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TOKANUI MENTAL HOSPITAL. Dk. Tothill reports : — I have the honour to present my annual report for the year ending 31st December, 1938. The total number of cases under care during the year was 788, which includes 29 voluntary boarders. Admissions numbered 108, of whom 7 were transfers from other institutions and 12 voluntary boarders. The discharges were 50 patients under certificate, 7 voluntary boarders, and 6 transferred. There were 48 deaths, senile decay and heart-disease being the predominant causes. At the end of the year 674 patients, including 33 on probation and 18 voluntary boarders, remained on the register. Reports have been made for the Justice Department on inmates at Waikeria and on children under the care of the Child Welfare Department, Hamilton. The general health of the patients has been good, though a number of cases of measles occurred among the patients and staff. For some months we have been conducting an interesting experiment in trying to rehabilitate male schizophrenics by intensive directional treatment. In various forms this is used as a concomitant of insulin therapy, but here we have omitted the insulin. This work is still in its infancy, and though no miraculous cures can be claimed a definite improvement in conduct and personal hygiene has been noted to the extent that patients taken out of a refractory ward are now well enough to be nursed in the admission ward. Good progress has been made in modernizing the older parts of the hospital and interior, and exterior renovation continues to be actively pursued. The detachment of Ward P. 2. is now complete, the kitchen addition is ready for use, a dining-room has been provided, and the new bath-room and improved lavatory accommodation are nearing completion. Wards F. 1 and P. 7 are in the process of being detached, and alterations will provide cooking facilities and improved bathing and lavatory arrangements. When the work has been executed Wards P. 1, P. 2, and P. 7 will be self-contained, independent units. Part of the long corridor on the female side has already been demolished, and eventually it will be completely removed. By the separation of the wards and elimination of this corridor serious fire risk will be abolished. A veranda has been built on to P. 7 and will be particularly useful in wet weather. The double-storied veranda addition to the female admission ward is now completed, the upstairs providing extra bed accommodation and the ground floor a sun room and facilities for the treatment of recent patients who are receiving bed. treatment. The roofs of Wards F. 1 and F. 7 have been painted, and those of F. 2 and the main kitchen are to receive attention in the near future. Stainless-steel sinks were installed in the sculleries of Wards A, C, H, and the male staff, benches renewed, and the backs tiled. Ward A has been completely repainted, and additional furniture increases its comfort. Fire-places throughout the hospital were repaired. The male-staff quarters have been renovated, the mess-room papered, and staff sitting-room furnished. The Assistant Medical Officer's new residence is now in occupation. Various improvements and repairs were carried out on the staff houses on the hospital estate. The pipes on the water-main from Te Awamutu are being replaced by spiral steel pipes, and will result in considerable economy by eliminating water leakage. An additional Public Works store was erected, and accommodation for Public Works staff is being built. The new mortuary, in which a post-mortem table was constructed, is in use. An all-weather road to-the hospital cemetery has been made, and a small shelter for the Ministers is being provided. Lights over the fire escapes at the Nurses' Home have been installed. Works due to begin include the erection of a new slaughter-house, skin-room, and boiling down works, exterior painting of Ward H, Villas 4, 5, 6, and the Nurses' Home, installation of foot-baths for farm-workers in A and C Wards, and alterations to the administration block to provide quarters for five officers. It is hoped to build an ample storage shed and a glass-house in the near future. The vegetable garden has been extended, lawns laid down round the male villas, and flowering shrubs planted. I shall be glad to see work commenced on the new laundry, engine-room, butcher's shop, and bakery as soon as possible. The laundry has been outgrown, and the butchery and bakery are out of date. A large number of patients are continuously employed on the farm, and further swamp land has been drained. We joined the herd-testing association, and our cows are now regularly tested. During the year some of our stock were affected with facial eczema, but, fortunately, not to any serious extent. It has been suggested that the cow-byres bo moved to the centre of the farm. This would be an advantage to both farm and hospital, as the cows will have a shorter distance to travel and valuable building-sites for new male villas be placed at our disposal. Visits were made by the Hon. P. Fraser, Minister in Charge of Mental Hospitals, and Mr. Simpson, Public Service Commissioner for Western Australia. Mr. S. A. Empson, who for many years has been associated with this hospital as Coroner, retired, Mr. W. Jeffery being appointed as his successor.

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