion ..10 .. .. .. 20 .. .. .. 30 Heredity .. .. 10 13 .. 1 2 6 5 4 2 l " 3 33" 9 10 0 l" 2 66 36 Ill-health . . ..2 1 . . 5 0 2 3 .. 01 21 2001 13 7 Involution .. 12 6 . . . . .. 0 2 1 0 .. .. 13 8 Mental stress . . 29 30 .. 8 8 34 37 1 4 0 4 9 7 3 14 0 ' 2 84 106 Organic brain disease ..21 .. .. 22 .. .. 50 .. 93 Previous attack .. 12 11 I 0 3 2 21 30 1 3 5 3 4 3 11 12 1" 2 59 66 Puberty or adolescence 4 3 .. 8 3 2 11 3 0 2 2 16 10 10 6 .. 45 35 Puerperal .. ..0 3 .. 0 4 0 8 .. . . 0 2 0 2 0 19 Senility .. .. 11 19 .. 1 4 22 15 5 4 1 0 11 15 13 7 .. 64 64 Syphilis .. ..7 3 .. 3 1 7 1 .. .. 2 0 3 0 .. 22 5 Toxle ■ • ..11 .. 1110 .. .. 11 .. .. 43 Traumatic .. .. .. .. .. .. .. .. 20 .. 20 Transfers .. .. 16 10 20 111 2 3 11 4 10 2 8 0 25 6 2 1 0 1 94 138 Totals ■ ■ 145 158 21 111 44 34 154 141 40 29 20 16 159 85 76 58 ' 2 8 661 640

H.—7

Table VIII.-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.

16

Discharged. Remaining . Percentage Percentage of Deaths ...... r —— - Died. 31st December in " of Recoveries on on Average Number, Year. Admitted. Recovered. Believed. Not Improved. I each Year. resldent - Admissions. res.dent. M F T I M F I T M. Y. T. I M. I F. T. I M. F. | T. j M. F. j T. I M. F. I T. M. i F. I • T. M. F. T. ,o 7I - I I | .. .. ! ... : 482 254! 7361 .. .. ! .. •' 00] 117 338 i 129 *79 208 "n "s *25 2 8 10 36 12 48 519 264 783j 491 257 748 54-53: 66-01 57-56 8-21 3-58 6-70 OT7 " 250 112 362! 123 57 180 20 5 25 1 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 " 947 nT 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 51 399! 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 " 229 149 378 100 67 167 36 25 61 5 2 7 54 20 74 729 396 1,125 703 371 1,074 43-66 44-96 44-17 7-68 5-39 6-89 88 " "32 127 359 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 " 267 152 «9 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 jgg3 055 j0g 40} i 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 1884 " 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 95 981 542 1,523 965 528 1,493 ! 38-62 57-14 45-12 7-56 ! 4-16 6-36 1886 " "07 165 372 99 60 159 11 17 28 i 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 " 255 11 416 103 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 " 215 146 361 116 92 "08 . 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 "30 160 390 98 88 186 23 17 40 I 12 5 17 76 35 111 1,095 702 1,797 1,078 685 1,763 42-61 55-00 47-69 j 7-05 5-11 6-29 89? " 234 171 405 88 74 162 33 24 57 14 .. 14 79 41 120 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 6-68 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 99 1,30S 860 2,168 1,241 812 2,053 j 39-63 43- 13j 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 " 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 1807 " 984 193 477 102 73 175 17 12 29 10 .. 10 105 43 148 1,440 990 2,43011,411 944j 2,355: 35-92 37-82| 36-69 7-44 4-55 6-28 1898 " 254 219 466 114 110 224 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 i 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 lann " qnn 9n9 509 103 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 Qoi " 320 223 543 125 104 229 20 17 37 .. 2 2 102 72 174 j 1,654 1,119| 2,773! 1,622 1,094 2,716. 39-06 46-64j 42-17. 6-29 6-58 6-41 1902 " 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 " 355 296 581 144 101 245 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 iQni " qqo 90 a Sfic , = 7 infi 263 24 11 35 1 1 120 70 190 1,801 1,237 3,038 1,780 1,198 : 47-59 44-91 46-30 6-74 5-84 6-38 loot " ok] mi 14q jo? 270 29 9 4 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 1 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 1Q07 " 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 iqn« " 496 318 744 180 146 326 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 1QOQ 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 1Q10 " 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 iqii 44s 317 765 jfi3 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 lQiq " 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 "I 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 I! J 518 361 879! 160 171: 331 35 34 | 69 f 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

