3

H.—7

This tendency to recurrence is one of the anxieties surrounding the question of discharge. While some patients make an apparently complete and lasting recovery, and some re'apse after a long period of sanity, some, who remain well in an institution sufficiently long to justify their discharge, to claim it as a right, soon relapse when exposed to the influences of the larger world. During the past year we have been fortunate in the recoveries being to all appearance more stable, and in the relapsed cases of former years having been returned without any untoward event resulting from their insane conduct. Though naturally gratifying, it must be allowed that this is not a matter of skill but of gooi fortune. The following is this year's return of the immigrants who became insane within one year of landing on our shores (the totals for 1906 and 1907 were 31 and 21 respectively) : — v , • , No History of History of m , , Natlveof Previous Attack. Previous Attack. r ° tel - United Kingdom .. .. .. .. 6 2 8 Commonwealth .. .. .. .. 5 1 6 Other parts of Empire .. .. .. .. 1 .. 1 Foreign countries .. .. .. .. 4 . . 4 Total ...... 16 3 19 Ratio of Admissions to Population. —Excluding the Native race (11 male patients) and all transfers, the proportion of admissions and first admissions to the estimated general population stands respectively at 7-63 and 6-24 per 10,000, or, in other words, every 1,311 persons in the general population contributed an admission and every 1,604 a first admission. In the following table the fluctuations may be studied. It will be noted that the difference between the present, the year with the highest ratio, and 1907, which was a favourable year, is very marked, amounting to 1-2 additional admissions for each 10,000 of the population : —

Discharges and Deaths. —The names written off the general register during the year numbered 570 (m., 338 ; f., 232), the discharges, (exclusive of transfers), accounting for 348 (m., 190 ; f., 158), and the deaths for 222 (m., 148 ; f., 74), out of a total of cases under care amounting to 3,984. In 11)07 the discharges numbered 334, the deaths 232, and the total under care 3,806. Of the discharges, 326 (m., 180 ; f., 146) were classed as recovered, and 22 (m., 10 ; f., 12) as unrecovered. The percentage of recoveries calculated on admissions was 43-82 (m., 42-25 ; f., 45-91). The figures for the previous year were 49-67, the highest percentage since 1888, when the record (57-62) was reached. The recovery-rate for the year is, however, well above the average. Table XVII summarises the admissions since 1876, and it will be seen there that our average recovery-rate is 40-61 per cent. The recognition, more and more as time goes on, of the fact that mental hospitals are not places for mere segregation but for the active treatment of persons of unsound mind has tended, and will further tend, towards the admission of patients in the earlier and more hopeful stages of their malady. In the treatment of insanity advances are being made which the medical officers in our mental hospitals are studying, and this further stimulates the public confidence. But such confidence cuts two ways. We are finding here what has been found in Great Britain—that many irrecoverable patients who could and would have been kept at home under former conditions are being sent by relatives to these institutions, knowing that they will be comfortably housed and humanely tended. The net results, so far as mere figures are concerned, has been the neutralising of one set of factors by the other. It is clear,

Ratio to 10,000 of Population of Number of Persons in Population contributing Year. Admissions. First Admissions. One Admission. One First Admission. 1898 1899 1900 1901 1902 6-14 5-93 6-39 6-83 6-48 507 4-71 502 561 5-07 1,627 1,685 1,565 1,464 1,542 1,972 2,119 1,990 1,774 1,971 Quinquennial average 6-36 5-11 1,571 1,957 1903 1904 1905 1906 1907 6-78 6-55 6'76 7-16 639 560 5-42 5-59 5-82 5-04 1,473 1,526 1,478 1,396 1,567 1,783 1,844 1,786 1,718 1,982 Quinquennial average 6'74 550 1,484 1,818 Decennial average ... 656 5-32 1,523 1,880 1908 7-63 6-24 1,311 1,604