H.—7

7

is a factor ; but the discovery of the fact that nature does not forgive is often left to this critical period. Few who are observant could not quote instances of illusage of the brain with apparent impunity earlier in life leading to a mental breakdown when that organ commenced to share in the general decay ; indeed, in many cases the condition is one of presenility. The proportion of patients admitted suffering from senile insanity is relatively large. Weekly Reports. The receipt of weekly reports from each mental hospital, the same being a copy of the entries into the Weekly Report Book, has been commented upon before as being very useful in permitting the institution of comparisons as well as in bringing out the total and proportional number of patients needing special oversight, care, or control of any reason, the number employed usefully, and thereby contributing to their well-being and comfort, the nature of the employment, and so forth. Hereunder, the figures for the weeks during the year, collected from these reports, are represented under some of the chiet headings in proportions per cent, of the total. The heading " Under constant observation " includes so very few beyond the suicidal that, though shown separately in the reports, they may be taken as coinciding for all practical purposes. Employment is one of the chief methods of treatment, and this and other methods, more or less general in application, are obviously excluded in the heading " Under special treatment," which embraces what the term implies, whether the disorder be mental or physical. The general totals give the proportions for the Dominion, and any marked individual variations depend, mainly upon the nature of the admissions and the effect of past transfers. The regular recording of these numbers furnish data for classification.

Accommodation. The question of providing accommodation for the yearly increment of patients, the excess of admissions over discharges and deaths, is a very serious one, by no means confined to this country, and it has to be answered by expenditure. Not to take examples nearer home, the returns received last year from England and Wales show that the cost of buildings, not including sites, for the country, district, and county-borough asylums exceeded twenty-two millions ; that twelve millions of this sum was spent in carrying the original designs of these institutions to a completion, including some recent huge establishments ; and the balance, ten millions odd, has been spent upon additions (partly on alterations), and yet in more than forty institutions there are patients in excess of accommodation. In this country the General Government undertakes the oversight, care, and control of the mentally defective, and the responsibility is great, one which cannot in the nature of things be evaded, and cannot be carried out without great cost to the taxpayer. There has been some discussion recently on the burden of the general hospitals. What would that burden be if the patients who did not recover were not discharged ? So regarded, the full significance of the accumulation of the mentally defective and the necessity to house and maintain them impresses itself upon the imagination. It is a grievous burden in a developing country, but one I venture to believe a humanitarian people will willingly bear. Nothing is wanted in the way of extravagance, but we do want sufficient floor-space per individual, and sufficient sunlight and fresh air—given these, comfort can be added at a negligible cost. Our older buildings did not look ahead sufficiently, and their design may be described as a band marked out at intervals into wards like a foot rule in inches. In course of time these buildings became filled, sometimes one ward more than another. They could not con-

Mental Hospital at Under Constant Observation Notice. Males. Pemales. Total. Males. Females. Total. Epileptics. Qei leral Paralytics. Males. Females. Total. Auckland Christchurch Dunedin (Seacliff and Orokonui) Hokitika Nelson Porirua Tokanui Ashburn Hall 3-94 1-74 3-69 0-02 0-16 1-98 6-65 0-82 4-05 1-12 0-10 2-99 5-00 1-30 3-82 0-29 0-13 2-42 5-85 6-89 7-72 7-62 8-70 8-91 10-61 8-33 6-10 6-52 9-20 8-33 4-56 6-89 5-65 7-12 8-20 8-60 547 7-00 2-42 0-74 2-34 (HI 0-33 0-50 0-16 1 •()() 0-63 i -44a 0-081 ■• Vi 1-30 -- M 1-07 1-72 0-76 0-29 1-44 0-77 8-08 i'-io Total for all institutions 2-58 3-29 2-88 7-68 8-19 7-90 1-69 0-40 ' 1-14

Employed. Under Special Tref itment. Dangerous. loin [ospil Males. ! Females. Total. Males. Females. Total. Males. Females. Total. Auckland Christchurch Dunedin (Seacliff and Orokonui) Hokitika .. Nelson Porirua Tokanui Ashburn Hall 7-16 2-10 1-53 2-79 ::-48 3-62 8-88 7-95 20-05 2-12 4-80 5-61 7-83 4-93 9-19 1-62 4-14 4-48 61-17 87-02 76-01 55-15 71-25 66-65 100-00 82-43 45-20 82-89 50-96 39-67 68-21 46-13 54-93 85-03 65-65 51-70 69-67 57-68 !00-00 76-67 2-02 1-59 1-91 1 -45 2-76 1-40 1-28 6-16 1-95 2-24 4-37 1-38 1-73 3-80 1-93 1-63 3-60 1-60 5-66 2-47 4-33 69-61 10-44 I 8-59 13-83 Total for all institutions 3-65 9-91 6-30 70-59 56-22 64-52 1-86 3-03 2-36