H.—7

CO K r 5

17

1918 ;; 437 402 830 142 141 983 17 36 53 I 19 19 11 318 2 ' 6H 1,904 j 4,515 i 2,543 l 1,825 4,368 36 ' 38 40-64 38-27i 8-06 6-19 7-28 1919 .. 512 371 883 190 U7 337 37 4 1 s? *o ? It 2 ! 4 74 448 f,603 1,943! 4,546 2,602 1,899 4,501 32-49 35-07 33-73 10-53 9-16 '9-95 1920 .. 455 418 873 162 i 148 i 310 97 07 ~ ! }«2 Itl I I' ' 4 ' 647 2,620 1,907 4,527 37 ' U 39 ' 62 38-17 8-09 6-82 ! 7-55 1921 .. 479 402 881 178 ! 193 1 371 30 21 5? 15 q \± 9m I Jw ! I'lll I' ' 4,754 2,674 1,980 4,654 35 ' 63 35-32 35-51 7-85 8-40 8-08 1922 .. 453 386 839 156 I 157 313 32 20 52 in 8 it 9?} : : i !' 772 2,0991 4,871 2,723 2 > 031 4 > 754 37 " 2 3 47-88| 42-11 7-38 5-76 6-69 1923 .. 442 366 808 168 i 151 1 319 19 qs sn 1« 1 9A i J«f 1 !! ! ' ,116 4,932 2,7471 2,062 4,809 34-44 40-67 ! 37-311 7 '6 7 8 " 92 i 8- 21 1924 .. 446 377 823 152 ' 198 I 9 80 qa 49 79 q oof n* ' ' ' 1 2 ' 157 4,996 2,789 2,079 4,868 38-00 41-25 i 39-48 6-95 6-30 ! 6-67 1925 .. 445 430 875 144 ■ 175 i flQ 29 37 66 23 7 fn 9n 19a 1 aL® ! f'nl?! f'ff 5 ' 131 2,146 4,953 34-08 33-951 34-02 7-87 4-42 ! 6-37 1926 .. 508 439 947 136 ! 145 ! 281 27 35 69 ?5 11 1a 9A7 Yft ; off ;l f' I ' 5,257 2,830 l 2,203 5,033 32-36 40-69 l 30-45 7-45 5-57 1 6-43 1927 .. 531 I 414 945 157 ! 12 a i 9«5 in 19 «9 ™ o to o?3 i I 3,044 2,423 5,467 2 > 926 2 > 287 5 » 213 26-18 80*75 29-67 6-16 6-42 ! 6-77 1928 .. j 506 450 956 115 I 134 ! 249 4n In sn 17 10 1 an E 132 i 349 j 3 > 147 2 ,526 5,673 3,022 2,373 5,395 29-56 30-91 30-16 7-17 5-65 | 6-47 1929 i 549 407 956 145 I 144 I 289 30 28 58 99 īfi : as 997 }*a I !qa 1 I'V* 2,628 5,9 ° 2 ' 3,120 2,459 5,579 22-72 29-77 i 26-04 6-63 6-55 ' 6-59 1930 .. j 621 474 1 095 138 ! 128 ! 266 98 34 69 I a7 9a S oīi ™ i ?oo 1 f* I ' 694 6,093 3,215 2,495 5,710 26-41 35-37 ! 30-231 7-06 6-13 6-65 1931 .. ! 587 476 1 063 127 1 120 ! 947 •>., of, S ?a ! fn IJ, 423 ! 3,572; 2,811 6 > 383 : 3 > 342 l 2,590 5,932 22-22 27-OOj 24-29 7-51 6-64 7-15 1932 ,. 587 484 1 071 141 I 160 1 301 39 49 «1 as ai 7Q o 10 Jen ' ofo ' ' ! 2,908 6,661 3,503 l 2,696 6,199 21-64 23-37 6-31 7,39 I 6-7 6 1933 563 554 1,'117 117 144' 261 35 97 , os 22 50 99? tfi 3 ! 8 3 ' 90 ?; ? ,9 ?2 6,883 i 3 ' 681 ' 2,738 6,419 24-02 33-05 28-10 5 " 97 6-17 6-06 1934 .. I 479; 504 983 114 146: 260 64 72 136 Ifa 9na ? 45 ' 4,065 i 3,217 7 >282j 3,809 2,932 6,741 20-78 25-99 23-36! 5-80 4-23 ! 5-16 1935 .. 567 502 1,069 117 > 136 253 I 72 1 55 197 " " " 99a 9ar ! '■ Hfoi H 2 I't < 3,899 l 3,039 6,938 23-80 28-97 26-45 5-98 6-68 I 6-28 ; ' d 53 °° 12< j ■■ •' j ' • 229 200 43 o 4 > 282 3,405! 7,687j 4,003! 3,111 7,114 20-63 27-09 23-67 5-72 6-62 j 6-11 22,491 16,887 39,378 7,998 6,908 14,906j2, 173 1,931 4,104 8,520 4,897 13,417 i ! j ! Excluding transfers between institutions —2,476 males, 1,641 females.

