MENTAL HOSPITALS OF THE DOMINION (REPORT ON) FOR 1913.

Appendix to the Journals of the House of Representatives, 1914 Session I, H-07

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1914. NEW ZEALAND

MENTAL HOSPITALS OF THE DOMINION (REPORT ON) FOR 1913.

Presented to both Houses of the General Assembly bij Command of I/is Excellency.

CONTENTS. PAOE PAOE Introduction .. .. .. .. .. 2 Voluntary Boarders .. .. .. .. 6 Number of Patients on Register .. .. 2 General Hospital Treatment .. .. .. G Their Distribution .. 4 .. .. .. 2 Accommodation .. .. .. .. 6 Their Ratio to Population .. .. .. 2 Farming Operations .. .. .. .. 7 Admissions .. .. .. .. .. 3 Financial Statement .. .. .. .. 8 Their Ratio to Population .. .. .. 3 The Staff .. .. .. .. .. 9 Ratios compared with Australia .. .. 3 Visits of Inspection .. .. .. .. 9 Discharges and Deaths .. .. .. 4 Medical Superintendents' Reports .. .. 10 Causes of Insanity .. .. .. .. 5 I Appendix— Weekly Reports .. .. .. .. 5 Statistical Tables .. .. .. 14

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The Hon. the Minister in Charge of Department for the Cake of Mental Defectives to His Excellency the Governor. My Lord, — Wellington, 31st July, 1914. I have the honour to submit to Your Excellency the report of the Inspector-General of Mental Defectives for the year 1913. 1 have, &c, R. Heaton Rhodes, Minister in Charge of Department for the Care of Mental Defectives.

The Inspector-General to the Hon. the Minister in Charge of the Department for the Care of Mental Defectives. Sir, — Wellington, 30th June, 1914. I have the honour to present, pursuant to section 78 of the Mental Defectives Act, 1911, the report for the year ended 31st December, 1913. The number of patients on the Mental Hospitals Register at the beginning of the year was 3,913 (males, 2,273; females, 1,640), and at tlit- end 3,964 (m., 2,332; f., 1,632), a net increase of 51, there being ">!) more males and 8 fewer females. The average increase during the former five years was a fraction over 134, the figures for the most and least favourable years being 86 and 174 respectively. The total number under oversight, care, or control was 4,805 (m., 2,816; f., 1,989), as against 4,743 (m., 2,813; f., 1,930) in the previous year, an increase of 62 (m., 3; f., 59), while the average number resident in our institutions during the year was 3,849 (m., 2,252; f., 1,597), against 3,697 (m., 2,146; f., 1,551) in 1912, or 152 more in the year under review. Distribution. Counting 93 (m., 69; f., 24) absent on leave as still resident in the mental hospital whence they left, the 3,964 patients on the register at the end of the year were distributed as follows : — Males. Females. Total. Auckland 552 344 896 Christchurch ... ... ... ... ... 339 313 652 Dunedin (Seacliff and Waitati) ... ... ... 546 378 924 Hokitika ... ... ... ... ... 202 68 270 Nelson ... ... ... ... ... 96 101 197 Porirua ... ... 485 407 892 Tokamii ... ... ... ... ... 89 ... 89 Ashburn Hall (private mental hospital) ... ... 23 21 44 2,332 1,632 3,964 Of those technically on leave, 41 men were resident at the Camp, near Dunedin, and 17 mentally deficient boys at the Richmond Home. The patients similarly on leave at Motuihi Island were returned to a temporary building on the Auckland Mental Hospital estate in September last owing to the buildings on the island, which had been adapted for their residence, being required by the Public Health Department in connection with the smallpox epidemic. Ratio in Population. The following calculations show the ratio of patients on the register at the end of the year to the estimated general popnlation, both exclusive and inclusive of the Native race. The number of Maoris on the register 39 only (in., 31; f., 8). The proportion of total mentally defective to the total population was, — Exclusive of Maoris ... ... ... ... 3619 per 10,000,0r lin 276 Inclusive of Maoris ... ... ... ... 3494 „ lin 286 The proportion of mentally defective males to the male population,— Exclusive of Maoris ... ... ... ... 4043 per 10,000,0r lin 247 Inclusive of Maoris ... ... ... ... 3915 „ lin 255 The proportion of mentally defective females to the female population,— Exclusive of Maoris ... ' ... ... ... 3150 per 10,000,0r lin 317 Inclusive of Maoris ... ... ... ... 3028 „ lin 330 Comparing these figures with those in the last report, and taking the ratios therein as a standard, there were, exclusive of Maoris, on the register at the end of the year 63 fewer patients than might have been anticipated by the natural increase of population. In the previous year there was an increase, limited to women patients, who were 60 in excess of the proportional increase in population, while the men were 5 fewer than anticipated. In the year under review the position of the men remains unchanged —6 fewer —while women patients are 57 fewer, a figure sufficient to alter the proportion from 1 in 307 to 1 in 317. In England and Wales the number of notified insane persons on the Ist January, 1913, stood to the estimated population (mean) in the proportion of 1 to 267, or 374 per 10,000.

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Admissions. Kxclusive of 108 patients (m., 77; f.. 31) transferred from one institution to another, the admissions numbered 784 (m., 466; f., 318), as against 839 (in., 458; f., 381; in the previous year, a decrease of 55. Of the 784, those admitted for the first time to any mental hospital in New Zealand numbered 660 (m., 394; f., 266), and those not admitted for the first time, 124 (in., 72; f., 52). To the first admissions 20 immigrants, who became insane within a year of landing here, contributed. Of this number, 5 men and 6 women came from the United Kingdom, of whom I woman had been previously insane, 3 men came from the Commonwealth, and 6 (one had been previously insane) from foreign countries. In addition, 3 New-Zealanders (men) were admitted shortly after their return from residence abroad. Ratio of Admissions to Population. Excluding the Native race (9 male and 5 Female patients) and all transfers, the proportion of admissions (whether firsi or not) and first admissions to the estimated general population (mean) stands respectively at 721 and 606 per 10,000; or, in other words, every 1,388 persons in the general population contributed an admission, and every 1,649 a first admission.

As a measure of the increase of patients under the Act in relation to the increase in the population, this table is more accurate than figures detailing the proportion of total mentally defective to the population. The first division in each section deals with all patients placed on the register during the periods; the second separates from the firsi patients whose names were placed on the register for the first time. As one attack of insanity predisposes to another, the return of many patients a longer or shorter time after discharge is not surprising, but an increase in the ratio of first admissions is of more serious import. During the last thirty-eight years there has been 1 readmieeion among every 461 admissions, or 1 return of a discharged patient for every 2 - 67 discharges—that is, cases discharged, not persons, for persons labouring under the recurrent forms of disorder will have been discharged and readmitted more than once. The general tendency, as demonstrated by the proportions at the quinquennia, indicates an increase of occurring insanity in excess of the increase in the population, though the proportions for 1913 compare very favourably with last year and favourably with the average of the previous five years. In this connection it is necessary to repeat that our population is materially augmented by ready-made adults, persons no longer immune by age, who have during their period of immunity diluted the statistics of some other country; and that the Mental Defectives Act, 1911, spreads its net wider than the Lunatics Act. Also, when dealing, as we are, with small numbers the addition of a few from any cause, such as an influx of adults and the advancing age of earlier settlers, makes a material difference. In England and Wales during 1912 every 10,000 of the general population contributed 5*13 first admissions and*6 - 14 total admissions (idiot establishments excluded). Our Ratios compared with Australian States. —For figures supplied for the construction of the following table I am obliged to the Inspectors-General of the States inoluded. Our admission proportions have, for purposes of comparison, been calculated on the population at the end of the year, whereas the figures in the table above were calculated on the mean.

Comparative Statement of Registered Insane Persons and Admissions to Institutions in relation to General Population.

Ratio to 10,000 of Population of Number of Persons in Population contributing Year. Admissions. First Admissions. One Admission. One First Admission. Quinquennial average, 1903-7 Quinquennial average, 1908-12 Decennial average, 1903-12 6-83 7-61 I 5-57 620 5-57 620 1,465 1,313 1,795 1,613 7-25 5-91 5-91 1,380 1,693 1913 7-21 606 606 1,388 1,649

Proportion oiInsane to 1,000 of the Population. Number of Ratiot^ Persons in lauc Population to one Insane Admissions. XX) of Popum of Number of Persons in Population contributing State. First Admissions. One Admission. One First Admission. M. F. T. M. F. T. M. F. T. M. F. T. M. F. T. M. F. T. ?ew South Wales r ictoria .. Queensland South Australia Vestern Australia Tew Zealand (exolusive of Maoris) 4-08J3-153-64 403'409|406 4122-953 59 2-78,2-14 2-46 ,3-741-90 2-M 4-04J3-15 3-61 245 248 317 244 274 7-97 246 7-17 .. 7-90 . . 7-40 340 8-55 276 8-03 5-78 6-93 6-67 606 6-616-63 i-63 6-86 .. 4-94 6-18 .. 5-38 7-17j .. 6-07 709 6-80 4-77 5-43 5-77 6-03 1,253 1,394 1,7291,4421,497 1,6511,512 1,507 .. 1,618 '.. 1,8511,394 .. 1,647 1,4091,470 2,095 1,841 1,732 1,657 2G7 247 526 817 5 06 5-97 1,169 1,245 1,975 1,674

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Diteharget ami Deaths. Omitting transfers, where discharge from one institution is coincident with admission into another, the number of cases discharged From the mental hospitals was 426 (m., 211; f., 215), and the deaths numbered 307 (in., 196; f., 111). The total number under care 'luring the year, deducting transfers, was 4,697 (m., 2,739; f., 1,958). The corresponding figures for the previous year were 402, 280, and 4,595 respectively. Had the previous year's relation of discharges and deaths to the total number under care been maintained in 1913, there would have been 15 fewer discharges and 21 fewer deaths. Of the patients discharged, 337 (in., 175; f., 102) were classed us recovered. In I!II2 the number discharged as recovered was 325 (in., 184; I., 141). The percentage of recoveries calculated upon admissions was 42"98 (m., 37*55; f., 50"94), as against .'W'74 (m., 4017; f., 37"01) in the previous year. In the summary of total admissions since 1876 the percentage of recovery works out at 39"87 (m., 3739; f., 43-58). In England and Wales (exclusive of idiot establishments) the rate for 1912 was 3476. The recovery rate is above our average. A lower may well have been anticipated under the Aci of 1911 on account of a larger proportion of mentally deficient and mentally infirm admissions, on account of a certain proportion of persons coming as voluntary boarders and recovering as such, instead of as patients, and because previously when a patient was discharged on probation it was often taken for granted that lie had recovered; bill under the new Act such persons have to be regarded as unreeovered unless there is medical evidence of recovery at the end of the probationary period. Unfortunately, people get careless about sending reports after they have left the institution, and their recovery is lost to statistics. For some years a prognosis has been made upon the admission of each patient, and at the end of the year the ease of every patient is reviewed, and his further detention depends upon the granting of a certificate that it is necessary for his own good or in the public interest. Incidental to this review is a reconsideration of the prognosis. The first stage is to set aside those whose malady is definitely incurable, and then to separate from the remainder the more hopeful cases. The results for 1913 are shown in the table hereunder :—

This table is sufficiently established to pass over without explanation. It is perhaps necessary to repeat that transfers ait included, and that the figures are not comparable with the return of recoveries on admission. Of the patients on the register at the beginning of the year, S7'2 per cent, were incurable, and 499 per cent, were expected to recover, but in as main as 12"8 per cent, there was deemed to l>e a chance of recovery. These arc average proportions, and it is mainly upon this margin that the medical work of the institution is focussed. The factor of expense should not be considered in providing what is adequate, The cost of the necessary treatment, even if the patient could be retained in private care, is beyond the ordinary private purse. It is a matter for gratification that proper admission buildings are going up. and ii must be understood that the maintenance of patients in these buildings will cost considerably above the average, if for no other reason than the larger proportion of nursing staff necessary for supervision ami to give individual attention. The percentage of deaths calculated on the average number resident was 798 (in.. 8"70; f., 696), in 1912 the proportion was 7■ 57 (m., 8"99j f., 5 , (>1); calculated on the total number under care (less transfers) the proportion per cent, in 1913 was 6"53 (in. 717; f., 567), and in the previous year 609 (m., 720; f., 4"54). In England and Wales the percentage, in 1912, calculated on the daily average number resident, was 970 (m., 1096; f., 861). , A Coroner's inquest is held in every ease of death in an institution, irrespective of the cause. Analysing Table XII in the appendix one finds that about 55 per cent, of those who died were over sixty years of age. and in 34 - 53 per cent, senile decay was the cause of death. Death resulted from diseases of the nervous system in 2."r08 per cent., general paralysis among males contributing 1122 pei , cent. Consumption and other forms of tuberculosis contributed 879 per cent. None

