6

H.—7

Weekly Reports. —Last year mention was made of the initiation of a system of weekly reports sent to the' Head Office from each mental hospital. In these is embodied the medical journal, and some further information which permits of the different hospitals being compared, and by addition to arrive at certain facts with regard to the whole body of patients. Hereunder are some gleanings : — The proportional average of parents under special-observation notices in the year under review was 286 per cent, (males, 2-49; females, 338). The supervision of these patients, who are for the most part actively suicidal, is one of the most anxious duties the staff has to perform. The notice issued by the medical officer contains a statement giving reasons necessitating such observation, and this notice has to be read and signed by each relieving attendant before he takes over duty. The proportion of those who were classed as more or less dangerous was bio per cent, (m., 392; f., 1080). These patients require careful observation, but, as a rule, not to the extent of those above, because whe'.i by themselves they are harmless, and many give indications when they cannot be trusted. It. will be noted how largely women preponderate in this class. To account for this, apart from periodicity of outbreaks and some other factors influencing the type of mental disorder, an explanation may be found in the form of occupation. Men take readily to outdoor work on the farm, and are, so to speak, subdued by the environment; whereas it is difficult to lead women to adopt an unaccustomed occupation. Ihey perform domestic duties m the kitchen, laundry, and sewing-room, and for obvious reasons it would be unwise to let them work about a farm' where they cannot be distinctly separated from other workers. Under the new hospital scheme of separate buildings, each in its own ground, (lower an.l kitohen garden plots will be tried to give women open-air occupation for some period of the day. Epileptics, owing to their impulsiveness and the occasional outbreaks of violence associated with fits, to some extent coincide with the above class. The proportion of epileptics was 727 per cent, (m., 6-64; f., 8-02). Patients who labour under general paralysis of the insane, a fatal malady, pass through phases in which they need varying attention. They are liable to be injured—their bones fracture easily, thei require supervision when taking their food, and h> the last stages need careful nursing. The disease is conspicuously less prevalent here than in Great Britain, and in each country the proportion of women attacked is considerably fewer. The proportion under care was as follows: 1-45 per cent, (m., 211 ; f.. 0-53). 'Ihe proportion of patients who were kept in bed in the daytime from whatever cause, whether *s a form of treatment for mental disorder or for physical enfeeblement or sickness, was 304 per cent, (m., 221; f., 408). The above groups comprise patients who are the particular care of the nursing stafi. On the other hand, the proportion of patieacs who were usefully employed according to their capacity was 65-43 per cent, (m., 70-84; f., 57-85). Work, while promoting the cure of the curable, is a great factor in bringing about contentment. Were it not for employment, the attitude of the patients towards the staff would make their care and control more anxious and costly, would engender a feeling of discontent, and would cause a decline in the recovery-rate. The men, as before stated, are principally empbyed upon the farm. As showing how the unfit now outside institutions may, under proper guidance, add to the wealth of the country, the farm returns may be studied. The Staff.— Though not falling within the year under review, 1 cannot, writing after the event fail to record with deep regret the death of Mr. Chapman, the Superintendent of the Nelson Mental Hospital. Mr. Chapman had had a long, useful, and honourable career in the service before taking up the work at Nelson, and the experience and enthusiasm he brought to bear in the management of that institution were apparent to all. He was a large-hearted, kindly man, of whom it would not be saying too much to say he was beloved by the patients, and possessed withal a rigid sense of duty. His untimely death was a great loss to the Nelson Mental Hospital, with which he had completely identified himself, and to the whole service. Death has also taken Mr. Newport, head attendant at the Sunnyside Mental Hospital, a mar whose influence for good during twenty-six years' service could not easily be overrated —of whom I for one felt that under any given circumstances he would have done what was just and right. His eafly military training "made order and discipline almost an instinct, but the exercise of authority was tempered by geniality, tact, and sound common-sense. I have to thank yoii, sir, for so readily agreeing, when representations were made, to the appointment of Dr. Gribben to assist mc, and for the appointment of an additional Assistant Medical Officer for the Mental Hospitals at Auckland. Seacliff, and Porirua. The vacancies have been advertised in Great Britain, and I am pleased to state that Sir James Moody, Medical Superintendent of the Cane Hill Asylum, has consented to make a selection. The nursing staff continues to receive instruction in their work by lectures and demonstrations. The first"year of service is probationary. At the end of this time there is an examination in elementary anatomy and physiology, and the duty of an attendant or nurse in certain emergen oies On passing this examination probationers are appointed to the staff as juniors, and so continue for two years, .luring which time instruction is given in their special work, including. as it does, the nursing care of patients suffering from mental and bodily disorders. The aim of id.' teaching is to 'leal with the subjects from the practical side. At the end of this period the candidates sit for a written examination, the papers being set in and returned to the Head Office for correction. I then hold in each institution an oral examination, with the Medical Superintendent as coadjutor, and Miss Maclean examines in nursing. The candidates who pass are registered, and become senior nurses and attendants. Those who do not pass have to put in another year's service before attaining the rank and pay of seniors. The" following if< the list of those who passed at, the last examination : Dorothea B. Browne. Mirhael .Tohn Cooney, Thomas L. Cooney, Mary Cruickshnnk, Christina Drummond, Annie E.