MENTAL HOSPITALS OF THE DOMINION (REPORT ON) FOR 1914.

Appendix to the Journals of the House of Representatives, 1915 Session I, H-07

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1915. NEW ZEALAND

MENTAL HOSPITALS OF THE DOMINION (REPORT ON) FOR 1914.

Presented to both Houses of the General Assembly by Command of Ifis Excellency

CONTENTS. PAOE paok Introduction .. .. .. .. .. 2 Single Patients .. .. .. .. 4 Number of Patients on Register .. .. 2 Private Caro .. .. 4 Their Distribution .. .. ..2 Accommodation .. .. .. .. 4 Their Ratio to Population .. .. 2 •n.__i__ r\ - 1 I 1 arming Operations .. .. .. .. 5 Admissions .. .. .. .. .. 2 | Financial Statement .. .. .. .. 6 Their Ratio to Population .. .. .. 2 „ , ,_,,,, The Staff .. .. .. .. .. 0 Ratios compared with Australia .. .. 3 Discharges and Deaths 3 Visits of Inspection li Causes of Insanity .. .. .. .. 3 Medical Superintendents' Reports .. .. 7 Voluntary Boarders .. .. . . .. 3 AppendixMinors ~ .. .. .. .. 4 Statistical Tables .. .. .. ..10 The Hon. the Minister tn Chabge of Department for the Care of Mental Defectives to His Excellency the Governor. .My Lord,-- Wellington, 30th July, 1915. I have the honour to submit to Your Excellency the report of the Inspector-General of Mental Defectives for the year 1914. I have, &c, R. Heaton Rhodes, Minister in Charge of Department for the Care of Mental Defectives I—H. 7.

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The Inspector-General to the Hon. the Minister in Charge op the Department for the Care op Mental Defectives. Sir,— Wellington, 24th 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, 1914. The number of patients on the Mental Hospitals Register at the beginning of the year Was 3,964 (m., 2,332 ; f., 1,632), and at the end 4,111 (m., 2,408 ; l, .1,703), an increase of 76 males and 71 females. The total number under oversight, care, or control was 4,856 (m., 2,858; f., 1,998), as against 4,805 (m., 2,816 ; f., 1,989) in the previous year, an increase of 51 (m., 42 ; i, 9) ; while the average number resident in our institutions during the year was 3,950 (m., 2,309 ; L 1.641), as against 3,849 (m., 2,252 ; L, 1.597) in 1913, or 101 more in the year under review. Distribution. The 4,111 patients on the register at the end of the year were distributed as follows : — Males. Females. Total. Auckland ... ... ... ... ... 558 359 917 Christchureh ... ... ... ... ... 338 324 662 Dunedin (Seacliff and Waitati) ... ... ... 528 388 916 Hokitika ... ... ... ... ... 190 62 252 Nelson ... ... ... ... ... 84 108 192 Porirua ... ... ... :... 519 422 941 .J; , ;. Tokanui ... ... ... ... ... 94 ... 94 Ashburn Hall (private mental hospital) ... ... 21 23 44 Absent on probation on 31st December, 1914 ... 76 17 93 2,408 1,703 4,111 Ratio to Population. The following calculations show the ratio of patients on the register at the end of the year to the estimated general population, both exclusive and inclusive of the Native race. The number of Maoris on the register was 27 only (m., 19 ; f.; 8). The proportion of total mentally defective to the total population was, — Exclusive of Maoris ... ... ... .., 37-26 per 10,000,0r lin 268 Inclusive of Maoris ... ... ... ... 3588 „ lin 279 The proportion of mentally defective males to the male population,— Exclusive of Maoris ... ... ... ... 42-05 per 10,000,0r lin 238 Inclusive of Maoris ... ... ... ... 40-50 „ lin 247 The proportion of mentally defective females to the female population,— Exclusive of Maoris ... ... ... ... 3211 per 10.000, or lin 311 Inclusive of Maoris ... ... ... ... 30-90 „ lin 324 In England and Wales the number of notified insane persons on the I st January, 1914, stood to the estimated population (mean) in the proportion of 1 to 267, or 37-4 per 10.000, and in Ireland 1 to 175, or 57 1 per 10,000. Admissions. Exclusive of 24 patients (m., 17 ; 1, 7) transferred from one institution to another, the admissions numbered 868 (m., 509 ; f., 359), or 84 (m., 43 ; f., 41) in excess of the admissions during 1913. Of the 868, those admitted for the first time to any mental hospital in New Zealand numbered 734 (m., 440 ; f., 294), and those not admitted for the first time 1.34 (m., 69 ;1, 65). To the first admissions 13 immigrants, who became insane within a year of landing, contributed. Of these, 6 men and 2 women came from the United Kingdom; 3 men and 1 woman (one of each sex had been previously insane) came from the Commonwealth; and there Was 1 foreigner, who had been insane before. Tn addition. 2 NeW-Zealanders were admitted shortly after their return from residence abroad. Ratio of Admissions to Population. Excluding the Native race (10 male and 1 female) and all transfers, the proportion of admissions (whether first or not) and first admissions to the estimated general population (mean) stands respectively at 7-86 and 6-67 per 10,000 ; or, in other Words, every 1,272 persons in the general population contributed an admission, and every 1,500 a first admission.