Of 3,913 Patients resident on 1st January, 1913. Of 892 Patients admitted during 1913. Totals. Showing as on 31st December, 1913, the Discharges, Deaths, and Length of Residence of those remaining, after the Exclusion of all Cases deemed incurable on 1st January, 1913, or on Admission in Cases admitted during the Year. uass A . ri. h (lass C. Th '• *»?& Remainder, d » as: dSs. 88 fiSa. Of Classes Of Classes n-.-, ■ A and C. B and D. General. 1 : M. J F. T. M. J F. I T. M. F. I T. M. F. T. M. F. j T. M. F. T. M. F. j T. 95J 100J 19b| 150 155 ; 305J 129 135 264! 82J 79 161 224 235| 459 J 232 234 4lili 466 469 B26 Discharged recovered .. 49 „ unrecovered .. 14 Died .. .. .. ..2 Remaining, residence 1 month or less j .. Ditto, over 1 and under 3 months .. „ 3 to 6 months „ 6 to 9 „ „ 9 to 12 „ .. .... „ over 12 „ .. .. 30 Total remaining .. .. 30 61 17 I i;o 3. 3 li 1 30 23 1 65 34 2 75 3 61 7 3 136 7 6 16 3 3 10 6 2 2(i (I 5 121 14 5 122 24 4 24(i 38 9 51 14 4 40 29 :( 91 43 7 175 28 9 162 53 7 3.(7 81 16 17 12 9 8 4 1 1-1 23 li Id 5 1 31 35 20 18 9 2 6 10 13 14 15 2 10 11 14 11 12 3 li; 21 27 25 27 5 17 12 9 S 4 31 14 23 11 Id 5 22 31 35 20 18 9 r>3 8 10 13 14 15 105 10 11 14 11 12 104 16 21 27 2.") 27 209 23 22 22 22 111 i:iii 24 34 L>.-, 2! 17 126 47 56 47 13 30 262 21 51 103 !(')' 204 21 51 10 204 51 64 lie 60 12 , 81 s.-, 166 163 32.-1 244 247 191 io:s li! 162

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of the remaining causes accounted for a sufficient number of deaths to make ils proportion per tent, of any value, but it should be mentioned that eight deaths were due to enteric -seven at Auckland and one at Porirua that one patient met with an accident involving fraoture of the skull, and three committed suicide. in England and Wales during l!) 12 the percentage of deaths due to tuberculosis was 143, and to general paralysis of the insane was 26\'! for males. Gauges of Insanity, For some years under this section Table Xlll has been analysed, and the percentage incidenrc of the principal assigned causes compared in tabular form. Having served the purpose of demonstrating that there were go startling differences from year to year, this is now omitted. To heredity as a principal factor was assigned 17 per cent, of the cases in 1913, and the same proportion to alcoholic excess in men. To senile changes, both sexes included, 14 per cent, of cases were assigned, and among males alone this was the highest single factor—lß per cent. The figures in Table XIII are given for what they are worth : in estimating to what particular stress a patient's condition may be due one has largely to rely upon the imperfect observation of relatives, who fall very readily into the post hoc fallacy. If there be a greater tendency to mental and nervous disease in the present day one must look for the operation of some general and unusual cause which makes the period its own. In the perspective of history this will be the Age of Science, and the world is undoubtedly in a state of unrest indicating that the present is transitional. The sum of human knowledge is added to daily, and while Science preaches the new beatitudes, which after all are the old. its true message is not heard by many, \f\- there is too much noise amidst the clatter of wheels and the hum of dynamos, the roar of competition which knows no repose. I'or the greater number work has lost individuality, is dehumanized by each doing an uninteresting fraction of something, it matters not what, to the accompaniment of pace-making machinery. This sort of existence creates -.t positive demand from those not utterly subdued to their calling for some reactionary stimulation. Itself fice from competition ami commercialism and ready at hand to help, Science, the innocent first cause of the situation, points out the pitfalls to which such restlessness leads; points out also that the competitive struggle is not only soul-destroying but is positively toxic —which fad makes the simple healthful care of tile fatigued body tin' more urgent. Education has done much and will do more to adapt man to preserve the integrity of his body and mind in the altering environment, and for the man who cannot stand anil look to the end something may recall the yesterday of implicit faith or take its place; but meantime much disease, misery, and crime will be found among those unfit for the struggle. Former reports have dealt with the general question of the causation of insanity, of the importance of heredity, of how best to combat its existence, and not wait with folded hands for fate, and of how to recognize the danger-signals of stress under different conditions, and to adjust the immediate environment, where, indeed, there is some chance of control to the varying necessities of the case. It is not necessary to go on repeating the same words to the same audience —there are in our midst associations and societies dialing with fundamental questions relating to the bodily and mental well-being of the race, ami gradually, therefore the more surely, making people think. Once a person thinks, tin' rest is easy. It will not perhaps lie considered invidious to name the Eugenics Education Society, which is studying and teaching the problems of heredity, and the Society for the Health of Women and Children, which draws attention to the paramount value of proper nutrition for the rapidly growing body and brain before and after birth. There are some who believe that legislation can do everything, hut it is futile to legislate in advance of public opinion. However, it is a hopeful sign when numbers of people interested in subjects of this nature band themselves together to learn and to enlighten others; and if they find ears to hear, legislation will become unnecessary. Weekly Reports. The receipt of wcclUv reports from each mental hospital, the same being a copy of the entries into the Week I \ Report Book, has been commented upon before as being very useful in permitting the institution of comparisons as well as in bringing out the total and proportional number of patients needing special oversight, care, or control for any reason, the number employed usefully, and thereby contributing to their well-being and comfort, the nature of the employment, and so forth. Hereunder the figures for the weeks during the year, collected from these reports, are represented under some of the chief headings in proportions per cent, of the total. The heading " Under constant observation " includes so very few beyond the suicidal that, though shown separately in the reports, tiny may be taken as coinciding for all practical purposes. Employment is one of the chief methods of treatment, and this and other methods, more or less genera] in application, are obviously excluded in the heading "Under special treatment," which embraces what the term implies, whether the disorder be mental or physical.

Proportion per Cent, of Patients olassed as Males. Females. Total. Under constant observation Epileptics General paralytics Dangerous Employed Under special treatment 2*0 7-54 1-81 3-33 70-36 2-16 4-17 8-28 0-33 11-47 5811 3-94 3-43 7-85 119 6-72 6526 2-90

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Voluntary Boarders, &c. The following changes have occurred in respect to voluntary boarders : — M. F. T. M. F. T. In mental hospitals, Ist January, L 913 ... I II 12 Admitted during year ... ... li) 21 10 Total under care... ... ... 20 32 52 Discharged recovered or relieved ... l<) 13 2;} Discharged on admission as ordinary patients ... ... ... i 3 7 Died ... ... ... ... 0 1 1 Total discharged and died... ... 14 17 31 Remaining -'ilst December, 1913 ... ... *6 15 21 The above figures are an encouraging introduction of a new system, especially so in respect to ex-patients returning of their own accord for treatment upon the early symptoms of a relapse being recognized. In certain recurrent cases it is impossible to arrest symptoms, and, once the state of the boarder is such that lie cannot be expected to appreciate the voluntary nature of his detention, it becomes necessary to have him committed as a patient in the ordinary course. Altogether there were seven transfers to the Register of Patients. The procedure permitting the admission of a minor under an order granted by myself on the request of a parent or guardian, supported by medical certificates, instead of under a reception order by a Magistrate, was followed in the case of two boys and one girl. Two patients were in private care under reception orders, one carried over from last year, and one admitted during the year. Such are technically "single patients," being committed to a private house instead of to an institution, on its being certified that the procedure can be carried out safely and upon the Magistrate's being satisfied with the house and householder. (>!n patient was discharged from private care. There was a single notification, in terms of section 122, of a person being under oversight without formal committal. General Hospital Treatment. From time to time mention is made that there should be legislation to allow of cases of incipient insanity being treated in general hospitals. As a matter of fact, tin. provision exists, which Hospital Hoards could put in operation were they so minded. An " institution " under the Act is a place where two or more mentally defective persons are detained, and any person keeping two or more pel , sons in a place not an institution is liable to a fine of £100. This is section 123; but under subsection (G) there is an exception in the case of three months' residence in a general hospital, or any special hospital not kept for gain, provided a medical certificate is sent to this office stating that the malady is not confirmed. A repetition of the procedure secures a further three months' residence. The introduction of a " special hospital not kept for gain " for the treatment of incipient mental disorder was not because there was at the time any such institution, but to meet the case should any benefactor come forward—there are few worthier objects. The treatment of mental disorders in home surroundings is difficult and expensive, and is still more expensive in other private care. Except for the wealthy there is little chance I'm , proper treatment outside institutions, and it is pitiful to wait until the symptoms income sufficiently pronounced to make institutional treatment necessary. 1 have pointed out that a proportion of such cases have conic to us as voluntary boarders, and as prejudices die (hey take "an unconscionable time in dying"—more will come, no doubt; but an institution such as indicated would be a refuge for the timorous, and especially for persons wilh small salary whose education ami calling place their paths among the more affluent and require from them .i certain expenditure on appearance, not as a luxury, but as a necessity. Many of (he possessors of the greatest names in tin , professions can look back to such a state of struggle and could testify what illness would have meant at that time. It will be noticed that the way is clear for general-hospital treatment of incipient insanity, but il should be understood that there are difficulties in the way. ami the first and foremost, which is shared by all institutions and enterprises in this country, is the absence of a preponderant city —a real capital. Large towns may have certain disadvantages, but the absence of large towns is a disability tending to dissipate energies, which if concentrated could achieve a great deal. The introduction of general-hospital treatment in incipient insanity would mean special wards in each of the larger centres, and possibly in some of the secondary centres, and each special ward would need to be under the care of an alienist as much as an eye ward needs the services of an ophthalmic surgeon. We have not the population in any one place which would provide a specialist with work outside the hospital duties. It is the balancing of these considerations which made us decide upon building recent ion wards on the mental-hospital estates detached from the other buildings, and departing as far as possible from the conventional asylum planning and architecture. Accommodation. Tt is very satisfactory to find oneself in a position to report that we are fairly embarked upon a definite building policy. Immediately succeeding the works in progress a programme of requirements in advance for eighteen months will be entered upon as arranged with the

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Medical Superintendents and myself at Hie recent conference held under your presidency. We who have the immediate responsibility of curing for the insane feel a relief of tension in that we arc well assured that your views on the responsibility of the State towards our charges correspond with ours. Ihe State having taken over the oversight, care, and control of the mentally defective cannot evade that responsibility, questions of cost notwithstanding, so long as there is no actual waste. Under this heading we are dealing with building alone, but intimately associated with the building is the treatment of patients, for the skilled carrying-out of which certain types of buildings are necessary; and intimately associated with skilful treatment is a staff under proper control. In all these questions the above conception of the State's duty holds. When the accommodation is abreast or ahead of requirements we shall be, to quote a few of many examples, in a better position to deal with evasions of the law, to care for the sensitive, to answer misguided agitations for the discharge of patients unfit for discharge in 'their own or the public interest, and so forth. The realization of such matters will convey some significance of the sense of relaxing tension to which allusion has been made. Buildings are in progress at each of the mental hospitals except Hokitika and Nelson. These two smaller institutions, mainly built in wood, are more or less congested structures of one story, but without proper fire-breaks, and it is evident that, in part at least, they require rebuilding. The case of Nelson as the more urgent lias been taken in hand. A plan of a new kitchen and the consequential alterations is about completed, which will allow the central kitchen in be removed and leave a space between the two divisions of the institution behind the dininghall. At Hokitika a small hospital ward will be added. The fire at Sunnyside in the attic dormitory rendered it necessary to inn ii|> a temporary building, and this was done with the greatest expedition. Apropos of the fire, I would like to record the excellent work done by the staff, our brigade having six leads of hose at work with professional promptitude, a fact which, I understand, was remarked upon by the city fire brigade when it arrived. The damage done was comparatively little, the fire being confined to the dormitory between the limits of the cut-off walls. It is not intended to use the room as a dormitory again. Farming Operations. During the year under review the farms have been most successful, as may be noted in the following summary of expenditure and receipts : — Dr. £ s. d. Cr. £ s . d. To Salaries and wages .. .. .. 4,076 13 6 By Cash sales of produce, &o. .. .. 5,837 4 10 Feed .. .. .. .. 2,944 15 3 Value of produce grown on farms and Seeds, &c, manures .. .. 1,126 7 5 consumed in the mental hospitals.. 14,629 0 8 Implements, harness, repairs, &c. .. 795 4 6 Stock .. .. •■ .. 793 10 8 Rents, rates, &o. .. . .. .. 690 610 Fencing, roading, &o. .. .. 257 12 9 Harvesting, threshing, &c. .. .. 116 0 10 Railages .. .. .. .. 119 8 10 Buildings .. .. .. .. 115 16 11 Sundries.. .. .. .. 211 4 1 Balance .. .. .. .. 9,219 311 £20,466 5 6 £20,466 5 6 The value of the produce consumed is shown at wholesale prices ruling in the district. Compared with the previous year the casli sales were about ,£336 less, and the value of produce consumed increased by £557, a total increase of about ,£222. Had it not been for pioneering expenditure at Tokanui Die balance would have been £l().(i(t!>. or £92 more than 1912. The expenditure on individual farms is shown hereunder : —