H.—7

Table IX,— Showing the Admissions, Discharges, and Deaths, from Ist January, 1876 , to 31st December, 1935 (excluding Transfers). M. F. T. lBtl)eo : mler,ms :: :: :: :: «.ffi w.S sjfs 22,973 17,141 40,114 Discharged — *. F. 1. Recovered .. .. 7,998 6,908 14,906 Not recovered .. .. 2,173 1,931 4,104 Died .. •• 8,520 4,897 13,417 J 18,691 13,736 32,427 Remaining on 31st December, 1935 .. .. 4,282 3,405 7,687

Table X .—Summary of Total Admissions: Percentages of Cases since the Year 1876.

18

j Males. Females. | Both Sexes. Recovered 34-81 40-30 37-16 Not recovered ■■ •• 9-46 oo qq T)l y r l 37-09 28-57 33-45 Remaining J8-64 19-86 19-16 100-00 100-00 100-00

4—H. 7,

H.—7

Table XI.—Debits for the Financial Year, 1935-36.

19

- Auckland. Kingseat. Tokanui. | Portrua. Nelson. Hokitika. | Christchurch. Seacliff. j Head Office. | Total. £ s. d. f s. d. £ s. d. £ s. d. £ s. d. £ s. d. £ s. d. £ s. d. £ s. d. £ s. d. Salaries .. .. .. .. 41,651 6 10 8,409 11 9 22,224 4 1 53,967 7 7 24,542 13 6 16,117 13 11 47,674 3 6 51,053 14 2 8,353 1 2 273,993 16 6 Official Visitors .. .. .. .. 44 13 9 .. .. 23 12 7 .. .. 21 12 0 .. .. 89 18 4 Advertising, books, &c. .. .. .. 346 .. 279 340 223 1 11 6 486 276 11 14 7 31 07 Bacteriological research .. .. .. 38 66 .. .. 29 18 0 0 10 6 050 855 .. .. 77 55 Bedding and clothing .. .. .. 5,433 9 1 1,514 6 5 1,596 2 8 5,810 10 11 2,426 9 4 1,903 12 6 6,120 6 6 4,703 3 3 0 13 6 29,508 14 2 Buildings, including additions, &c. .. .. 1,010 3 11 42 17 8 441 7 9 1.026 4 3 290 14 9 211 4 6 1,158 15 11 1,542 2 8 .. 5,723 11 5 Dental services .. .. .. .. 3 16 1 .. 8 5 11 2 13 10 15 2 7 16 6 4 9 9 1 10 6 0 .. 65 19 10 Farms .. .. .. .. .. 1,078 7 4 568 19 5 2,754 0 3 1,141 3 5 981 14 6 458 13 1 1,626 15 7 1,236 2 2 .. 9,845 15 9 Fencing, draining, and roading .. .. 41 8 0 31 12 1 265 10 4 170 11 6 45 0 10 11 0 5 120 11 6 162 9 6 .. 848 4 2 Freight, cartage, and transport .. .. 58 6 10 59 19 2 170 6 4 261 5 11 185 17 5 42 2 6 394 19 0 359 1 8 .. 1,531 18 10 Fuel, light, water, &c. .. .. .. 5,980 18 1 1,315 17 3 3,055 7 3 5,872 19 0 4,170 7 5 1,330 0 1 6,526 14 6 5,447 14 10 | 43 2 7 33,743 1 0 Funeral expenses.. .. .. .. 97 10 0 14 0 0 48 15 0 94 12 0 20 15 0 26 10 0 18 15 0 82 19 0 ! .. 403 16 0 Furniture and fittings .. .. .. 559 3 6 66" 15 1 239 7 4 565 13 2 228 2 5 76 7 9 523 0 9 390 8 5 34 3 10 2,683 2 3 Gardens and shrubberies .. .. .. 48 19 0 3 13 8 13 18 1 38 17 10 67 12 10 38 10 2 110 13 5 13 15 8 .. 336 0 8 Laundry .. .. .. .. 304 17 0 71 12 9 196 19 4 342 7 1 259 4 6 51 16 5 228 6 10 224 11 4 .. 