In England and Wales during 1913 every 10,000 of the general population contributed 4-98 first admissions and 6-04 total admissions (idiot establishments excluded); in Scotland the ratio for total admissions was 7-78, and in Ireland 7-89.

Ratio to 10,000 of Population of Number of Persons in Population contributing Year. Admissions. First Admissions. One Admission. 0ne First Admls - sion. Quinquennial average, 1904-8 Quinquennial average, 1909-13 .. Decennial average, 1904-13 914... 7-01 5-71 7-50 615 7-27 5-94 7-86 6-67 1,426 1,333 1,375 1,272 * 1,751 1,627 1,683 1,500

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Ratios of Total Insane and Admissions to Population in Australia. ■ Through the courtesy of the departmental chiefs lam able to give the information below. When going to press the returns had not been completed in the States omitted; and the figures for Queensland are an approximation, being calculated on the population returns for September. Now South „ , , Western Tasttt i Queensland. . . ~ Wales. Australia. mania. C Male .. 242 258 Ratio insane to population, lin .. -{ Eeniale .. 341 510 t Totals .. 279 329 f Male 42-3 41-0 38-7 26-2 Insane to 10,000 of population .. ■< Female 31-8 29-2 19-6 26-5 [_ Totals 37-2 35-8 30-3 26-4 [ Male 1,101 1,142 1,094 2,856 Population contributing one admission -{ Female 1,648 1,599 1,827 3,155 [_ Totals 1,310 1,314 1,327 2,962 f Male 9-08 8-75 9-14 3-57 Admissions from 10,000 of population •{ Female 6-07 6-25 5-47 3-16 [_ Totals 7-83 7-60 7-50 3-37 Discharges and Deaths. Omitting transfers, where discharge from one institution is coincident with admission into another, the number of cases discharged from the mental hospitals was 440 (m., 240 ; L 200), and the deaths numbered 281 (m., 193 ; 1, 88). The total number under care during the year, deducting transfers; was 4,832 (m., 2,841 ; f., 1,991). The corresponding figures for the previous year were 426, 307, and 4,697 respectively. Of the patients discharged, 369 (m., 207 ; f., 162) were classed as recovered. In 1913 the number discharged as recovered was 337 (m., .175; f., 162). The percentage of recoveries calculated upon admissions was 42-51 (m., 40-67 ; f., 45-12), as against 42-98 (m., 37-55 ; f., 50-94) in the previous year. In the summary of total admissions since 1876 the percentage of recovery works out at 39-93 (in., 37-48 ; f., 43-61). In England and Wales (exclusive of idiot establishments) the rate for 1913 was 32-71, and in Scotland 35-4 per cent. The percentage of deaths calculated on the average number resident was 7-11 (m., 8-36 ;L, 5-36), as against 7-98 (m., 8-70 ; f., 6-96) in 1.913. Calculated on the total number under care (less transfers) the proportion per cent, in 1914 was 5-82 (m., 6-79 ; f., 4-42), as against 6-53 (m., 7-17 ; f., 5-67) in the previous year. In England and Wales the percentage in 1913, calculated on the daily average number resident, was 9-33 (m., 10-18 ; 1, 8-58). A. Coroner's inquest is held in every case of death in an institution, irrespective of the cause. Analysing Tables VI and XII in the appendix one finds that above 46 per cent, of those who died were over sixty years of age, and in over, 23 per cent, uncomplicated senile decay was the cause of death. General paralysis contributed nearly 19 per cent, of the male and 13 per cent, of the total deaths. Consumption and other forms of tuberculosis also contributed 13 per cent. There was 1 death from enteric fever. Two patients committed suicide; for these regrettable events blame did not attach to the staff. There were no fatal accidents. In England and Wales during 1913 the percentage of deaths due to tuberculosis was over 15, and to general paralysis of the insane was over 25 for males. Causes of Insanity. Table XIII has been remodelled to show combinations of causes. A stress seldom operates singly, and the cause assigned by relatives is generally the last straw, if not the first symptom. Hitherto the principal cause assigned was all that appeared, and this will explain the few associated factors disclosed by the table. The first column deals exclusively with cases alleged to be due to a single cause ; the last column shows the total incidence (either alone or in association) of any cause ; and the figures in the intermediate columns deal entirely with associated causes or factors. It will be seen that heredity is acknowledged to contribute a fair proportion (about .19 per cent, of the known causes), though an absurdly low estimate; and the total incidence assigned to the toxic effect of alcohol and venereal disease is 21-7 and 9-6 per cent, respectively among males, after deducting cases in which there was no known cause. With respect to heredity, we may try to practise selfdeceit and lull the conscience by laying the blame on the past generation, but what is to be said of alcoholism and venereal disease ! Now as perhaps never before these, social questions, always deserving serious consideration, become clamant for action. We are plunged in a dysgenic war ; the gaps in our voluntary army are being filled by the best of our sons, and it behoves us who are left behind to do what we can to make the nation cf the future worthy of the sacrifice. Voluntary Boarders. Persons labouring under mental defect, but capable of understanding the meaning of the procedure, may seek admission to a mental hospital as voluntary boarders. At the beginning of 1914 there were 21 (m., 6 ; f., 15) boarders in residence, and during the year 47 (m., 17 ; f., 30) were admitted. If a voluntary boarder should after admission show mental defect sufficiently pronounced and sustained to render it .improper to classify him any longer as such, application for a reception order has to be made to a Magistrate. During the year 14 (m., 7 ; f., 7) were transferred from the voluntary to the ordinary register, and 2 died, while' 31 (m., 9 ; 1, 22) were discharged, leaving the total at the end of the year the same as at the beginning. The increasing number taking advantage of this provision of the Act, and the numerous expressions of gratitude on the part of voluntary boarders for the benefits received, is most encouraging.