Auckland. Christchurch. Seaclifl. Hokitika. Nelson. Forirua. Tokanui. Total. Salariee and wages Feed Seeds,&c,manures Implements, harness, repairs, &o. Stock Rent, rates, &o... Fencing, roading, &c. Harvesting.threshing, &c. Railage Buildings Sundries £ s. d. 250 0 0 221 14 0 186 15 4 78 1 8 £ s. d. 510 0 0 253 14 2 159 9 10 152 19 0 £ s. d. 2,031 0 0 1,163 8 10 243 12 2 223 19 5 £ s. d.j ]01 12 6! 27 0 4 26 7 0 28 16 0l £ s. d 230 0 0 68 12 0 41 0 10 31 9 5 £ a. d. 408 0 0 935 7 1 271 8 11 58 10 9 £ s. d. 540 1 0 275 3 10 197 13 4 221 8 8 £ s. d. 4,076 13 6 2,944 15 3 1,126 7 5 795 4 6 7 8 6 66 17 6 431 11 3 113 8 8 94 7 0 143 18 1 26 19 6 8 0 6: 96 14 2 114 17 6 57 10 1 520 3 0 793 10 8 690 6 10 257 12 9 le'ia 2 4 19 7 4l"2 9 39 16 8 54 15 5 21 8 9 116 0 10 0 7 5 20°7 8 77 12 3 172 1 5 80 0 0 11 11 5 10 3 3 4 15 0 34 6 5 26 13 3 2 11 9 119 8 10 US 16 11 211 4 1 Totals 778 6 4 1,977 10 9| 4,089 10 1 191 16 4i 402 5 7 11,247 1 7 1,942 8 6 1,865 4 0

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The statement of receipts is extended in the following table : —

There was a return of £47;") from the farm at Tokanui, which is very good indeed for a start. Of course, the expenditure where new country is being brought in and fenced is necessarily high, but it will repay the outlay. 'I he net profit on the working of each of the other farms was as Follows: Auckland, .£2,371; Christchurch, £2,941; Seacliff, 2,696; Hokitika, £238; Nelson, £765; Porirua, £1,598: making a total of £10,609. "Financial Statement. The details of expenditure are given in Tables XX and XXI, and in the following table the gross and net cost per patient is given for 1912 and 1913, showing an increase in the net cost of 10s. l£d. :—

The increase in the net cost is entirely due to the inclusion of Tokanui, where the cost of farm-developmeni approximates what is spent on such [arms as Sunnyside and Porirua, while the returns are relatively., but of necessity, meagre. Also, the staff has to be disproportionately large. The cost per patient at Tokanui is relatively high not only in respect to the farm and salaries, but with regard to provisions, because the cost of the board Tor the numerically disproportionate staff is added to the cost of the patients' board and divided by the average number of patients, making a substantial difference. Also, certain minor buildings have been carried out by our own workmen out of our vote, which are assets, but chargeable against the year's maintenance. In a word, without Tokanui, the gross coel per patient is £37 Is. 4*d., or 3s. 74/1. more than the previous year, and the net cost £24 6s. BJd., or 19s. lljd. less than 1912. The net cost indicates the returns from the farms, dealt with in the preceding section, and the highly satisfactory payments for maintenance. The following figures amply justify the centralization of the Maintenance Branch in the Head Office, especially when it is pointed out that, the first year (1910) was the record up to that time. ~ Total collected. Average per Patient Year - £ B. d. £ S. d. 1910 ... ... ... ... ... 25,632 18 7 7 7 7^ 1911 ... ... .. ••• ... 33,898 8 5 910 2J 1912 ... ... ... ... ... 34,732 17 9 911 8| 1913 ... ... ... ... ... 40,046 17 4 10 9 10 Included in the last total is about £200 paid for voluntary boarders, which will account for any slight discrepancy when compared with Table XXI.

Mental Hospital. Produce sold for Cash. Value of Produce consumed. Total. Auckland Christchurch Seacliff Hokirika Nelson Porirua Tokanui £ s. d. 574 3 11 1,698 3 10 2,105 17 11 £ s. d. 2,574 14 7 3,220 4 10 4, (579 6 3 430 4 6 924 6 6 2,391 15 3 408 8 9 £ s. d. 3,148 18 6 4,918 8 8 6,785 4 2 430 4 6 1,167 6 7 3,540 15 11 475 7 2 243 0 1 1,149 0 8 66 18 5 Total ... 5,837 4 10 14,629 0 8 20,466 5 6

1913. 19: .2. 1913. 1913. Mental Hospital. Total Cost per Patient, less Total Cost Receipts for I per Patient. i Maintenance, Sales of Produce, &o. Total Cost per Patient. Total Cost per Patient, less Receipts for Maintenance, Sales of Produce, &c. Decrease. Increase. Auckland Christchurch ... Seaclifi Hokitika Nelson Porirua Tokanui £ s. d. 29 13 If 41 4 10f 43 4 1H 28 6 10 34 11 7 37 9 9£ 87 19 2 £ b. d. 19 1 0 27 4 0£ 28 4 6£ 23 4 6J 25 1 ll| 23 15 9| 85 11 2" £ s. d. 28 19 40 1 11J 43 8 0 29 19 0 33 16 3£ 37 11 3 £ 8. 19 4 27 8 28 16 25 16 25 11 25 19 d. 5i 2 0* 8 £ a. d. 0 3 5J 0 4 6 0 11 8 2 11 74 0 9 1J 2 3 10* £ s. d. Averages ... 38 4 11 25 16 9| 36 17 1) 25 6 8i 0 10 1*

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The cost of collection (salaries, stationery, stamps) was 172 per cent., which speaks well for the assiduity of the Receiver, Mr. Wells, and his small staff of an assistant clerk and a cadet. In stating the cost per patient above the lirst five items in 'I able XX are omitted, and no allowance is made for interest on capital expenditure and tdr repairs charged to the Public Works Consolidated Fund. Adding these items, the approximate full cost per annum was — s. d. £ a. d. Average gross cost in mental hospitals ... ... ... ... 38 4 11 Proportion of Head Office salaries and expenses ... ... 16 10} Proportion of fees for medical certificates, &c. ... ... 6 10} 1 3 8£ Proportion of interest (averaged at 4 per cent.) on Public Works expenditure from July, 1877, to 31st March, 1914 ... ... ... ... ... ... ... 7 2 7i Proportion of interest (averaged at 4£ per cent.) for capital cost previous to above period ... ... ... ... 013 Of Gross cost ... ... ... ... ... ... 47 4 3£ Less receipts for maintenance and sale of produce ... 12 8 l^ Net cost ... ... ... ... ... £34 16 2 In 1912 the full cost so reckoned was £45 19s. and the net £34 7s. ll£d. The Staff. Last year the very special nature of the duties of those who minister to the irresponsible was enlarged upon to demonstrate the necessity for greater local control and differential treatment with respect to the Public Service Act. Nothing that has happened since alters that view, which has the unqualified support of all the Medical Superintendents as expressed at the recent conference. It is a matter which should not need argument, ami though apparently not selfevident, as it appears to us it should be, it becomes almost immediately evident to those brought into contact with the administration of the Department. The idea that a Department such as this is can lie managed on the lines of a more or less clerical or industrial Department must be abandoned. The more the fact that the staff is not dealing with the general public is lost sight of the greater is (he tendency to undermine discipline. Happily nothing makes a difference to the majority —the loyal, died, and capable officers; but want of immediate control is, to say the least of it, disturbing in its effects upon a proportion of the younger and, under better conditions, more hopeful, and is positively harmful to those, fortunately only a few, who under such local control as existed some years ago would he gradually eliminated as they were found to be careless or wanting in alertness, or temperamentally unfitted for the service. The effect of past agitations in favour of persons of this last class has made it increasingly difficult to dispense with their services on general grounds, and this has, of necessity, lowered the standard by disaffecting a proportion of the impressionable having better potentialities. I say advisedly that the agitation was on behalf of the less competent, because any one having a rudimentary knowledge of the working of institutions for the mentally defective knows that the interest of the competent staff and of the Superintendent is identical in ensuring the well-being of the patients. If the bracing of discipline is slackened let it be distinctly understood that it is done at the expense of the well-being of the patients; and, curiously enough, when that well-being is in any way disturbed the advocates of taking control from those having the responsibility do not associate the happening in its relation of cause and effect. The new classification has improved the position of the staff, and I should add that the Public Service Commissioners realize some of our responsibilities, and that we therefore look to them with some confidence to assist in weeding out the incompetent, which, let me emphasize, are very few. I believe it is their policy to have the best possible staff, and that was the impression conveyed when they mSt the Medical Superintendents in conference. With respect to the inclusion of allowances in the nature of salary for purposes of superannuation, a move has been made where the income of officers in the General ami Clerical Divisions is £300 and under, and one is pleased to accept this as an earnest of a complete and logical solution of the problem. The following nurses and attendants, having served the necessary period and had the necessary training, had their names placed on the Register of Mental Nurses on passing the Senior Examination : Lucy Anstey, Jane Bryan, Eva Castles, Ann Genge, Esther Hodgson. Jeannie Johnston. Mary Kelly, Charlotte Mclnnes. Rachel Shepherd. Edith Williams. Robert Short Anderson, Eli Brighton, James Coakley, Alwyn Cocker, William Hayes, Arthur Litchfield, Neil McCormack, John McLeod, George Oulds, Frederick Stevenson, Andrew Taylor, George Ward. Visits of Inspection. Auckland. —Visited June and December, 1913, and January, February, April, and June of this year. The impression made was that work was no longer being done under a sense of oppression—that, in fact, the sight of two large buildings visibly progressing had relieved the tension. In September the quarantine building on Motuihi Island had to be returned to the Public Health Department, owing to the outbreak of smallpox, and our patients were transferred to a temporary building put up in the Mental Hospital grounds. Once the new annexes are com-

2—H. 7.

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pleted, alterations can be effected in the main building, and then the classification in this institution will be satisfactory. The connection of our drainage with the town system is being pushed. Sunnyside. —Visited July, August, September, October, November, December, 1913, and in March and April, 1914. The new ward for women is pleasant and convenient. The fire mentioned elsewhere made it necessary to concentrate the energies of the artisan staff in providing temporary accommodation, but we are now in a position to tackle the large building programme detailed in Dr. Gow's report. I wrote last year about the ill-planned interior of the old building, which was also commented upon in the report of the Commission. When the new buildings are up some modifications in the old will be curried out. The current for electric lighting is about to be obtained from the Lake Coleridge supply. We expect to get this at a cost per unit which will enable us to use it for heating single rooms and dormitories and for electrifying some of the present machinery. Mr. Smail is a daily visitor, moving freely among the patients at all times, and I can endorse what Dr. Gow has stated of his kindness and tact in dealing with them and the success of his efforts in contributing to their well-being. Seacliff. —Visited February, June, August, October, and December, 1913, and in March and April of this year. A number of important works are in progress. These completed, further extension will be on the women's side, leaving additions for males at Waitati whicb is still in a developmental state. The hospital was in the usual good condition, as were also the institutions at Waitati and Ihe Camp. Hokitika. —Visited April, July, and October, 1913, and March of this year. As usual, everything satisfactory. The time is not distant when some of the older buildings will need to be renewed. A start will shortly be made by adding a small sick-ward. Nelson. —Visited June and December, 1913, and March of this year. Dr. Mackay retired on superannuation on the 31st March of this year. He left the institution beloved by the patients and regretted by the staff. Dr. Jeffreys, the Senior Assistant Medical Officer, Seacliff, was appointed Superintendent, a well-merited promotion. Parts of this hospital are old, wooden, and will need to be rebuilt, but the initial step in the scheme of rebuilding is a new kitchen, plans for which are now prepared. The Richmond Home for boys has suffered a great loss in the retirement of Mr. and Mrs. Buttle, who managed it from the beginning, and whose attitude towards tin , little patients was parental. The institution is too small, and the site too small to justify extension, therefore it will have to be moved elsewhere. Meantime Dr. and Mrs. Howard have taken over the management. Porir-ua. —Visited January, February, March. September, November, December, 1913, and January, March, and May this year. There was nothing calling for particular comment. The buildings now in progress will make this a very complete institution. Tokaniii. —Visited frequently in the earlier part and in July, September, November of last year, also in February, April, and May of this year. Pending the electric-light installation, &c, the buildings are not used to their Fullest extent; but additional buildings are on the way, and when the permanent kitchen, laundry. &c., are in working-order, as they soon will be, the number accommodated can be more than doubled. A water-service under pressure is being considered. Mr. Vickerman, of the Public Works Department, presented a very valuable report on this subject. The work being done on the estate, developing the land and roadmaking, A-c, is exceptionally good. Ashburn Hall. —Visited June and October, 1913, and March and April this year. Always found in good order, clean and comfortable, the meals well cooked and served, and the patients looking well cared for. Conclusion. Last month there was a conference of the Medical Superintendents. It was most pleasant and helpful. Upon this occasion and the former conference a year ago the time was taken up mostly witli staff and building matters. Doubtless the conference will now be a yearly fixture, and will be the occasion for discussing questions of care and treatment, of the failure or success of different methods, and so forth, matters of practical and scientific interest, as well as routine questions of rules and regulations. I have to thank Dr. G-ribben and Miss Maclean for their assistance, and Mr. Router and the Head Office staff for their loyal co-operation. I have, &c, Franr Hay.