1,839 15 3 Legal and inquiry costs .. .. .. 190 .. .. .. .. .. .. .. .. 190 Machinery repairs and stores .. .. 131 9 11 8 11 5 138 0 3 53 0 8 103 13 3 15 6 6 193 6 4 135 6 9 .. 778 15 1 Medical fees .. .. .. .. 634 2 6 .. 144 2 6 652 0 9 110 5 6 59 19 0 367 3 11 267 14 6 .. 2,235 8 8 Motor-vehicles — Maintenance of .. .. .. 5 12 8 7 8 6 73 19 5 56 6 7 99 8 9 34 2 0 226 0 5 132 16 5 .. 635 14 9 Purchase of .. .. .. .. . . .. .. .. .. .. 198 13 7 .. .. 198 13 7 Nursing staff uniforms .. , .. 149 17 8 37 11 2 90 0 9 337 10 9 75 18 7 57 5 5 244 8 8 174 0 7 .. 1,206 13 7 Office equipment .. .. .. 201 .. 180 .. 5 12 0 0 16 6 484 729 2 15 2 24 2 10 Patients' expenses connected with gratuities .. 28 10 0 .. 4 9 2 77 12 11 119 4 7 13 17 6 0 16 4 44 13 6 .. 289 4 0 Friends .. .. .. .. .. .. .. .. .. .. . . 94 6 0 .. 94 6 0 Recreation .. .. .. .. 1,027 15 5 357 0 3 586 8 2 1,359 9 9 601 9 1 325 11 1 749 9 10 852 19 4 .. 5,860 2 11 Transfers .. .. .. ., 9 13 3 13 3 0 1 10 7 207 9 9 52 16 9 7 3 6 19 13 6 6 19 0 .. 318 9 4 Postages, telegrams, &c. .. .. .. 90 19 0 15 6 2 54 4 6 158 2 5 32 12 10 13 10 10 104 9 8 112 11 0 183 9 10 765 6 3 Printing and stationery .. .. .. 221 14 8 76 2 4 80 3 1 175 5 3 78 8 1 55 0 5 178 10 5 104 0 5 96 16 10 1,066 1 6 Rations .. .. .. .. 12,036 2 5 5,686 18 4 4,643 15 10 16,667 8 3 6,729 18 10 5,138 1 8 12,748 1 0 12,239 2 8 .. 75,889 9 0 Rents and rates .. .. .. .. .. .. .. .. 2 16 2 .. 677 2 1 8 0 0 608 17 11 1,296 16 2 Stores .. .. .. .. .. 670 12 10 174 11 4 328 19 1 945 3 1 428 0 4 320 11 5 964 3 8 586 1 3 .. 4,418 3 0 Surgery and dispensary drugs, &e. .. .. 409 4 8 41 2 8 152 17 9 389 4 10 151 1 5 75 7 11 282 15 7 228 3 5 .. 1,729 18 3 Telephone services .. .. .. 65 16 4 76 14 10 92 15 2 170 1 9 62 19 1 34 4 3 116 18 1 184 11 9 113 0 1 917 1 4 Transfer and removal expenses .. .. 93 3 3 1 8 0 3 16 8 211 2 5 183 0 0 80 13 8 6 2 5 32 3 2 135 10 3 I 746 19 10 Travelling-allowances .. .. .. 34 11 3 131 3 5 30 13 2 30 6 6 102 9 0 71 12 5 0 9 11 178 3 3 151 9 7 730 18 6 Travelling-expenses .. .. .. 85 6 0 25 7 2 14 12 11 62 15 5 31 18 6 24 7 11 51 3 5 111 11 4 178 0 6 585 3 2 Treatment in General Hospital — Patients .. .. .. .. 175 10 6 24 12 0 .. 124 16 0 93 4 0 7 2 6 135 18 5 137 0 6 .. 698 3 11 Staff .. .. .. .. .. 466 .. 2 14 0 .. .. .. 8 18 6 3 10 0 .. 19 90 Contingencies and miscellaneous .. .. 2 10 10 0 14 4 38 6 9 116 0 3 772 15 0 1 1 4 3 8 6 155 0 0 0 8 9 1,090 5 9 Totals .. .. 72,234 19 2 18,877 0 2 37,499" 9 10 91,184 18 5 43,073 19 7 26,621 10 0 81,889 0 1 81,024 13 9 9,913 4 7 462,318 15 7

