H.—7

2

In the following table the general population and the mental-hospital population, with its admis' ; '>ns and recoveries, are arranged in. proportions per < ent. of age-groups.

Comparing the age-distribution of the general population with ours one immediately learns that insanity is an adult disease, one-third of the general and only one-sixtieth of our special population being contributed by persons under fifteen years of age. This fact disturbs the relative value of the other figures; but if the juveniles in each series were divided proportionately among the other groups the mental hospitals would still have a markedly higher proportion of elderly persons, due mainly to the higher tendency amongst the aged to mental disorder, partly to their small chance of recovery and to institutional care prolonging their lives, and partly to the admission of senile, patients who should be treated elsewhere than in a mental hospital. The proportion in the. admission table accentuates what has been said about senile, cases, and it will be noted that the proportion of juveniles is relatively higher. This has been observed of recent years, and called forth the remarks in my last report for the, necessity of a separate institution for their care, and training. The largest proportion of admissions and recoveries is contributed by persons between these extremes, and we would be in a. much better position to deal with them if we were not hampered by the presence in the same institutions of mentally deficient children and aged mentally infirm, quite, apart from the fact that they are occupying accommodation which was designed for the mentally unsound. The following table will make this clear. It is brought up to the sth June, 1920, and demonstrates a want of accommodation which would be more than adjusted if thosefin their dotage and the mentally deficient were provided for elsewhere. As things are, there are some adjustments still to be made by transfer of patients to new buildings. Our discharge-rate is high, our death-rate low, and. between these and the total admissions there is always a balance more or less permanently added to our population. I illustrated this some years ago by picturing the structural proportions which general hospitals would attain if the Boards were forced to keep patients till they had practically recovered the use of body and limb they had prior to their illness. Last year 883 patients were admitted, and 779 were discharged or died ; thus 104 were added to the mentally defective, population, or 10.1 to the mental hospitals, for 3 were transferred from mental hospitals to private care as single patients. We have, been endeavouring to keep) pace with estimated increments and a little more besides ; but the difficulty of getting material and labour has meant slow progress. At the present time buildings so delayed are being proceeded with at Auckland, Tokanui Nelson, Sunnyside, and "Waitati, and more will be. needed before these are finished. Considering the obligation to study economy, the shortness of labour in war years, and the slow rate of progress in building since, we. are not so badly off for bare accommodation as we might have been, had we not done a good, deal when we were able ; nor, for that matter, are we as badly off as many public bodies and private individuals are at present. But we want more than bai-e accommodation. By reference, to the table below it will be seen that the total accommodation is divided into a number of wards, and, I may add, some of these, wards are subdivided If patients labouring under the different classes of mental disorder could at all times be trusted to fill the wards as designed there would be very little trouble ; but one is dealing with a very uncertain quantity, and so one ward, may be overfilled while another has accommodation to spare. We are countering this by adding new wards instead of additions to existing wards, and so providing for more detailed classification. The reception wards are in this respect a noteworthy addition to our resources. A considerable portion of our expenditure will be directed not to adding to dormitory accommodation, but to enlarging old-time living-rooms and modernizing buildings which have got out of date but are too good to abandon, and also to carrying out renovations and repairs which were largely suspended during the war years.

Age-groups. Under 15 16 and under 20 20 „ 30 30 ,, - 40 40 ,, 50 50 „ 60 60 „ 70 70 ,, 80 SO and upwards. . Proportions at each Age-group of 100 Persons. In the General Population In Mental Hospitals on Admitted to Mental lies- Dlschaq (Approximate). 31st December, 1919. pitals in 1919. 1 Males. Females. Total. Males. ! Females. Total. Males. I Females. Total. Males. I. 30-17 .'12-58 31-81 ! 1-72 1-50 1-67 4-09 3-04 4-17 0-54 8-44 0-17 8-78 j 2-10 2-52 2-27 5-59 4-07 5-33 3-78 19-60 19-67 19-66 10-14 8-88 9-liO 20-16 16-57 18-66 21-62 16-73 15-99 16-39 22-15 20-17 21-31 22-56 24-04 23-18 28-11 10-44 10-08 10-26 24-09 24-69 24-35 17-97 25-14 20-97 27-57 6-96 6-13 6-57 17-92 21-15 19-29 12-37 11-60 12-05 10-27 4-47 3-98 4-24 13-53 13-14 13-37 6-59 I 9-39 7-76 5-95 2-62 1-96 | 2-30 I 6-41 l 6-37 6-39 7-18 4-14 5-91 2-16 0-51 I 0-44 0-49 1-94 1-49 1-75 2-59; 1-11 1-97 ged as Re< In 1919. Females. f 0-69 4-83 21-38 28-96 22-76 12-41 7-59 1-38 covered Total. (Mil 4-24 21-52 28-48 25-45 11 -21 6-67 1-82

Mentally Defective ; Mental Hospital. Class I, ! Class II, Unsound Mentally Mind. i lulirm. Patients on Register as classified on Patients on H 5tb June, 19211. Class 111, Class IV, ffi*?, V J Class VI, , . Idiots. Imbeciles. m ™™ d - Epileptics. , " 1 '"- (Agister. -Lrlster Accommodation on * 5th June, 1920. Absent on Pro- | iiation. Absent Number mi Pro- . nl Total. liation. Wards. M. ]f. M. If. Auckland .. 313 235 141 48 Christchurch .. 231 300 40 29 Dunedin (Seacliff 485 325 14 37 and Waitati) Hokitika . . 155 40 20 14 Nelson . . 24 34 35 39 Porirua . . 504 394 22 10 Tokanui . . 141 41 M. I''. M. .If. it. If. M. If. M. If. S (i 91 53 4 31 49 29 606 402 7 4 33 39 20 11 30 37 301 420 II 4 40 31 11 9 48 33 639 439 M. If. 5 13 II 18 4 2 M. If. M. If. M. If, 5 13 9 8 645 385 II 18 8 7 380 435 4 2 11 7 532 403 2 1 5 2 4 8 12 6 198 71 12 8 10 101 7 7, 9 8 97 100 4 4 22 27 : 16 15 55 30 623 480 15 3 2 1| I 3 149 49 l ____J 1 2 2 4 5 14 12 4 2 206 04 2 4 2 3, 92 l\04 5 14 10 8 590 403 ..• .. 4 2 172 99 28 53 48 372,617 1,893 Totals .. ,1,853 1,369 302 183 44 28 206 165 M 82i 204 146 2,673 1,973 ■ -H !