MEDICAL SUPERINTENDENTS' REPORTS. AUCKLAND MENTAL HOSPITAL. Sir, — I have the honour to report as follows for the year 1913 : — During the year we treated 1,091 patients: of these, 246 were admitted in 1913. The total remaining at the end of the year was 896, of whom 552 were males and .344 females. The chief causes assigned for the mental affliction of the males were alcohol, heredity, and syphilis, in the order mentioned, and for the females climacteric and heredity. As usual, more single than married men were admitted, and more married than single women. Of the males, 96 were single and only 48 married; of the women, 40 were single and 43 married.

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As usual, too, the majority of males admitted were labourers, and the majority of women those engaged in domestic duties. Forty-five labourers and 20 farmers were admitted. The farmers were for the most part those engaged in farm labour; a few were small farmers whose strenuous, unfinancial life had ended in disaster. Of those admitted, 788 per cent, were between twenty and sixty years of age, whilst 18 were over seventy years. The recovery-rate was about the average, 43"!) pur cent.; but the male recoveiT-rate was small, 3T37 per cent., as against 64"5 l per cent, for females. The death-rate was 9'ol per cent. —Males, 936 per cent.; females, 847 per cent. Of the deaths, 19 males and 4 females were due to senile decay, 1 female to suicide, and 4 males and 3 females to typhoid fever. As the new drainage scheme is now in progress I am hopeful that the typhoid outbreaks which we have had for the last few years will be totally suppressed after 1914. In view, however, of the known methods of dissemination it is perhaps not wise tv be too sanguine. The disease is so insidious in its onset and can be so readily introduced by the staff, or even by visitors, that the infectious germs may become widely distributed before any accurate diagnosis can be made or the disease be even suspected. The general work of the institution has progressed fairly steadily, although I am bound to admit that the general efficiency of the staff has been gradually lowered during the last five or six years. There are always some members of the staff who are capable and thorough and worthy of every encouragement, otherwise progress would be practically impossible. It is pleasing to report that during the coming year the overcrowding will be a thing of the past, at least on the female side. As the progress of the Auckland Province is rapid, and the increase in our admissions also rapid. I would urge upon the Department the necessity for making further provision to meet this increase. Considering the overcrowding, the general health of the patients during the year has been wonderfully good. I am pleased that the -Matron has been granted six months' leave of absence. After fifteen strenuous years, during which she has performed her duties with a rare loyalty and devotion, the holiday is thoroughly deserved. The work of the farm and the supervision of all work in progress has been most capably performed by the Farm Manager. Our thanks are due to the Deputy Inspector and Official Visitors for their general interest in the Hospital, and my personal thanks for the help they have extended to me from time to time. We have also to thank Miss Fleming for the use of a cab once weekly for the patients' benefit. This has been granted now for over three years, and it affords to the patients the greatest possible pleasure. We have also to convey our thanks to the I/era!// for papers supplied daily for the patients' use, and the various city bands for their frequent entertainments, and to Mr Macpherson for controlling the religious services. I have, &c, The Inspector-General, Mental Hospitals, Wellington. R. M. Beattie.

SUNNYSIDE MENTAL HOSPITAL. Sir,— I have the honour to submit my annual report, with the statistics, for the year ending 31st December, 1913. At the beginning of the year there were 717 patients, which was an increase of 28 over the previous year, but at the end of the year the number was reduced to 652. This reduction was due to the transfer of 50 patients to Hokitika and 10 to Tokanui, and afforded much-needed relief. The average number resident during the year was 685"06. There were 63 deaths during the year, which gives a rate of 9*l, calculated on the average number resident. Thirty-four of the deaths were in patients upwards of sixty years of age, and 25 of these were over seventy. There were 118 rjatients admitted for the first time, which is a decrease of 12 as compared with the previous year. There was also a decrease in readmissions. which gives a total decrease on the previous year of 24. There were 71 recoveries during the year, which gives a recovery-rate, calculated on the admissions, of almost 49 per cent. As I mentioned above, the transfer of patients to other institutions has given us temporary relief, but further building is necessary. On the male side I recommend that an addition should be made to D ward of a hospital annexe, with single rooms, which could be used for admissions and sick cases until the new reception and hospital wards are built. Afterwards this could be used for the old and decrepit who are not really hospital patients, but linger out their days alternating between an arm-chair and their beds. The fire which occurred on the female side lias cramped the accommodation there, but a temporary dormitory for 46 beds is now in use, and will tide us over until we get the nurses' home built. The site and furniture for this building is being goi ready so that there will be no delay. This building has been much needed, and will have beneficial effects in many ways. It will release about 40 single rooms for the purpose for which they were built—namely, for patients —and it should oonduce to a more contented female staff, who will have comfort and quietness to retire to after the strain of their arduous duties. As regards the fire, I am glad thai the decision lias been come to that all the patients shall be brought down out of the attic dormitories. In spite of all efforts there is always the fire risk,

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.iiid no matter how good the training ami discipline of the .shift as regards fire duty it is awful to contemplate what the result might have been had the fire broken out during the night instead of during the day. 1 here take the opportunity of oommending the nurses for their ooolnees in getting the patients safely out of the building, and the male staff I'm' their work as a fire brigade. The female patients showed wonderful restraint, and deserve praise for their help in preparing temporary accommodation for themselves, and their good humour during their trying eviction. The loss of dormitory accommodation through the closing of the attic will involve the building of new dormitories, and a new ward to provide for the natural increase will also be required in the near future. We are now using our electric plant to its full capacity, but are wiring the rest of the institution to be able to take advantage of the power from Lake Coleridge when it is available. The general health of the patients has been good, and we have got rid of the scarlet-fever epidemic which troubled us so long. The usual services have been held during the year, and these have been supplemented by Mr. Smail, the newly appointed officer, who conducts reading parties in the wards in the evenings, which affords pleasure and recreation to a great many of the patients. Thanks are due to those who have contributed to the patients' pleasure by the giving of i oerts and passes to places of amusement, and also to the donors of the gramophone with records, which is a valuable acquisition. Since the end of liie year I have lost I he capable services of Dr. IJainsliot loin, who left to take up praotioe in England, and to him and the staff in general 1 have to express my appreciation for loyal and valuable assistance. I have, &c, W. Baxter Cow, The Inspector-General, Mental Hospitals, Wellington. Medical Superintendent.

SEACLIFF MENTAL HOSPITAL. SlH,— 1 have the honour to submit the following report on the Seacliff Mental Hospital for the year 1913. At the beginning of the year there were 1)15 patients, and at the close 924, including 0 who had been transferred from other institutions. The returns show that, exclusive of transfers from other institutions, there were I •'!() patients admitted during the year, and that 61 patients were discharged, relieved, or recovered, being at the rate of 47 per cent. The general health has been good, and there has been no serious accident or casualty during the year. The deaths during the year were ."i4 : of these. L'-'i were aged bit ween seventy and a hundred, and five were between ninety and a hundred. The leading cause of death was senile decay. The death-rate was just over .">.', per cent, on the total number of patients under treatment. In addition to the improvements in accommodation to which 1 drew attention in my last year's report (which are now under way or about to be taken in hand), the following are our most pressing needs : — (1.) Extension of the Nurses' Home to provide further accommodation for about twenty. (2.) Extension of accommodation lor female patients so as to make room at Seacliff for the women who are now housed temporarily at the Orokonui Branch institution at Waitati. (3.) A small wooden shelter-cottage for the better isolation and treatment of male patients suffering from tuberculosis. Consumptive women can be accommodated suitably by modifying one of our present wooden pavilions so as to make it serve this purpose. (4.) Improved -equipment for bathing, to meet the great increase of patients during late years. (5.) Improved* kitchen and baking equipment and facilities for the main buildings at Seacliff. (6.) Farm and workshop, &c. : (a.) Owing to the decreasing number of capable milkers a machine-milking plant ought to bo installed. (b.) Suitable woodworking machinery has long been a pressing need, and would save a large annual expenditure, (c.) An adequate telephone system. 'Ihis would prevent much waste of time, and would economize and facilitate the harmonious working of the institution. In its expansion not only has the Mental Hospital quite outgrown the menas of intercommunication which barely sufficed originally, but the position has become such that a more modern equipment is now imperatively needed. The yields in produce from the various estates have been satisfactory, but our fishing returns have been poor. Further development of the Orokonui Branch Mental Hospital at Waitati is highly desirable.. The institution is well and very harmoniously worked by Dr. Ross. The Camp Auxiliary at the Peninsula is well managed, and the year's work has been highly satisfactory. Religious services have been held by various denominations throughout the year. The thanks of the authorities arc due to the Otago Daily Times and Witness Company and to the Evening Star Company for newspapers and journals supplied free, and also to other donors wholiave kindly contributed to the amenities of our hospitals.

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During my absence from New Zealand for nine months as Government delegate to the Infantile Mortality Congress in London the Mental Hospital was well managed by Dr. Jeffreys, to whom and to Dr. Buchanan, the present Senior Medical Officer, I liave to express my appreciation. I have, &c, F. Truby King, The Inspector-General, Mental Hospitals, Wellington. Medical Superintendent.

I'OlilKt A MKXTAL HOSPITAL. Sir, — I have the honour to submit the following report on this Mental Hospital for the year 1913 :— At the beginning of the year there were 908 patients on the register, and at the end 892 (485 males and 407 females), of whom 7 males and 4 females were absent on trial. The average number resident was 890. Eleven men were transferred to the new Mental Hospital at Tokanui in May, and 12 women to the Nelson Mental Hospital in July. These transfers served to relieve the congestion in the wards, which on the female side of the institution continues to be embarrassing. I understand the Department is about to construct a new auxiliary building to accommodate 100 patients, and designed for the' reception of recent admissions as well as for sick patients. Ibis addition will go far in overtaking our immediate requirements. During the year 182 cases were admitted for the first time, of whom GO per cent, were males and 10 per cent, females, and of whom more than half were chronic and incurable. It is satisfactory to find that these first admissions were 22 less than in the previous year. There were 33 readmissions, or 4 less than in 1912. Of the 142 patients discharged, 88 were recorded as recovered, making a recovery-rate of 40 per cent, on the number admitted. But this does not represent the full recovery-rate. A number of the patients away on probation were written oft as discharged unrecovered at the expiration of the probation period because they failed to present themselves for examination or to return a medical certificate as to their mental state. Had they done so probably fully 30 of these probationary cases so discharged would have been passed as recovered. There were 68 deaths, a ratio of 76 per cent, of the average number resident. The causes of death included 12 from general paralysis of the insane (10 males and 2 females), and 27 from senile decay. In addition to the new auxiliary building above referred to, I am pleased to find that the Department has decided to construct two large day-rooms (one for male and one for female patients), extending from the central wards of the main building on the north side and commanding a particularly fine view of the landscape and the harbour, as well as overlooking our sports-ground. The accommodation will provide day-room space for a large number of patients who have hitherto been very poorly served in this respect. I have to express my appreciation of Dr. McKillop's and Dr. Simpson's capable and loyal assistance. In all departments I have been fortunate in having a very good staff of officers, who take their responsibilities seriously and can be trusted to discharge the duties required of them in the best interests of the institution and its inmates. There has been some trouble in maintaining the' female nursing staff at anything like adequate strength, especially towards Christmas and during the-summer months. The shortage was mostly due to resignations of the juniors and recently appointed probationers and to the difficulty of obtaining suitable candidates to fill the vacancies. I have, &c, Ghat Hassell, The Inspector-General, Mental Hospitals, Wellington. Medical Superintendent. -f

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APPENDIX.

Table I.—Showing the Admissions, Readmissions, Discharges, and Deaths in Mental Hospitals during the Year 1913.

Table II. —Admissions, Discharges, and Deaths, with the Mean Annual Mortality and Proportion of Recoveries, etc., per Cent. on the Admissions, etc., during the Year 1913.