H.—7

Table XIa.—Credits for the Financial Year, 1935-36.

Table XII.— Average Cost of each Patient per Annum.

20

Auckland. | Kingseat. Tokanui. Porirua. Nelson. | Hokitika. Chri&tchurcli. Seacliff. | Head Office. Total. £ s. d. £ s. d. £ s. d. £ s. d. £ s. d. j £ s. d. £ s. d. £ s. d. | £ s. d. £ s. d. Receipts for maintenance .. .. I 22,557 11 8 6,874 9 1 10,689 3 2 30,921 15 2 10,037 2 5 | 4,482 16 2 26,310 2 4 25,78/ 14 0 .. 137,660 14 0 Receipts from farms .. .. ! 358 9 10 2,059 3 7 3,828 15 6 694 8 8 1,515 11 10 22 6 11 1,422 18 1 j 1,833 15 7 .. 11,735 10 0 Miscellaneous 4,865 12 0 1,182 18 11 2,842 7 6 7,101 6 11 2,860 14 2 1,769 0 10 5,673 13 I | 7,038 12 3 4 13 1 33,338 18 9 27,781 13 6 10,116 11 7 17,360 6 2 38,717 10 9 14,413 8 5 j 6,274 3 11 33,406 13 6 34,660 1 10 4 13 1 182,735 2 9

Number i Bedding Buildings Fuel, Light,! Sufgerv > . Total Cost | Other I Net Cost Net Cost Decrease Increase Mental Hospital. : resident Salaries. and j and Farm. Water, and Provisions. and Sous _ g er ,, Main- i Ee " t „ ?. er t J?re™us m „ (inclusive of | Clothing. ! Kepairs. Cleaning. | Dispensary.j mueuus< Patient.* | ten *„ ce payments. | Patient. Year. 1935-36. ;i98o-36. Boarders). | j ! 1 ' I j I I ! £ s. d. j £ s. d. £ s. d. £ s. d. £ s. d. £ s. d. £ s. d. j £ s. d. £ s. d. £ s. d. £ s. d. £ s. d. £ s. d. £ s. d. £ s. d. Auckland . 1,287 32 7 11 4 4 5 0 15 8 0 16 9 4 12 11 9 7 0 0 6 4 3 11 4 56 2 4 17 10 6 4 1 2 34 10 8 28 6 6 .. 6 4 2 Kingseat . 424 19 16 11 3 11 6 0 2 0 1 6 10 3 2 1 13 8 5 0 1 11 3 1 3 44 10 11 16 4 6 7 13 0 20 13 5 26 19 5 6 6 0 Tokanui " . 585 38 0 1 2 14 7 0 15 1 4 14 2 5 4 6 7 18 10 0 5 2 4 12 0 64 4 5 18 5 7 11 8 1 34 10 9 35 18 10 1 8 1 Porirua " ' . 1,543 34 19 9 3 15 3 0 13 3 0 14 9 3 16 1 10 16 0 0 5 0 4 1 6 59 1 7 20 0 9 5 1 0 33 19 10 31 14 3 .. 2 5 7 Nelson " ' . 683 35 16 8 3 10 10 0 8 6 1 8 8 6 1 9 9 16 6 0 4 5 5 10 5 62 17 9 14 13 1 6 7 9 41 16 11 39 5 1 .. 2 11 10 Hokitika " " . 416 38 13 8 4 11 4 0 10 1 1 2 0 3 3 11 12 6 8 0 3 8 3 6 7 63 17 11 10 15 2 4 6 0 48 16 9 45 13 7 .. 3 3 2 Christchurch .. .. 1,335 35 14 6 4 11 8 0 17 4 1 4 4 4 17 9 9 10 11 0 4 3 4 5 10 61 6 7 19 14 1 5 6 3 36 6 3 32 9 10 .. 3 16 5 Seaclifi .. .. .. 1,221 41 16 3 3 17 0 1 5 3 1 0 3 4 9 3 10 0 6 0 3 9 3 14 11 66 7 2 21 2 5 7 5 4 37 19 5 34 0 11 .. 3 18" 6 Head Office .. .. .. 124 .. .. .. 0 0 1 .. .. 041 166 .. .. .. 150 .. Totals .. .. 7,494 36 91 3 18 6 0 15 3 162 499 10 1 10 047 447 61 99 18 62 604 37 33 34 90 .. 2 14 3 * Note. —Cost does not include interest and depreciation on land, buildings, &c.

