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OUR LUNATIC ASYLUMS., Issue 8001, 2 September 1889
OUR LUNATIC ASYLUMS.
Dr Macgregor's report shows that at the end of last year there were 1,681 insane persons in the New Zealand asylums, or fourteen less than at the end of 1887. Of these Seacliff had the largest number—viz., 490; Auckland came next with 367; then Christchurch, 363 ; Wellington, 237 ; Hokitika, 104; Nelson, 96; and Ashburn Hall (private asylum), 24. The proportion to population is, exclusive of Maoris, 1 in 361, and, inclusive of Maoris, 1 in 386; so that civilisation, generally speaking, may be set down as one of the causes of insanity. In New South Wales the proportion is 1 in 374, and in England it was the year before last 1 in 346. New Zealand thus stands midway between the Mother Country aiid the mother colony of Australasia. The inspector complains, ass in former reports, of the scarcity of accommodation a defect which has been lately aggravated by the iire at Sunnyside and the landslip at SeaclilE Another complaint reiterated in the present report is that the asylums are being steadily converted into refuges for the mere safe keeping of chronic and incurable lunatics. This reprehensible practice has prevailed in all these colonies. Dr Manning, whom Dr Macgregor calls the greatest authority in such matters in Australasia, however, says that the muchdebated question as to separating acute and chronic cases, by placing them in different institutions, is at length finding a practical settlement. .
At Parramatta, in New South Wales, Sundbury in Victoria, and Ipswich in Queensland, buildings erected for other purposes, and unauited for the more demonstrative classes of the insane, have been set apart for chronic cases; and there can be little doubt but that this arrangement will be more fully carried out in future, as tending to economy and more systematic classification. Tho system under which all patients who are brought to our asylums in all the Australian colonies are admitted, whether there is room or not, is one that, so far as X am aware, obtains in no other conntry—certainly in no other English-speaking community, In Great Britain, in tbe United States, and in Canada a standard of accommodation is fixed, and no patient is admitted in excess of this. In Great Britain the numbers in excess of the accommodation in local asylums are accommodated temporarily in the asylums of other districts, in licensed houses, or in poorhouses. In Canada and the United States the temporary accommodation provided is in poorhouses or other receptacles, and the patients must await their turn for admission should the State asylums be full. Our system has one advantage : it gives us our patients at an early stage, and in many cases a curable stage, of their malady; but it has disadvantages which outweigh this.
The defective arrangements described by Dr Manning exist also in NewZealand ; and at present, from the two circumstances already mentioned, to an unusual extent. The evil of overcrowding is moreover greatly enhanced by the criminal lunatics, who, although they number only sixty in all, have a most mischievous influence on the conduct of the asylums. They are often, says the Inspector, extremely violent and dangerous, and cause great difficulties and turmoil both among the patients and the staff. But Dr Macgregor is hopeless of being able to segregate this description of lunatics, as a properly-equipped criminal lunatic asylum would be a very ostly institution ; and he makes a suggestion which, we fear, is quite impracticable. "It seems to me," he says, '•' until we "are able to afford separate accommo- " dation for this class, that criminals "who become insane under sentence "should remain in prison till their " sentence expires, unless they can be "treated like ordinary patients." It is to be hoped that the Inspector will not be allowed to give effect to this extremely questionable proposal; and we can scarcely help thinking that he has exaggerated the effects of the presence of these criminal lunatics on the general condition of the asylums. Judged by the percentage of recoveries, our New Zealand asylums must be better managed than those of any of the other Australasian colonies. Here it is 57.62, while in Queensland (which comes next) it is only 46.88 ; in Victoria it is 41.85, in New South Wales 40.22, in South Australia 29.20, and in Tasmania 16.1)4. But such a wide difference as this list shows, for instance, between New Zealand and Tasmania, compels the inference that something besides management must be concerned with the results—either this, or the management of the asylums in South Australia and TasJ mania must simply be infamous. The percentages we have quoted are all for one year—lßß7—and it is, of course, possible that the character