M. F. T. II. P. T. 2,273 1,640 3,913 In mental hospitals, 1st January, 1913 Admitted for the first time Readmitted Transfers.. 394 72 77 266 52 31 660 124 108 I 543 349 892 Total under care during the year •2,816 1,989 4,805 Discharged and died— Recovered Relieved Not improved Died 175 35 78 1% 16-2 43 86 111 337 83 114 307 484 357 841 Remaining in mental hospitals, 31st December, 1913 '2,332 1,632 3,964 Increase over 31st December, 1912 59 851 Average number resident during the year 2,252 1,597 3,849 ♦ Decnue, 8,

Admissions in 1913. Total Number of Patients under Care. Mental Hospitals. In Mental Hospitals on 1st January, 1913. A,1 Fh^Thr 1,u I *»*>.»«. Total. M. F. T. Auckland.. .. .. 500 345 845 Christchurch .. .. 375 342 717 Dunedin (Seacliff).. .. 545 370 915 Hokitika 180 51 231 Nelson .. .. .. 94 94 188 Porirua .. .. .. 488 420 908 Tokanui .. .. ■. 64 .. 64 Ashburn Hall (private mental 27 18 45 hospital) Totals .. .. 2,273 1,640 3,913 M. P. 134 78 79 39 45 50 8 10 12 6 109 73 i io T. M. 212 19 118 18 95 15 18 35 18 5 182 25 29 17 3 F. 15 11 16 15 13 11 2 T. 34 29 31 50 18 36 29 5 M. 153 97 60 43 17 134 29 10 p. T. 93 246 50 147 66 126 25 68 19 36 84 218 .. 29 12 22 M. 053 472 605 2-23 111 622 93 37 P. T. 438 1,091 392 864 436 1,041 76 299 113 224 504 1,126 93 30 67 394 260 660 149 83 232 543 349 892 2,816 1,989 4,805 Patients disci larfjed and died. In Mental Hospitals on 1)k .,, Total discharged 1,11 ''• and died. 19 "- Mental Hospitals. Discharged recovered. Discharged not recovered. Auckland .. .. .... Christchurch .. Dunedin (Seaclifl) Hokitika Nelson Porirua Tokanui Ashburn Hall (private mental hoepital) Totals M. F. T. M. P. 48 60 108 4 5 34 37 71 59 19 17 29 46 8 9 5 3 8 .. 1 4 5 9 2 .. 64 24 88 31 47 1 .. 1 2 .. 2 4 6 7 3 175 162 337 113 84 T. 9 78 17 1 2 78 2 10 197 M. P. T. 51. P. T. ' M. P. T. 49 29 78 101 94 195 552 344 896 40 23 63 133 79 212 339 313 652 34 20 54 59 58 117 546 378 924 16 4 20 21 8 29 202 68 270 9 7 16 15 12 27 96 101 197 42 26 68 137 97 234 485 407 892 1 .. 1 4 .. 4 89 .. 89 5 2 7 14 9 23 23 21 44 113 84 197 196 111 307 484 357 841 2,332 1,632 3,964 Mental Hospitals. Average Number resident during the Year. Percei of Kecoy Admii during tl itage eries on isions tie Year. jgggfi '"^Zns. If. P. T. M. P. T. M. P. T. , H. P. T. Auckland .. .. .. 523 342 865 31.78 6452 44-26 9-37 8-48 9-02 32-45 31-18 3197 Christchurch.. .. .. 360 325 685 35-79 7400 4897 11-11 708 <J-20 42-11 46-00 43-45 Dunedin (Seacliff) .. .. 512 368 880 2982 46-03 38-33 664 543 614 5965 3175 4500 Hokitika .. .. •• 172 48 220 62-50 30-00 44-44 9-30 833 909 20000 4000 111-11 Nelson .. .. ■• 81 96 177 23-53 71-43 37-50 1111 729 904 52-94 10000 6666 Porirua .. .. •■ 489 401 890 4885 2857 4093 8-59 6-48 764 32-00 30-95 31-63 Tokanui 90 .. 90 Ill .. Ill , Ashburn Hall (private mental 25 17 42 2857 3636 33-33 20-00 11-76 1667 7143 18-18 3889 hospital) Totals .. .. 2,252 1,597 3,849 37-55 50-94 42-98 870 696 7-98 4206 3490 3916 M. F. T. , H. P. T. 9-37 8-48 9-02 ' 32-45 31-18 31-97 11-11 708 <J-20 42-11 46-00 43-45 6-64 5-43 614 5965 3175 4500 9-30 8-33 9'09 200-00 40-00 111-11 11-11 7-29 904 52-94 10000 6666 8-59 6-48 7-64 32-00 30-95 31-63 111 .. Ill 2000 11-76 16-67 7143 18-18 38-89

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Table IV.—Duration of Disorder on Admission.

Table III.— Ages of Admissions.

Ages. Auckland. Christchurch. Dunedin (Seacliff). Hokitika. Nelson. Porirua. Tokanui. Aahburn Hall (Private Mental Hospital). Total. Under 5 years.. Frcm 5 to 10 years „ 10 „ 15 ,. „ 15 „ 20 ., „ 20 „ 30 „ „ 30 „ 40 „ „ 40 „ 50 „ „ 50 „ 60 ,. „ 60 „ 70 „ ., 70 „ 80 „ „ 80 ,. 90 ,. „ 90 ,,100 „ Transfers •., M. F. T. 1 0 1 2 J5 7 37 18 ,55 38 26 64 25 24 49 16 10 26 18 6 24 14 4 18 2 0 2 M. 1 0 1 1 12 27 19 6 12 13 3 P. T. 0 1 1 1 0 1 3 4 10 22 12 39 9 28 4 10 6 18 4 17 1 4 M. F. T. 0 1 1 12 18 30 16 12 28 10 12 22 6 12 18 5 4 9 6 0 6 2 3 5 0 1 1 3 :i <> M. 3 1 2 0 1 1 35 F. T. 4 7 1 2 2 4 1 1 2 3 0 1 15 50 M. 1 2 6 2 2 0 1 3 0 F. 0 2 2 0 1 1 0 1 12 T. 1 4 8 2 3 1 1 4 12 M. F. T. 2 13 6 7 13 i 34 15 49 30 29 59 24 18 42 15 5 20 14 6 20 2 3 5 4 0 4 3 0 3 M. 29 F. T. 0 29 M. 0 1 3 1 0 2 0 3 F. 3 1 3 0 2 1 1 3 2 6 1 2 3 ] 4 M. F. T. 1 0 1 3 2 .-) 2 0 2 '.) 16 25 100 70 170 119 83 202 85 68 153 46 33 79 49 25 74 39 14 53 13 6 lit 0 I I 77 31 1OS 2 0 2 Totals 153 93 240 97 50 147 60 66 126 43 25 68 17 19 36 134 84 218 29 0 29 10 12 22 i 543 349 802 I I

Auckland. Chrietchurch. Dunedin (Seacliff). Hokitika. Kelson. Porirua. Tokanui. Ashburn Hall (Private Mental Hospital). Total. 109 50 159 M. F. T. 50 22 72 M. F. T. 19 21 40 M. F. T. 3 5 8 M. 6 F. T. 3 9 M. F. T. 79 50 129 M. F. T. -M. F. T. 5 11 M. F. T. 272 156 428 First Class (first attack, and within 3 months on admission) Second Class (first attack, above 3 months and within 12 months on admission) Third Class (not first attack, and within 12 months on admission) I'ourth Class (first attack or not, but of more than 12 months on admission) Transfers 7 7 14 15 17 32 10 9 19 25 17 42 15 12 27 11 11 22 0 1 1 3 2 5 4 5 1 5 1 6 14 7 21 28 21 49 I 0 1 2 2 2 51 38 89 87 71 158 20 19 :m 10 2 12 12 19 31 3 3 6 2 2 4 35 15 50 2 0 2 4 12 12 10 6 16 3 0 3 0 3 3 56 53 109 2 0 2 2 0 2 29 0 29 3 1 4 77 31 108 Totals 153 93 246 97 .50 147 60 66 126 43 25 68 17 19 36 134 84 218 29 0 29 10 12 22 543 349 89:

H—7

16

Table V.—Ages of Patients discharged "Recovered" and "Not Recovered" during the Year 1913.

Table VI.— Ages of Patients who died.

Auckland. Christchuich. Dunedin (Seacliff). Hokitika. Nelson. Poriraa. Tokanui. Ashburn Hall (Private Mental Hospital). Total. Ages. Recovered. Notre- Be- Notre- Becovered. covered, covered, covered. Not recovered. Be- I Not re- Be- Not re- Becovered. covered, covered. covered, covered. Not recovered. Becovered. Not recovered. Recovered. covered, Not recovered. M. F. T. M. F. T. M. F. T. 1 0 1 M. P. T. M. P. T. M. F. T.I M. P. T.: M. F. T. M. P. T. M. P. T. M. F. T. M. F. T.| I M. F. T. M. P. T. M. F. T. M. P. T. M. P. T. 1 0 1 M. F. T. Under 5 years From 5 to 10 years .. „ 10 „ 15 „ .. „ 15 „ 20 „ .. „ 20 „ 30 „ .. „ 30 „ 40 „ .. „ 40 „ 50 „ .. „ 50 „ 60 „ .. „ 60 „ 70 „ .. „ 70 „ 80 „ .. „ 80 „ 90 ,. Unknown Transfers 1 4 5 18 15 33 12 15 27 8 17 25 4 5 9 4 2 6 1 2 3 o i i o i i o i i 0 1 1 1 1 2 7 13 2t) 10 9 19 9 5 14 0 2 2 5 5 10 1 1 2 1 6 1 l£ 3 18 18 4 22 12 8 20 5 3 8 1 0 1 1 1 2 1 0 1 4 9 13 7 6 13 2 8 11 1 3 4 1 1 2 •■ .. 1 1 2 1 2 3 1 2 3 1 1 2 1 2 3 1 0 1 2 0 2 0 1 1 112 2 0 2 .. 0 11 112 .. 3 0 3 10 1 .. 0 11 0 11.. 0 11.. 1 0 1 0 1 i: 0 2 2 1 0 1 3 2 5 16 5 21 7 11 18 19 9 28 7 11 18 13 3 16 2 8 10 7 0 7 2 3 5 4 4 8 2 1 3 2 13! •• 1 6 1 ■• 0 2 2 1 1 2 2 0 2 0 1 1 0 1 1 3 14 1 2 3 7 8 15 48 43 91 52 42 94 34 36 70 12 11 23 14 13 27 5 7 12| 0 1 1 4 2 6 15.15 30 23 18 41 24 14 38 16 13 29 8 4 12 4 3 7 0 1 1 0 2 2 1 0 1 0 i 1 4 0 4 '.'. 11 13' 24 64 24 88'31 47 78 2 0 2 1 0 1 1 6 1 2 0 2 19 i3 32 Totals 48 60 108 4 5 9 [ 34 37 71 59 1!) 78 17 29 46 8 9 17 5 3 8 0 1 14 5 9 2 0 i 101 .. 2 0 2 2 4 6 7 3 10 175 162 337! 113 84 19' I I

Ages. Auckland. Christchurch. Dunedin (Seaclifl). Hokitika. Nelson. Porirua. Tokanui. Ashbuin Hall (Private M.H.). Total. M. F. T. M. F. T. M. F. T. 0 11 112 0 11 l> 1 7 4 4 8 112 1 .> 6 li 1 7 r> 4 <) 6 7 13 2 .> 7 2 4li 7 4 11 4 15 5 1 (5 13 5 18 6 3!) 4 :S 7 16 6 22 15 7 22 14 4 18 2 13 2 2 4 10 1 M. p. T. M. F. T. M. F. T. M. F. T. M. F. T. M. F. T. 0 1 1 1 1 2 1 1 2 15 10 25 21 13 34 21 22 43 24 12 36 35 16 51 60 30 !)0 13 5 18 1 0 1 4 0 4 From 5 to 10 years » 10 „ 15 „ „ 15 „ 20 „ „ 20 ., 30 „ „ 30 „ 40 „ „ 40 „ 50 „ „ 50 „ 60 „ ,- 60 „ 70 „ „ 70 „ 80 „ „ 80 „ 90 „ „ 90 „ 100 „ Unknown • 0 1 1 1 1 2 :! 1 4 3 0 3 1 0 1 4 1 5 i i o 6 o i 1 1 i 1 8 8 5 9 8 3 3 4 2 10 4 12 4 9 5 14 7 15 1 4 1 0 1 1 0 2 1 1 0 1 2 2 0 2 0 1 0 1 2 5 5 1 7 6 49 20 78 40 23 63 34 20 54 4 0 4 Totals 16 4 20 9 i 16 42 26 68 1 0 1 5 2 7 196 111 307

17

H.—7

Table VII.—Condition as to Marriage.

3—H. 7.