H.—7

Table XIV.—Total Expenditure out of Public Works Fund for Buildings and Equipment at each Mental Hospital from 1st July, 1877, to 31st March, 1936.

Table XIII.—Expenditure out of Public Works Fund on Mental Hospital Buildings, etc., during the Financial Year ended 31 st March, 1936.

Approximate Cost of Taper.—Preparation, not given; printing (560 copies), £28 10s.

By Authority: G. H. Loney. Government Printer, Wellington.— 1936.

Price 9d.'\

21

5 J-wv. I T tal N t E d't Mental Hospitals. 1877-1926. j 1926-27. 1927-28. I 1928-29. 1929-30. j 1930-31. 1931-32. 1932-33. j 1933-34. 1934-35. 1935-36. | T °1st Ju!yf 187V to™ 31st March, 1936. j_ | : £ £ £ j £ £ £ £ £ j £ £ £ £ C . k l™ d , - •• 179,729 19,988 12,213 12,461 2,279 3,372 621 676 j 155 2,321 307 234,122 Lhristchurch (Sunnyside) .. 206,882 7,229 10,164 7,777 35,291 , 23,993 4,650 7,960 3,481 23,489 12,397 343,313 Dunedm (The Camp) .. 4,891 .. .. j , ■ 4 891 Hokitika .. .. .. 43,763 1,745 141 ! 401 3,064 14,764 8,381 3,107 8,753 5,629 2,739 92'487 Hornby .. .. .. 11,102 .. .. .. .. 11 102 Motuihi Island .. .. 561 .. " " " " " ' s61 Napier .... .. 147 .. ! j |' 147 Nelson and Stoke .. 59,351 3,496 753 956 33,250 26,494 3,339 2,680 12,251 28,552 18,307 189,429 «rtitahi (Kingseat) .. .. .. .. .. .. 16,130 16,433 10,278 35,438 29,784 21,973 130,036 beaclift .. .. .. 197,759 17,888 9,408 i 27,132 34,609 8,914 3,065 414 6,618 4,888 1,453 312,148 T,°? n . U1 •' •' " 122,926 1,658 2,124 19,887 32,405 27,787 7,164 2,918 6,295 3,797 12,682 239,643 ™ atl 17,662 627 .. 853 2,170 9,557 936 516 .. .. .. 32,321 Wellington .. .. 29,641 ...... .. 29 641 Wellington (Porirua) .. 272,983 16,004 16,315 27,315 9,028 ; 3,129 1,349 207 "29 'l70 j !! - 346^529 Totals •• •• 1,147,397 68,635 51,118 96,782 152,096 : 134,140 45,938 28,756 73,020 98,630 1 69,858 1,966,370

Mental Hospitals. 1 Set '°ī„L ear r ended 31st March, 1936. £ Auckland .. .. .. . . .. .. . . .. . . 307 Christchurch (Sunnyside) .. .. .. .. .. .. .. 12,397 Hokitika .. .. .. .. .. .. .. .. .. 2,739 Nelson and Stoke .. .. .. .. .. .. .. .. 18,307 Porirua Kingseat .. .. .... .. .. .. .. .. 21,973 Seacliff .. .. .. . . .. . . . , . . .. 1,453 Tokanui .. .. .. .. .. .. .. .. .. 12,682 Waitati Total .. .. .. .. .. .. .. | 69,858