H.—7. Minors. The procedure which permits of defective children being cared for without a reception order granted by a Magistrate was put into operation in the case of 3 boys and 3 girls. Two of the boys were transferred to the Home for Defectives, KichmondSingle Patients. There were 2 patients, both males, admitted under Part II of the Act. One of these was discharged, and the other was transferred to a mental hospital. Private Care. In the last report attention was drawn to the penalties to which any one was liable who undertook the oversight, care, or control of a mentally defective person without notification (section 122), and to the prohibition (section 123) against two or more such persons being cared for in the same house except (subsection (6)) in the ease of a general hospital or a special hospital not kept for gain. It is well that these facts should be known. Persons of average common-sense receiving payment for the oversight, care, or control in private of a mentally defective patient should know that the law is being transgressed, and should seek information. In future prosecutions the Department will not be satisfied with merely drawing attention to the requirements of the Act and asking for a nominal penalty. Accommodation, &c. The position with regard to buildings is as follows: — Auckland. —Auxiliary No. 2 (female) for noisy and troublesome patients, taking them out of the main building, has been occupied- The accommodation is for 75. A day-room and dormitory added to the Women's side, main building, have been occupied. Auxiliary No. 3, for 100 male patients, is nearing completion. A cottage has been built for the Assistant Medical Officer, who now resides in it. The removal of the noisy patients has altered the character of the main building on the women's side, and the wards lately occupied by these patients have been altered, thoroughly renovated, and adapted for an infirmary. Thus bit by bit the whole of the main building will be modernized. Porirua. —A large extension of day-room space, Ward No. I (male) and A Ward (female). The block of buildings for a reception-house, sick-hospital, and nurses' home is progressing favourably. The accommodation on the women's side is considerably taxed, but will be relieved almost immediately by transfer to Tokanui. The women's unit at that hospital is now being furnished for that purpose. The drying-closets in the laundry have been found inadequate for requirements, and an extension is now being carried out. Mechanical water-filters have been set up. Tokanui. —A unit for 50 males has been completed and another started. A reservoir with 75,000 gallons capacity is being constructed on the nearest hill to the present buildings. Water will be pumped from the present pumping-station. The electric light has been installed. Some minor buildings have been erected for the farm and for the accommodation of the married staff. Sunnyside. —A nurses', home for those employed in the main building, with accommodation for 50, is well advanced, and promises to be a comfortable and picturesque building. Its occupation will relieve an equal number of single rooms in the main building for the accommodation of patients. The block of buildings now in progress will be approached from Martin's Lane, and will be employed as a reception-house, sick-hospital, and nurses' home. The general design is the same as at Porirua, the accommodation being for 25 each, males and females, in the reception block,' and 25 each in the hospital portion, with suitable day-rooms, verandas, &c. The advent of electric light derived from the Lake Coleridge supply has been a great boon. We are using the current for heating some of the single rooms, and also for power purposes. The main hall has been much improved by the introduction of windows where possible, and the scheme of redecoration has been carried out with considerable skill and taste. An addition to D Ward is about to be undertaken, and a report has been made with regard to the introduction of the Vigilant automatic fire-alarm. Seacliff. —A reception cottage for males, corresponding to the reception cottage for females which has been successfully in use for a number of years, is about ready for occupation, and is eminently suitable for its purpose. It would be hardly possible to obtain a more beautiful site for this building. On the women's side a building is Well advanced which will add largely to the dormitory and single-room accommodation. In the planning of this building additions in the near future have been kept in view. When this is occupied one of the dormitories on the front of the main building will be adapted for a day-room, as was done some years ago on the male side. A considerable extension has been made to the nurses' home. The comfort and convenience of the new dining-room for male attendants must appeal to them. On account of the decided falling-off in patients capable of milking, machine milking has been installed- The bakehouse has been fitted with breadmaking machinery. Nelson. —As I stated before, this hospital is old, and, having been built of wood, which has served its time, needs to be gradually rebuilt in some permanent material. Plans and specifications have been drawn up, and tenders are about to be called for the first instalment of this work —namely, a kitchen block in brick and a small reception hospital (removed from the main building) also in brick. Meantime a temporary ward attached to the auxiliary is in course of construction. To this temporary ward will be removed in turn the inmates of any particular ward being rebuilt. New stables, barn, and byres are urgently needed, and a start has been made. Hokitika. —This is also a wooden building, the life of which has undoubtedly been prolonged by scrupulous attention to cleanliness and by executing repairs promptly. A concrete fire cut-off has been carried through the centre of the main building, and less important ones will follow. These will largely minimize the danger of any fire that may break out becoming extensive.