Admissions. Discbarges. Deaths. Auckland — Single Married Widowed Transfers M. F. T. .. j 96 40 136 48 43 91 7 10 17 2 0 2 M. 96 48 7 2 F. 40 43 10 0 T. 136 91 17 2 M. 32 14 2 4 p. 25 34 6 0 T. 57 48 8 4 M. 28 17 4 F. 12 15 2 T. 40 32 6 Totals 153 93 246 153 93 246 52 65 117 49 29 78 Cheistchdbch— Single Married Widowed .. .. Transfers 52 19 71 .. 39 19 58 4 12 16 2 0 2 t 52 39 4 2 19 19 12 0 71 58 16 2 70 22 1 18 30 8 88 52 9 25 12 3 10 7 6 35 19 9 Totals 97 50 147 97 50 147 93 56 149 40 23 63 Dunedin (Seacliff) — Single Married Widowed Transfers 32 30 62 ..i 20 26 46 5 7 12 3 3 6 32 20 5 3 30 26 7 3 62 46 12 6 15 9 1 14 22 2 29 31 3 22 7 5 7 10 3 29 17 8 Totals .. 60 66 126 1 60 66 126 25 38 63 34 20 54 HOKITIKA— Single Married Widowed Transfers 3 5 8 4 4 8 112 35 15 50 4 1 0 1 2 1 5 3 1 12 2 2 2 1 1 14 3 3 Totals 43 25 68 5 4 9 16 4 20 Nelson — Single Married Widowed Transfers II 4 15 3 14 3 2 5 0 12 12 4 1 5 2 3 5 0 1 1 5 1 6 1 0 1 3 6 9 Totals 17 19 36 6 5 11 9 7 16 Porirua— Single Married Widowed Transfers 76 35 111 47 41 88 8 8 16 3 0 3 53 22 75 25 32 57 6 4 10 11 13 24 18 10 28 16 7 23 8 9 17 Totals 134 84 218 95 71 166 42 26 68 Tokantji— Single Transfers 29 6 29 1 2 0 0 1 2 1 0 1 Totals 29 0 29 29 0 29 Ashburn Hall (private mental hospital) Single Married Widowed Transfers 2 4 6 5 4 9 0 3 3 3 14 2 5 0 3 4 4 3 1 6 9 3 4 2 4 3 4 5 8 3 1 1 2 0 0 5 1 1 3 6 3 Totals 10 12 22 10 12 22 7 16 Totals — Single Married Widowed Transfers 272 137 409 166 138 304 28 43 71 77 31 108 272 137 409 166 138 304 28 43 71 77 31 108 181 84 265 77 127 204 10 22 32 20 13 33 114 56 26 44 158 40 96 27 53 Totals 543 349 892 543 349 892 288 246 534 196 111 307

H.—7.

18

Table IX.—Ages of Patients on 31st December, 1913.

Table VIII.— Native Countries.

Countries. Auckland. Christchurch. Dun^|£ ) ! Sea - Hokitika. Nelson. Porirua. Tokanui. Ashburn Hall (Private M.H.). Total. England and Wales Scotland Ireland New Zealand .. Australian States France Germany Austria Norway Sweden Denmark Italy China Maoris Other countries.. Unknown M. F. T. 149 84 233 37 18 55 70 53 123 186 l<56 342 27 14.41 2 0 2 8 2 10 14 1 15 1 0 1 7 1 8 2 0 2 3 0 3 2 0 2 15 3 18 29 12 41 103 92 195 26 20 46 45 48 93 130 131 270 I 9 8 17 4 2 6 1 1 2 1 0 1 2 0 2 2 1 3 1 0 1 I 0 1 1 1 2 4 9 13 103 57 160 99 65 164 83 58 141 198 150 348 20 19 39 8 19 1 0 1 3 1 4 3 0 3 2 2 4 1 0 1 8 0 8 17 25 42 M. F. T. 44 15 59 13 7 20 45 11 56 58 23 81 9 3 12 6 0 6 1 6 1 5 0 5 7 0 7 6 0 6 10 1 5 0 5 2 9 11 10 24 34 146 92 238 5 7 12 i 41 32 73 13 16 29 55 59 114 j 58 45 103 184 192 376 13 4 25 14 39 10 1 2 0 2 10 1 2 4 6 0 11 0 2 2 2 0 2 4 2 6 7 18 011 303 2 0 2 2 0 2 3 4 7 3 3 6 11 6 17 M. 26 4 13 35 1 1 4 1 1 1 1 1 F. T. 0 26 0 4 0 13 0 35 0 1 0 1 0 4 0 1 0 1 0 1 0 1 0 1 M. F. 'T. M. P. T. 4 4 8 585 368 953 6 2 8 231 151 382 10 1 325 245 570 9 14 23 867 711 1578 0 11 92 62 154 5 0 5 10 1 31 9 40 19 3 22 5 2 7 24 4 28 15 2 17 16 3 19 12 0 12 31 8 39 2 0 2 72 55 127 2 9 11 " Totals 552 344 896 552 344 896 339 313 652 339 313 652 546 378 924 546 378 924 202 68 270 202 68 270 96 101 197 485 407 892 96 101 197 485 407 892 89 89 0 89 0 89 23 21 44 2332 1632 3964 23 21 44 2332 1632 3964

Ages. Auckland. Christchurch. DunedinfSeaHokitika. Nelson. Forirua. Tokanui. Ashburn Hall (Private M.H.). Total. From 1 to 5 years 5 „ 10 „ ., 10 „ 15 „ ,. 15 „ 20 „ „ 20 „ 30 „ „ 30 „ 40 „ ,. 40 „ 50 „ ,. 60 „ 60 „ „ 60 „ 70 „ „ 70 „ 80 „ Upwards of 80 ,. Unknown M. F. T. '.'. 3 0 3 2 0 2 9 4 13 63 38 101 109 69 178 142 95 237 .. I 120 65 185 58 45 103 34 20 54 5 |6 11 7 2 9 M. p. T. 3 2 5 3 2 5 3 3 6 34 28 62 8(1 61 141 67 75 142 57 62 119 46 50 90 41 26 67 5 4 9 M. P. T. o i l 2 4 6 49 43 92 114 75 189 125 87 212 103 72 175 78 50 128 61 35 90 14 11 25 M. F. T. 2 0 2 9 6 15 47 11 58 43 13 56 37 11 48 30 10 40 18 9 27 2 1 3 14 7 21 M. P. T. 6 1 7 4 16 7 1 8 14 6 20 12 17 29 12 27 39 18 24 42 13 15 28 9 2 11 1 0 1 0 7 7 M. F. T. 1 5 6 6 4 10 8 9 17 78 55 133 107 79 186 105 99 204 91 90 181 64 45 109 19 18 37 6 3 9 M. P. T. 7 0 7 26 0 26 28 0 28 12 0 12 8 0 8 4 0 4 M. F. T. 2 '2 4 1 1 2 3 6 9 7 4 11 3 6 9 6 1 7 1 1 2 M-. F. T. 13 8 21 15 8 23 31 21 52 256 178 434 490 313 809 525 402 927 445 328 773 300 221 521 192 111 303 34 26 60 25 16 41 4 0 4 I _ Totals 552 344 896 339 313 652 339 313 652 546 378 924 546 378 924 202 68 270 202 68 270 96 101 197 485 407 892 89 0 89 23 21 44 2332 1632 3964

19

H.—7

Table XI.—Length of Residence of Patients discharged "Recovered" during 1913.

Table X.—Length of Residence of Patients who died during 1913.

4—H. 7.

Length of Residence. Auckland. Cbristchurch. Dunedin (Seacliff). Hokitika. Nelson. Porirua. Tokanui. Ashburn Hall (Private M.H.). Total. Under 1 month From 1 to 3 months .. „ 3 ,. 6 „ 6 „ 9 „ 9 „ 12 „ 1 „ 2 years „ 2 ., 3 „ ., 3 „ 5 „ ., 5 „ 7 „ ,. 7 „ 10 „ » 10 „ 12 „ » 12 „ 15 „ Over 15 years M. 6 10 7 2 5 8 2 1 0 3 P. T. 4 10 2 9 2 4 1 6 "2 10 0 *2 2 3 4 4 2 5 M. F. T. 7 4 11 7 1 8 6 1 7 1 0 1 1 0 1 3 1 4 3 2 5 2 2 4 2 2 4 3 1 4 M. 3 1 0 1 1 5 5 2 0 1 1 2 2 2 0 2 0 2 2 2 T. 4 3 2 3 1 7 5 4 2 3 M. F. 1 1 2 0 3 0 2 0 4 1 0 i 1 1 1 0 2 6 T. 3 2 5 1 2 1 2 M. P. 2 i 1 1 1 0 1 2 0 1 4 2 T. 3 2 1 3 1 6 M. P. T. 4 15 11 3 14 4 2 6 1 1 2 3 2 5 3 1 4 3 3 6 2 3 5 M. F. T. M. r. 1 0 T. 1 M. P. T. 21 11 32 33 12 45 17 7 24 9 6 15 13 3 16 23 7 30 14 5 19 9 11 20 4 9 13 12 9 21 2 0 2 1 5 6 38 26 64 4 15 1 0 1 0 1 1 6 8 14 1 6 1 1 0 1 0 0 1 1 1 1 5 5 10 12 3 4 7 11 0 15 2 3 2 18 2 i 3 Totals 49 20 78 40 23 63 34 20 54 42 26 68 196 111 307 16 4 20 ; 9 7 16 1 0 1 r> 2 7

Lengtb of Residence. Auckland. Christchurch. Dunedin (Seacliff). Hokitika. Nelson. Porirua. Tokanui. Ashburn Hall (Private M.H.). Total. Under 1 munth From 1 to 3 months .. „ 3 „ 6 „ 6 „ 9 » 9 „ 12 „ 1 „ 2 years „ 2 „ 3 „ ., 3 „ 5 „ „ 5 „ 7 „ ., 10 ., 12 ,. „ 12 „ 15 „ Over 15 years ■" I M. F. T. 0 1 1 17 12 29 12 18 30 9 8 17 3 9 12 4 4 8 1 3 4 1 1 2 0 3 3 1 1 2 M. F. T. 1 0 1 12 9 21 6 8 14 3 10 13 2 9 11 7 1 8 1 0 1 M. F. 1 5 5 3 3 11 1 5 3 0 0 4 1 0 2 1 T. 8 14 6 3 4 1 3 1 M. 1 1 1 P. T. 0 1 1 2 2 3 M. F. 2 1 1 1 1 1 0 1 0 1 T. 3 2 2 1 1 M. 12 18 15 5 4 4 2 1 1 F. T. 4 16 4 22 5 20 5 10 0 4 4 8 0 2 1 2 1 2 M. 1 F. 0 T. 1 M. F. 2 0 0 2 0 1 0 1 T. 2 2 1 1 M. F. T. 15 10 25 57 30 87 37 45 82 18 29 47 13 20 33 17 16 33 5 4 9 5 3 8 3 4 7 3 1 4 2 0 2 i i 6 i 0 1 2 0 2 2 6 2 Totals 175 162 337 . 48 60 108 34 37 71 17 29 46 5 3 8 4 -■> 9 64 24 88 1 0 1 2 4 6

H.—7

20

Table XII.—Causes of Death.

CauRes. AuckUod. g*fc g-gjj ftokltit.. Nelson. 1 <__ ; ! Porirua. Tokamii. Aehburn Hall (Private M.H.). Total. M. F. M. F. M. F. M. F. M. F. M. F. M. F. M. P. M. F. Group I.—General. 0 1 2 0 1 0 0 1 1 0 0 2 3 3 1 0 2 1 1 2 12 11 3 1 r> 3 Carcinoma Lardaceous disease Si'pt ionmia Syphilis Tuberculosis of lungs Tuberculosis of other organs Typhoid fever 1 1 4 2 0 1 1 2 1 0 6*' 3 I I 1 0 0 4 1 0 I 0 4 3 1 0 1 0 Group II.—Nervous System. Cerebral abscess Cerebral hemorrhage Cerebral tumour Cretinism Epilepsy Exhaustion from mania „ melancholia General paralysis Organic brain-disease 1 1 i 2 1 0 1 1 (i 1 S 4 1 0 0 1 2 2 :! 2 2 0 1 1 0 2 0 1 2 1 a 2 0 1 2" 0 0 1 4 2 1 0 1 0 10 2 1 0 1" 0 0 1 7 ••{ 0 1 0 1 10 8 5 2 4 4 22 r> 8 0 0 2 1 1 1 0 o i 1" 0 1 0 l" 0 Group III. —Diseases of Circulatory System. Arterio-sclerosis Cardiac degeneration Valvular heart-disease. . 0 1 1 0 2" 1 0 1 0 3 8 1 4 3 o" 2 3 0 1 0 0 2 4 0 0 1 Group IV. —Respiratory System. Acute catarrhal laryngitis Acute oedema of lungs Broncho-pneumonia Pneumonia (lobar) „ (hypostatic) 0 1 0 1 1" 0 1 0 0 0 2 8 0 I 1 0 5 1 5 1 l" 1 0 1 2 :i Group V.— Digestive System. Abscess of liver Chronic gastritis Gall-stones Peritonitis Strangulated hernia .. 0 1 1 0 o" l 1 0 o" l l 0 1 1 11 1 2 0 1 1 1 0 1 0 1 0 Group VI. — Genito - urinary System. Chronic nephritis Urfemia 1 2 l o 2 1 3 1 1 0 0 1 l" 0 Group VIII. —Skin and CufiLUL&B Tissue. Raynaud's disease .. ■ .. Senile gangrene .. i 0 1 0 1 1 0 1 0 Group XII.—Old Aoe. Senile decay 19 1 18 8 9 5 I 0 7 5 18 0 75 31 Group XIII.—External Causes. Suicide Fracture of skull 0 1 1 II 1 0 0 1 1 2 1 0 Group XIV.—Ill-defined. Asthenia Syncope 1 1 1 0 2 0 3 0 1 0 f> 1 Totals 40 20 40 23 3! 20 16 4 1 9 7 42 26 1 0 5 2 190 111

21

H.—7

Table XIII.—Principal Assigned Causes of Insanity.

