9

H.—7

PORIRUA MENTAL HOSPITAL. Dr. Jeffreys reports : — The number of patients under care (luring the year was 1,363 (males, 782 ; females, 581) ; the average number resident being 1,119 (males, 654; females, 465). In addition there were 56 voluntary boarders under treatment, the average number being 25 (males, 10; females, 15). Exclusive of transfers from other institutions there were 257 admissions (males, 133 ; females, 124), and 102 patients were discharged recovered, the recovery-rate being 39-3 per cent. The deaths during the year were 82, or a little more than 7 per cent, of the average number resident. The chief causes of death were- cardiac disease, 14; pulmonary tuberculosis, 12 ; senility, 11 ; and general paralysis, 10. Fifty-one of those who died were over fifty years of age. There were two deaths from typhoid fever on the female side. Three " carriers " have been discovered, and these have been isolated as far as possible, but, owing to our lack of accommodation and to the fact that two of them are very difficult patients to deal with, complete isolation is impossible without a special ward. The. general health of the patients has been very satisfactory in spite of the congested state of many of the wards. Our numbers continue steadily to increase, and there is now considerable difficulty in finding accommodation for new admissions, as already we have far too many shakedowns in day-rooms and corridors, and there is urgent need of more day-room space. The kinematograph plant has been installed, and the patients thoroughly appreciate the pictures, many of the older inmates never having seen a moving picture before. The male dininghall, which is also the recreation-hall, is hardly large enough to accommodate all the patients who are fit to go, and if the suggestion to utilize the present engine-room block for the kitchen were carried out the recreation-hall could be enlarged by taking in part of the kitchen. In addition to the religious services, pictures, and usual fortnightly dances, we have been fortunate in having a number of excellent concert parties from Wellington, and I desire to thank all those who have helped to bring a little brightness into the lives of the unfortunate inmates whose liberty has of necessity been taken from them. I have to thank my colleagues Drs. Prins and Monaghan, other officers, and the staff, for their loyal co-operation in carrying on the work of the institution. NELSON MENTAL HOSPITAL. Dr. Gray reports : — At the beginning of 1921 there were upon the register 206 patients—99 males and 107 females. During the year we had 37 admissions (26 males and 11 females), and at the close of the period under review there remained 215, an increase of 9. There were 10 deaths, giving a mortality-rate of 4-6 per cent, upon the average number resident. Our recoveries totalled 12, or 32-4 per cent, on the admissions. The general health of the patients has been good, and we have been almost free from zymotic diseases. Several important structural alterations have been carried out during the year. On the male side the bathing-facilities have been greatly improved, and a commodious staff dining and recreation room provided. On the female side the wing hitherto occupied by the boys has been completely renovated and reserved for the recently admitted cases. The system of dormitory observation for depressed cases adds materially to the comfort and well-being of this class of patient, and to such an extent does it lessen the anxiety involved to the staff that I am strongly of opinion that it should be. laid down as a regulation that no depressed patient should be treated in a single room. The outstanding event of tin; year has been our entry into possession of Stoke Farm, with a view to the foundation of a mental hospital upon the "villa system." Having had four years' experience in a villa mental hospital in Scotland, 1 have no doubt whatever as to the superlative merits of the scheme, and I consider the acquisition of this property to be a very big advance towards that perfect classification which we all desire. Secluded, yet easy of access, commanding a magnificent view of mountain, bush, and sea, and with natural advantages in regard to sun, water, and drainage, Stoke Farm is ideally situated for our purpose, The buildings generally are in a very good state of repair, and, with few additions and alterations, will form a good nucleus of a large mental hospital. At the time of writing there are over 70 male patients in residence, and the establishment is conducted on villa lines. There are no airing-courts or parks, and every patient is free to roam within the estate, provided that he occupies his time usefully and punctually obeys the few rules of the institution. The freedom from irksome restraint and the sense of being "on parole " have a wonderfully tranquillizing effect upon the patients, and I would like to emphasize the following three facts : (1) Every inmate who is physically fit is usefully employed (92 per cent.) ; (2) we have had no escape, nor attempt at escape ; (3) there has not been a single injury, however trifling, inflicted by any patient upon another. As one recently admitted patient remarked, " This is not an asylum, it's a rest camp." Our staff is enthusiastic in regard to the system—we had some sceptics to start with —we have none now. A very suitable cottage on the estate has been reserved for female cases, and is in frequent use. The routine followed will approximate that laid down and so successfully carried out by Dr. Truby King at Seacliff Cottage.

2—H. 7.