H. —7

The admissions numbered 1,109 (in. 553, f. 556), or 40 more than in the previous year. Of these, 161 had been previously under care, mating the proportion of readmissions 14-52 per cent., and 948 patients were admitted for the first time. The ratio to population of all admissions (exclusive of Maoris) was 7-07 (m. 7-34, f. 7-20) to 10,000, and of first admissions 6-17 (m. 6-19, f. 6-14), so that 1,388 persons in the general population contributed one patient, and 1,620 contributed a patient admitted for the first time. The discharges (excluding transfers) numbered 471, or 91 more than in 1935. 201 (or 74 more) harmless unrecovered persons were returned to the care of friends ; and 270 (m. 121, f. 149) recovered —17 more than last year —representing a percentage of 24-34 (m. 21-88, f. 26-80) on the total admitted. With voluntary boarders added the percentage rises to 27-34. Altogether, 50-92 per cent, of the inmates admitted were able to leave institutional care. Of a total of 8,796 patients under care, 465 (m. 252, f. 213) died, or 6-38 per cent, on the average number resident. An inquest is held in the case of every death, whatever the cause. The causes are detailed in Table VI, and the following is the percentage of causes mainly contributing : Senile decay, 18-71 ; diseases of the brain and nervous system group, 23-01 ; heart-disease, 19-57 ; tuberculosis, 6-45. In Table VII the principal causes assigned for the mental breakdown in the admissions are stated ; but as a matter of fact they are merely approximations, and these, with the small numbers with which we have to deal, show such divergencies from year to year that the proportion assigned to any one cause in any one year cannot be assumed to be our average incidence. Causation is always complex, and the most potent factor is the individual. Hereunder the assignment causations in the table referred to are grouped and shown in their relative proportions :— Males. Females. Total. Heredity .. .. .. .. .. 8-68 6-83 7-76 Congenital .. .. .. .. .. 19-89 12-41 16-14 Predisposed by previous attack .. .. 12-12 18-70 15-42 Critical periods .. .. .. .. 6-87 14-21 10-55 Child-bearing (puerperal, non-septic, and lactation) .. 1-99 0-99 Mental stress .. .. .. .. 18-44 20-32 19-39 Toxic, including — M. p. Syphilis .. .. .. 4-88 1-441 ~ . .. Alcohol 3-61 0-72/ 9 ' 95 3 ' 06 6 " 49 Traumatic .. .. .. .. .. 0-54 .. 0-27 Disorder of nervous system, including— m. f. Epilepsy .. .. .. 2-89 2'52 5-06 3-78 4-42 Other bodily affections .. .. .. 8-50 6-65 7-57 Senility .. .. .. .. .. 9-95 12-05 11-00 100-00 100-00 100-00

Voluntary Boarders.

It will be noted that there were 303 voluntary admissions in the year under review, that 248 were discharged, and that 41 boarders, representing 13-53 per cent, of the admissions, had to be transferred to the register of patients (having shown mental disorder in degree sufficiently pronounced and sustained to render it improper for them to be continued as voluntary boarders), while the proportion of deaths on average number of resident was 4-72 per cent. The column devoted to " Not First Admissions " records readmissions on a return of illness in those previously treated to recovery as voluntary boarders. The average daily number of voluntary boarders in 1936 was 360.

12

y par ' First Not First j Total ?„ ra gl'S e i ™ tv , Remaining Year ' : Admission. Admission. ! Admissions. % » e » st . er D,eii - Discharged. on of Patients. 31st December M. F. T. M. F. T. M. F. T. M. F. T. M. F. T. M. F. T. M. F. T. 1912 .. .. 6 17 23 0 0 0 6 17 23 1 3 4 0 0 0 4 3 7 1 11 12 1913 .. .. 18 19 37 0 2 2 18 21 39 2 5 7 0 1 1 12 12 24 5 14 19 1914 .. .. 17 19 36 3 2 5 20 21 41 7 5 12 1 1 2 11 15 26 6 14 20 1915 .. .. 15 17 32 1 2 3 16 19 35 3 4 7 0 1 1 8 14 22 11 14 25 1916 .. .. 13 23 36 5 8 13 18 31 49 4 4 8 1 2 3 14 14 28 10 15 25 1917 .. .. 14 21 35 1 13 14 15 34 49 6 6 12 0 1 1 10 23 33 9 19 28 1918 .. .. 23 38 61 5 11 16 28 49 77 1 4 5 2 2 4 15 30 45 39 32 51 1919 .. .. 31 39 70 5 19 24 36 58 94 3 3 6 0 2 2 26 42 68 26 43 69 1920 .. .. 26 38 64 16 12 28 42 50 92 3 4 7 1 2 3 33 33 66 31 54 85 1921 .. .. 39 39 78 11 15 26 50 54 104 2 3 5 5 1 6 38 41 79 36 63 99 1922 .. .. 47 38 85 10 16 26 57 54 111 6 5 11 4 4 8 40 48 88 4-3 60 103 1923 .. .. 44 50 94 15 21 36 59 71 130 3 6 9 3 3 6 47 47 94 49 75 124 1924 .. .. 38 44 82 16 20 36 54 64 118 4 8 12 6 3 9 39 48 87 54 80 134 1925 .. .. 64 59 123 15 34 49 79 93 172 10 15 25 6 3 9 60 63 123 57 92 149 1926 .. .. 71 60 131 11 29 40 82 89 171 10 11 21 7 2 9 49 71 120 73 97 170 1927 .. ..70 70 140 25 32 57 95 102 197 8 6 14 5 12 17 75 58 133 80 123 203 1928 .. ..120 94 214 37 39 76 157 133 290 8 10 18 10 8 18 102 97 199 117 141 258 1929 .. .. 102 63 165 50 43 93 152 106 258 11 3 14 9 9 18 119 110 229 130 125 255 1930 .. .. 152 84 236 41 35 76 193 119 312 15 9 24 8 6 14 130 79 209 170 150 320 1931 .. ..166 98 264 43 36 79 209 134 343 11 14 25 11 7 18 159 102 261 198 16] 359 1932 .. .. 150 85 235 50 40 90 200 125 325 24 32 56 14 5 19 190 108 298 170 141 311 1933 .. .. 112 109 221 53 32 85 165 141 306 11 14 25 5 4 9 121 107 228 198 157 355 1934 .. . . 132 90 221 56 33 89 188 123 311 7 11 18 10 6 16 152 99 251 217 164 381 1935 .. ..130 87 217 40 55 95 170 142 312 18 20 38 19 10 29 151 116 267 199 160 359 1936 .. .. 98 99 197 62 44 106 160 143 303 21 20 41 7 10 17 137 111 248 194 162 356