Causes. Auckland. Christchurch. Aehburn (SeacHff) Hokitika. Nelson. Porirua. Tokauui. (P 2?"te M. H.). Total. Heredity Congenital mental deficiency Previous attacks Puberty and adolescence Climacteric Senility Pregnancy Puerperal state Lactation Sudden mental stress .. Prolonged mental stress Masturbation Alcohol Syphilis Tuberculosis Other diseases Trauma Epilepsy 111 health Solitary life Dissolute habits Sunstroke Organic brain-diseaee . Unknown Not insane Transfers M. F. hi 13 li 7 12 9 0 15 20 4 0 1 0 4 0 2 M. F. 11 10 (i 4 19 8 3 3 1 5 21 (i M. F. 9 20 4 2 10 6 10 12 6 M. F. M. F. M. P. 2 2 4 0 27 21 0 1 1 1 11 5 9 7 II 7 0 1 .. 0 13 2 2 4 2 17 10 ..0 1 0 1.. 0 8 0 10 1 M. F. M. F. 2 3 1 0 0 1 2" 2 M. F. 71 69 29 20 i 38 22 2(i lit 2 43 84 32 0 2 0 18 0 r> 0 2 22 25 4 0 7!) 13 40 3 0 1 1 10 4 1 18 ti 7 9 1 i 1 3 1 0 0 1 38 11 0 I 7; :)i 0 1 0 4 0 1 10 11 25" 3 15 1 0 2 2 2 4 0 12 1 4 1 0 1 0 3 1 0 3 0 3" 5 7" 2 7 1 2 14 4 3 1 . . 31 t> 2 0 12 0 1 2 ] 0 1 2 3 I 3 2 7 7 0" 3 0 1 0" 1 3 2 0 1 1 1 !! !! 9" 2 0 1.. •■ •■ 0 1 1 3 1 0 25 7 0 1 2 0 0" 1 8 1 11 4 0 35 15 0 12 3 0 43 25 17 19 134 84 0" 2 2" 0 3" 3 2!» II 3" 1 Totals %) 0 10 12 543 34<> 153 93 97 50 GO (SO f

22

H.—7.

Table XIV.—Former Occupation of Patients.

Occupations. .5 i 1 I I £ 1 1 a •5 a 5 i \ 11 S i! H gi i H OccupatioiiB. I I 1 i 11 i ,L 3 « 3 a 9 ? O C B X £ ■£ a fi s > s o O U Q M 2 o< u El -& gi f 1 I 0 d g i a a I Aboriginal Natives Aooountanta and olerks 1 Architeoi .. .. 1 . Ami ioneer .. .. Mm iES. Baoon-curer .. Blackemiths .. .. I . Bricklayers . . . . I Bootmakers .. .. 2 . Bottle-washer Builder .. .. 1 . Burnham boy Bushmen .. .. 3 . Butcher .. .. I . Cab-drivers .. Cabinetmakers .. ! 2 Canvassers .. ( larpentere .. .. 2 ('aiteis ami carriers .. 1 . Chairmaker .. .. 1 . Chimney-sweep (lergymen .. .. '2 . ( loachbuilder.. .. 1 . Cooks .. .. 2 (lommission agent ('olliposit ill's Dairymen Dealer .. Dentist . . Digger .. .. .. Drapers . . . . 1 Drovers .. .. 1 Engine-driver .. 1 . Engineers .. .. 2 Farmers .. 20 Farm labourers .. Fishermen .. .. 1 Fishmonger Flour-miller .. .. 1 Fruitgrower .. .. 1 Fruiterer Gardeners .. .. 2 1 las expert (Irooers .. .. 1 ( Iroonis Glum-diggers.. .. 7 Hawkers . . . . 1 Horse-trainer 1 1 1 1 4 i> "■2 1 1 2 1 i i i 1 i 2 .. 4 .. i '.'. i .. .. 2 .. 1 .. 2 .. 3 .. i .'. i '.'. 2 1 14 I 1 1 3 3 3 1 I 1 3 I 2 .. 4 3 .. 11 4 1 1 }. i 6 1 2 1 I 1 1 4 2 1 3 2 44 1 8 2 1 1 1 1 .. 16 1 2 2 7 4 1 [ron-mouldei Jeweller Kitchenman .. Labourers Land agent .. Law student .. Linotype!' Malster .Maoris Master mariner Miners News agent .. Night-watchman No occupation Painters Paper-runners Persioners .. Piano-tuner .. Plasterer Platelayer Plumbers Porter Restaurant-keepers Saddlers Seamen Schoolmaster Settlers Sharebroker . . Shearer Sheep-farmers Solicitors Stat ion-manager Steward Storekeeper .. Storeman Surveyor's assistant Tailor Timber worker Tobacconist .. Transfers Trapper Travellers Typists Upholsterer .. Veterinary surgeon "I ..I I 1., I I '7 I I s 3 4 1 ■2 I (i 1 37 i 5 1 2 i 1 ■2\ i 1 4 li I i :t 2 i i> 1 3 1 i 48 ]' i " . .1 .. s .. 1 .. "i 1 1 l i 1 1 I I no I I 1 I 7 I II I I 30 6 2 9 1 I 1 2 1 2 4 10 I 2 I I 2 4 1 I 1 1 I 1 1 1 77 1 4 2 2 I .. .. i i ;! i 2 1 ;, I i 1 i 2 i I i I .. i .. I 1 i 12 .. 7 . . i 1 i I i I i i 1 .. 8 .. 1 .. ■ 2 :: i .. '•2 I 2 i :s 36 i i :s ':') 29 '3 ' i i 2 1 1 1 •-f I IT 134 Totals . . 153 97 60 43 29 10 543 Aboriginal Natives ( lharwoman .. • llerke (Companion .. Domestic duties .. 81 I dressmakers .. 1 Factory hand .. 1 .. Florist .. .. .. Housewives .. .. .. ! Laundresses .. .. I Mauris . . . . 2 3 .. F EM, lles. Milliner No occupation Nurses Old-age pensioner Saleswomen .. Schoolgirls .. School-teacher Tailoresses .. Transfers I Ml I I 1 1 t'i •• .-> 1 73 1 '.'. \ .. .. .. 3 3 1 I 2 1 3 242 4 1 1 5 30 2 2 4 1 1 1 i 1 3 "■2 2 I i I • •! " 'I 1 • ■ 1 4 1 I '■ I •• 2 1 Hi 3 1 2 2 1 3 31 • ' 1 i 3 ■2 22 "3 "I .. 5 . . 1 . . 15 12 i i 93 00 25 Totals .. .-,(1 19! S4 12 34!t

H.—7

23

Table XV.—Showing the Admissions, Discharges, and Deaths, with the Mean Annual Mortality and Proportion of Recoveries per Cent. of the Admissions for each Year since 1st January, 1876.

Year. Admitted. Discharged. Not Improved. J Died. Remaining Average Numbers 31st December 111 resident. each Year. Percentage of Recoveries on Admissions. Percentage of on Average Nu resident Deaths lnibers Recovered. Relieved. 1876 1877 1878 1879 1880 1S81 1882 1883 1884 1885 1886 1887 1888 1889 1890 1891 1892 1893 1894 1895 1896 1897 1898 1899 1900 1901 1902 1903 1904 1905 1906 1907 1908 1909 1910 1911 1912 1913 M. F. T. 221 117 338 250 112 362 247 131 378 248 151 399 229 149 378 232 127 359 267 152 419 255 166 421 238 153 391 294 160 ! 454 207 165 372 255 161 : 416 215 146 ! 361 230 161 391 230 160 390 234 201 435 231 158 389 281 179 460 320 256 576 379 302 681 296 170 466 300 244 544 355 258 613 264 247 511 335 263 598 373 224 597 352 192 ! 544 454 237 691 340 240 580 399 280 679 401 277 678 421 279 700 434 325 759 447 376 823 639 371 1,010 455 322 777 593 394 987 543 349 892 M. F. T. 129 79 208 123 57 180 121 68 189 112 76 * 188 100 67 167 93 65 158 95 59 154 102 78 180 S'J 77 166 95 76 171 99 60 159 103 78 181 116 92 208 93 53 H6 98 88 186 88 74 162 89 76 160 101 89 190 107 76 183 105 77 182 104 70 174 102 73 175 114 110 224 88 J 99 187 103 96. 199 125 104 • 229 135 99 234 144 101 245 157 106 263 149 121 270 157 126 283 160 139 299 180 146 326 179 170 349 182 145 327 163 ' 168 331 184 141 325 I 175 162 337 1 M 7 20 14 15 36 41 49 13 17 10 11 34 31 31 23 i 33 21 17 15 24 25 26 13 15 39 ! 40 26 41 24 45 28 31 9 17 30 23 17 35 F. T. M. F. 8 25 6 6 9 29 7 2 14 28 3 3 13 28 ' 8 3 25 61 5 2 36 77 8 1 32 81 5 7 20 33 10 9 9 26 18: 12 5 15 73 29 17 28 12 8 17 51 .. .. 28 59 2 2 30 61 3 1 17 40 12 5 24 i 57 14 30 17 38 8 2 12 29 • 9 9 11 26 55 84 19 43 128 139 16 41 20 12 32 53 17 31 23 36 104 47 25 40 7 42 10 49 25 65 17 57 33 3 15 41 10 9 25 66 84 12 13 37 9 2 32 77 23 21 22 50 i 6 14 19 50 53 32 13 22 9 6 2-2 39 29 68 29 59 164 55 16 39 11 7 44 61 146 18 48 83 78 36 T. 12 9 6 11 7 9 12 19 30 102 20 4 4 17 44 10 18 139 267 32 48 151 49 90 36 19 96 11 44 20 85 15 97 219 18 164 114 M. 36 42 51 55 54 49 60 65 68 73 57 74 78 70 76 79 74 78 64 101 86 105 88 114 99 102 120 129 120 147 146 168 148 136 186 198 193 196 F. T. M. 12 48 519 21 63 581 17 68 638 16 71 695 20 74 729 14 63 709 19 79 827 18 83 892 24 92 938 22 95 981 19 76 1,009 27 101 1,053 26 104 1,041 30 100 1,074 35 111 1,095 41 120 1,115 34 108 1,154 23 101 1,229 35 99 1,308 42 143 1,329 32 118 1,390 43 148 1,440 60 148 1,472 43 157 1,512 46 145 1,581 72l 174 1,654 55 175 1,715 44 173 1,771 70 190 1,801 67 214 1,836 85 231 1,900 64 232 1,909 74 222 1,997 68 204 2,083 97 283 2,160 105 303 2,220 87 280 2,273 111 307 2,332 1,718 5,503 F. 264 291 319 361 396 406J 442 483 514 542 604 643 640 687 702 734 763 810 860 885 925 990 1,008 1,045 1,091 1,119 1,133' 1,188 1,237 1,276 1,306 1,331 1,417 1,465 1,510 1,536 1,640 1,632 T. 783 872 957 1,056 1,125 1,175 1,269 1,375 1,452 1,523 1,613 1,696 1,681 1,761 1,797 1,849 1,917 2,03'J 2,168 2,214 2,315 2,430 2,480 2,557 2,672 2,773 2,848 2,959 3,038 3,112 3,206 3,240 3,414 3,548 3,670 3,756 3,913 3,964 M. 491 541 601 666 703 747 796 860 911 965 984 1,034 1,045 l,046£ 1,078 1,089} 1,125 1,172 1,241 1,313 1,347 1,411 1,438 1,487 1,534 1,622 1,071 1,741 1,780 1,796 1,823 1,851 1,894 1,970 2,028 2,105 2,146 12,252 F. T. II. 257 748 54-53 277 818 49-20 303 904 4898 337 1,003 4516 371 1,074 43-66 388 1,135 4008 421 1,217 35-58 475 1,335 40-00 497 1,408 37-39 528 1,493 32-31 559 1,543 4782 613 1,647 40-39 641 1,686 53-95 000J1,707 40-43 685 1,763 42-61 699Jl,789i 37-61 714}i,839} 38-53 758 1,930 35-y4 812 2,053 39 63 849 2,162 41-27 882 ,2,229 37-41 944 2,355 3592 973 2,411 44-88 1,004 2,491 32-31 1,049 2,583 30-74 1,094 2,716 3906 1,114 2,785 38-35 1,160 2,901 40-56 1,198 2,978 46-18 1,232 3,028 41-39 1,265 3,088 39 75 1,285 3,136 44-29 1,346 3,240 42-25 1,404 3,374 42-72 1 1,445 3,473 38-40, 1,496 3,601 36-38 1 1,551 3,697 4017 1,597 3,849 37 55 F. T. 6601 57-56 50-80 49-72 51-90 5000 50-33 4711 44-96 44-17 5110! 4401 38-81 : 36-70 46-98 42-75 50-32 42-45 47-50 3766 36-36 42-74 4870 43-61 63-01 57-62 82-92 37-34 5500 47-69 36-82 37-24 48-10 42-42 49-72 41-30 4518 41-03 46-66 43-40 44-02 39-82 37-82 36-69 5189 48-07 44-33! 37-58 36-50 33-27 46-64 4217 51-56 4301 44-69 4217 44-17 45-34 4S-21 44-19 47-73 42-94 57-68 49-67 45-91 43-82 57-24 48-74 4618 41-50 53-00 43-27 3701 38-74 50-94 42-98 M. 8-21 7-76 8-48 8-25 7-68 B-29 7-53 7-55 7-46 7-56 5-79 715 7-56 669 7-05 7-25 6-58 6-66 516 7-69 638 7-44 6-12 7-67 6-45 6-29 718 7-41 6-74 8-18 8-01 9-08 7-81 6-90 9-17 9-41 8-99 8-70 F. 3-58 7-58 5-61 4-74 5-39 3-60 4-51 3-78 4-82 416 3-39 4-40 405 4-54 511 5-86 4-76 303 4-31 4-94 3-63 455 6-17 4-28 4-38 6-58 4-94 3-79 5-84 5-44 6-71 4-98 550 4-84 6-71 7-02 5-61 6-96 T. 6-70 7-70 7-52 707 6-89 5-55 6-49 6-21 t-53 6-36 4-91 613 6-16 5-86 6-29 6-71 5-87 5-23 4-82 661 5-29 628 614 6-30 5-61 6-41 6-28 5-96 6-38 7 07 7-48 7-39 6-85 6-00 8-15 8-41 757 7-98 12,4648,355 20,819 4,659 3,641 '8,300 : 956 ' ' 784 1,740 1,214' 834 2,048 3,785 I I .. I I .. I .. I In mental hospitals, 1st January, 1876 In mental hospitals, 1st January, 1914 M. F. T. 482 254 736 .. 2,332 1,632 3,964

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Table XVI. —Showing the Admissions, Readmissions, Discharges, and Deaths from the 1st January, 1876, to the 31st December, 1913.