of the patients in the different asylums might alone account for much of the marked difference in the results. New Zealand has also the lowest death rate respect the percentage is more uniform, the highest being in South Australia—viz., 11.40; Victoria and Tasmania have respectively 7.30 and 7.24, and New South Wales and Queensland 6.79 and 6.58. The management of all our asylums is, according to the report, highly satisfactory. For some time after Dr Macgregor's reign commenced there were a number of rather serious troubles. He seems, however, at last to have got into comparatively smooth water—the only difficulties at present arising from defective accommodation, chiefly in consequence of the mishaps at Christchurch and Seacliff. The reduction in the cost of maintenance would also seem to bear testimony to improved management. Last year's report showed a saving of 8s 2d per head, and this years shows a further saving of £2 5s 7d per head, " without in any way diminishing the
"comfort of the patients, and nor- '• withstanding the increased cost of " many articles of consumption." The total cost per head is £24 13s sd; which, however, is brought down by repayments to £2O Gs 7d. The care of the insane thus costs the Colony a little over £33,G00-a large sum for such a small community to pay for such a purpose. The report says : " The Auckland Asylum again heads •' the list for economical management, «' and next to it comes Christchurch. "Nelson and Wellington are the "costliest asylums, even when due " allowanco is made for the neces- " sarily greater cost of small institutions. Seacliff has not yet taken "the place it ought to occupy as the "least expensive of all our asylums. "The explanation is to be found " partly in. tko c<m£vision, caused by " the enforced removal of the females " (owing to the landslip), and partly "in the fact that an expenditure of "M 8s 3d per head was required to "bring the stock of bedding and «' clothing up to Dr King's ideas of " what it ought to be." The only private asylum in the Colony is Ashburn Hall, in our own neighborhood. This is a remarkably ■well conducted institution. The buildings and grounds are admirably arranged, the situation is cheerful and healthy, and the organisation of the asylum is very satisfactory. The patients, says the Inspector, "are " treated with very great kindness—--41 well-fed, well-lodged—the only cause "of dissatisfaction being the loss of " liberty and the necessity for control. "I am always particularly anxious to " discover any indications that patients "may give of improper detention. " Every one of them had the opportunity of private conversation with " me, and nothing could be more satis- " factory than the accounts they give "of their experience on the whole." In this asylum there were twenty-four patients at the end of last year, as against twenty-five at the end of 1887. °Of the causes of insanity drink still takes the highest place; so that the Colony has, like individuals, to pay dear for its vice. Forty-one of the cases are set down to this cause; but it is probably—nay, certainly—responsible for a large proportion of the ninety cases of which the causes are said to be unknown. Strange to say, religion comes next to drink in the list of causes; but this cause acts of course in a very different manner. And who can say how many of the twenty cases of religious mania are really due to weakened brains, the result of intemperance in the parents 1 Of inherited mania there are nineteen cases; and the only other principal cause is childbearing, the number of cases of puerperal mania being eighteen. Eight coses are set down to solitude mostly shepherds, we presume, who have been stationed among the hills in the back country. . To brain disease, only ten cases are j assigned, and one to softening of the brain; to senile decay, nine; to mental anxiety, four (this cause, however, should surely include " financial difficulties," which has six set opposite it); to grief, one ; and to love, two, both being of the stronger sex. Such is a resume of Pr Macgregor's painful but interesting report. Of the causes of mental disease many are preventible; and it is somewhatdisappointing to find that our young, vigorous civilisation should be about as deeply tainted with such a distressing malady as that of the Old Country. But it should be remembered that a large number of the cases treated in our asylums may be said to have been imported; and there can be no doubt that the mere transplantation of human beings tends in many instances to produce mental and moral disturbance. It is said that colonial-born youths are more temperate than their fathers. Let us hope that they will also develop less madness.
OUR LUNATIC ASYLUMS., Issue 8001, 2 September 1889
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