Table XVII.—Summary of Total Admissions: Percentage of Cases since the Year 1876.

Table XVIII.—Expenditure, out of Public Works Fund, on Mental Hospital Buildings, etc., during the financial year ended 31st march, 1914, and Liabilities at that Date.

Persons admitted during period from 1st January, 1876, to 31st December, 1913 .. Readmissions M. P. T. 9,923 6,370 16,293 2,541 1,985 4,526 M. F. T. Total cases admitted Discharged cases— Recovered Relieved Not improved Died 4,659 3,641 956 784 1,214 834 3,785 1,718 8,300 1,740 2,048 5,503 12,464 8,855 20,819 Total cases discharged and died since January, 18T6 10,614 6,977 17,591 Remaining, 1st January, 187(1 482 254 736 Remaining, 1st January, 1914 2,332 1,632 3,964

Males. Females. Both Sexes. Recovered Believed Not improved Died .. Remaining 37-39 7-67 9-74 30-36 14-84 43-58 9-38 9-98 20-57 16-49 39-87 8-37 9-83 26-43 15-50 10000 100-00 100-00

Mental Hospitals. Net Expenditure for Year . ended 31st March, 1914 Liabilities oil 31st March, 1914 Motuibi Island Auckland Tokanui Porirua .. Cliristchurch Seaclitf .. vVaitati .. Nelson Totals .. £ a. d. 560 16 10 8,907 7 10 8,873 16 1 1,951 8 3 616 10 10 a,257 8 4 1,633 15 5 200 0 0 26,001 3 7 £ s. d. 18,552 3 6 2,126 0 0 37 7 G 11 13 6 20,727 4 6 26,001 3 7 20,727 4 6

25

H.— 7

Table XIX. —Total Expenditure, out of Public Works Fund, for Buildings and Equipment at each Mental Hospital from 1st July, 1877, to 31st March, 1914.

Mental Hospitals. 1877-1906. 1906-7. 1907-8. 1908-9. 1909-10. Auckland Reception-house at Auckland Wellington Wellington (Porirua) Christchurch Seacliff Waitati Dunedin (The Camp) Napier Hokitika Richmond Nelson " I £ s. d. 104,905 19 2 28,869* 2 9 119,621 6 10 113,133 15 3 143,107 2 2 3,014 3 6 147 0 0 3,445 18 0 989 4 8 16,522 18 11 £ s. d. 527 17 3 4 10 0 482 0 9 1,175 12 2 1,962 6 5 1,997 4 5 320 10 2 899 7 11 £ s. d. 253 7 10 462 10 0 198 2 1 • 2,369 14 10 2,018 2 7 1,313 17 6 252 4 10 918 18 8 £ s. d. 1,318 8 9 61 16 0 106 10 0 2,246 13 5 4,143 14 11 5,598 4 8 86 18 10 58 16 9 £ s. d. 1,523 10 2 1,788 8 0 10,347 13 10 1,133 4 5 2,796 17 9 19 7 0 107 14 7 552 8 11 256' 7 0 200 0 0 1,675 0 0 1,992* 6 1 i — Totals 533,756 6 3 8,048 19 7 7,986 18 4 15,296 3 4 19,838 7 3 Mental Hospitals. 1910-U. 1911-12. 1912-13. 1913-14. Total Net Expenditure, 1st July, 1877, to 31st March, 1914. mckland teception-house at Auckland lotuihi Island .. Vellington Vellington (Porirua) 'hristchnrch ieacliff Vaitati Junedin (The Camp) Napier lokitika Richmond kelson .. .. .» £ s. d. 462 17 2 2,531 6 5 £ R. d. 105 8 9 105 5 7 £ s. d. 135 3 8 104 16 9 £ s. d. 8,907 7 10 £ s. d. 118,140 0 7 5,058 12 9 560 16 10 35,277 16 6 29,655 15 7 157,146 7 7 129,348 13 1 164,936 7 5 6,742 17 4 4,891 6 10 147 0 0 3,727 1 4 1,096 19 3 21,895 10 6 165 16 8 4,303 1 1 21,935 2 8 560 16 10 8,873 16 1 8,121 7 0 1,062 14 10 4 4 7 1,762 5 0 411 13 3 1,479 9 2 442 1 9 9,550 S 9 4,866 10 7 5,381 18 10 4,007 6 4 1,951 8 3 616 10 10 3,257 8 4 1,633 15 5 *5 14 4 352 16 7 200 0 0 200 0 0 200 0 0 Totals .. *., 12,706 17 7 8,809 5 1 46,181 4 7 26,001 3 7 678,625 5 7

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26

Table XX.— Showing the Expenditure for the Year 1913.

Table XXI.— Average Cost of each Patient per Annum.

Approximate, Cnst. of Paper.—Preparation, not given ; printing (STO copies), £24.

Authority : John Mackay, Government Printer, Wellington.— l9l4

Price 9d.]

Items. Auckland. Christehurcb. Dunediu (Seacliff). Hokkika. Nelson. Porirua. Tokauui. Total. £ s. d. £ s. d. £ s. d. ; £ s. d. £ s. d. J £ s. d. I £ s. d. £ s. d. 1,000 0 0 448 19 10 994 16 1 1,302 18 0 762 7 0 117 12 0 3,930 16 5 2,593 10 11 Inspector-General* Deputy Inspector-General and Assistant Inspector* Clerks* Medical fees* Contingencies Official Visitors Superintendents Assistant Medical Officers Visiting Medical Officers Clerks Matrons Attendants and servants .. .. . Rations .. .. .. .. ...... Fuel, light, water, and cleaning Bedding and clothing Surgery and dispensary Wines, spirits, ale. and porter Farm Buildings and repairs Necessaries incidental, and miscellaneous 25 4 0 650 0 0 474 II I 286 0 8 230 14 0 8,330 7 I I 7,790 12 9 1,747 12 3 2,269 0 l> 102 14 3 12 0 0 526 18 6 588 15 6 2,639 0 3 .. 0 6 0 39 18 0 650 0 0 708 6 5 32!) 12 9 990 I!) 4 330 0 0 443 0 8 135 0 0 141 15 0 9,111 8 7 12,630 16 7 6,747 13 4 7,430 7 8 2,886 18 10 2,702 18 4 2,617 19 6 2,715 9 7 112 2 8 220 18 4 li 7 0 10 8 0 945 15 3 3,118 18 0 650 10 9 I,737 17 0 3,723 3 8 5,16fi 3 2 28,252 18 4 38,057 16 1 9,620 4 11 13.219 4 0 12 12 0 235 0 0 200 0 0 90 0 0 2,579 18 9 2,173 8 9 108 li 7 247 6 1 12 13 3 0 5 0 8fi 0 4 8 18 2 480 16 2 8 8 0 400 0 0 16 13 4 45 0 0 115 0 0 2,178 li 7 1,680 11 8 434 13 0 365 18 0 41 14 8 6 11 0 162 16 8 25 4 0 687 10 0 581 14 5 340 0 0 135 0 0 12,418 3 4 8,057 19 8 2,125 3 9 2,524 19 5 219 18 II 14 5 3 1,481 4 5 886 IS 4 3,867 16 3 liOO 0 0 2,084 10 10 1,382 9 8 134 17 9 213 19 11 9 S 9 1,424 1 4 847 9 0 49,333 12 7 35,263 3 6 10,140 10 6 10,954 13 0 719 7 10 49 16 3 8,567 1 9 4,327 5 4 17,333 5 2 2,245 8 7 454 S 7 791 8 2 664 17 6 Totals Repayments, sale of produce, &c. 25,653 II 8 9,175 15 4 6,235 5 1 1,125 11 2 6,120 10 5 1,678 7 8 33,365 17 9 12,193 1 4 7,916 6 3 215 19 5 150,111 6 6 47,228 3 10 Actual cost 7,700 6 10 102,883 2 8 16,477 Iβ 4 18,632 13 5 24,838 12 1 5,109 13 11 4,442 2 9 21,172 16 5 * Not included in Table XXI.

Mental Hospital. Provisions. Salaries. Bedding and Clothing. Light, Fuel, Hnreerv Wines, CleaninR. l ,enSftr y- Porter. and "'™.'«'i p er uieu»» lui Kepavinents ««P--. „«&**. Parent. fSrW Total Cost Total Cost per Head, per Head, less Decrease Increase less ; Receipts of in in Receipts of all kinds pre- 1913. 1913. all kinds. vious Year. Auckland Christchurcli Dunedin (Seacliff) m .. Hckitika Nelson Porirua Tokanui £ s. d. i 9 0 lj| 9 17 0 8 8 104: 9 17 7 9 9 10} 9 1 1 15 7 24 £ s. d. 11 10 8J 15 8 4} I 16 19 lOJ 14 3 5 15 12 3 15 18 10 2!> K> tff 1 r> (i 0£ £ s. d. 2 12 5) 3 Iβ 5 3 1 8i 1 2 I! 2 1 4 2 16 8* 2 7 HJ 2 17 6j £ s. d. £ s. d. 2 0 5 0 2 U 4 4 3J ! 0 3 3J 3 1 5J 0 r> 0J 0 9 10 0 J 2 2 9 1J 0 4 84 2 7 9J; 0 4 llj 1 9 11}! 0 2 1 2 13 3 9j £ s. d. 0 0 ii\ 0 0 2J! 0 0 2} 0 0 8J 0 0 4 £ s. d. £ s. d. I 0 12 2J 0 13 7i 1 7 7] 0 19 0 3 10 10} I HI 6 0 7 9} 0 0 9} 0 18 5 1 13 24 1 0 0 24 1!( 0 •"> 0 Hi £ s. d. 3 1 04 5 8 84 5 17 5 2 3 84 3 l"> 14 4 f> 11 8 ir> ioj £ s. d. 29 13 1} 41 4 10} 43 4 II! 28 6 10 34 1 1 7 37 9 94 87 19 2 £ s. d. £ s. d. 9 5 :>J 20 7 104 11 2 8| 30 2 24 12 9 04 30 •"> 5 4 1 r> (i I 23 1 1 4 8 3 84 26 7 104 11 18 34 25 11 (5 1 (> 14 86 13 04 £ s. d. £ s. d. 19 1 0 19 4 ">J 27 4 0i 27 8 <i| 28 4 (>4 28 Iti 2| 23 4 t>4 25 1<> 2 25 1 HJ! 25 11 04 2:i 15 9|l 25 19 8 85 11 2 £ s. d. £ s. d. 0 3 r>i 0 4 (i 0 118 2 11 7 J 0 9 lj 2 3 104 Averages 9 5 3 I 0 0 3 2 f> Oil 2 9 4 II 0}l 38 4 11 10 9 4j\ ■21 V> (<i 25 16 94I 25 6 8j 0 10 1 Table XXIa. In eluding first five items in Table XX I 39 8 7JI I 27 0 6 2(5 10 14 I 0 10 4, Table XXIb. Richmond Home for 13 16 11} 40 16 4}| 3 18 9}l 3 11 44 Feeble-minded Patients on probation 12 10 11 28 13 4J 1 9 5J 2 17 3 0 2 4J at The Camp ! 4 7 114 0 (5 44 4 8 2J 71 (5 1 1 6 7J 0 9 2 I 6 13 11 54 3 0} (50 15 0 59 5 2} 53 0 2 51 19 If 1 9 9j 1 1 Oj