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Home for Defectives, Richmond. —The Education Department, from whom we originally took over this estate, has arranged with us to retake it. They are building accommodation for a special school for girls, and in due course we will betake ourselves to Tokanui, as the extent of this estate is really too small for our purposes. However, in order to add to the safety of the more helpless in case of fire, the dining-room downstairs was extended and converted into a dormitory, to which the boys were removed. Far mi) ig 0 per alio ns. The following summary of expenditure and receipts in connection with the farms at the mental hospitals demonstrates another successful year : — Dr. £ s. d. Or. £ s. d. To Salaries and wages .. .. .. 4,199 16 1 By Cash sales of produce, &c. .. .. 6,640 5 6 Feed .. .. .. .. 3,136 2 5 Value of produce grown on farms and Seeds, &c., manures .. 1,043 2 1 consumed in tho mental hospitals.. 14,942 13 11 Implements, harness, repairs, &c. .. 778 7 4 Stock .. .. •• .. 637 2 11 Rents, rates, &c. .. .. .. 883 16 8 Fenoing, roading, &c. .. .. 278 19 3 Harvesting, threshing, &c, .. .. 114 18 4 Railages .. .. .. .. 113 9 6 Buildings .. .. .. .. 61 7 2 Sundries.. .. .. .. 421 14 1 Balance .. .. .. .. 9,914 3 7 £21,582 19 5 £21,582 19 5 The value of produce consumed is shown at wholesale rates ruling in the particular district. Compared with the previous year, the cash sales increased by £803 and the value of produce consumed by £313. The credit balance of the year's transactions was £695 higher. The fluctuation is partly accounted for by the addition of Tokanui. Hereunder is a statement of expenditure on individual farms :—

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

These returns are highly satisfactory, for if they did not pay the cost of management the farms would remain an essential part of our system. In their beauty and spaciousness and in their varied interests we have a suitable environment for the treatment of mental disorder, and, while providing open-air occupation and recreation for patients, they ensure a plentiful supply of fresh wholesome food.

Auckland. I Christchuroh. Seaoliff. Hokitika. Nelson. Porirua. Tokanui. Total. Salaries and wages Feed Seeds,&c. .manures Implements, harness, repairs, &c. Stock Rent, rates, &o... Fenoing, reading, &c. Harvesting.threshing, &e. Railage Buildings Sundries £ s. d. 250 0 0 193 12 3 158 15 1 33 17 3 £ s. d. 510 0 0 241 1 7 112 3 2 169 8 3 & s. d. 2,181 0 0 1,606 8 4 216 5 0 221 1 2 £ s. d.i 136 15 0| 25 14 3! 24 19 7 5 4 0 £ s. a. 248 15 0 16 13 7 104 IB 10 33 17 0 £ s. d. 386 15 0 907 19 6 221 8 0 86 4 4 £ s. d. 486 10 4 144 17 11 204 12 5 223 15 4 £ s. d. 4,199 16 1 3,136 2 5 1,043 2 1 778 7 4 5 0 0 142 17 2 431 11 3 .10 13 2 24 3 0 336 17 11 82 19 5 65 4 6 106 8 0 95 10 10 115 7 6 63 7 1 197 19 6 637 2 11 883 16 8 278 19 3 10 4 6 '20 IS 4 10 19 9 54 0 6 11 2 9 49 15 1 114 18 4 18 12 4 36 7 2 187 6 0 57 8 6 25 0 0 142 4 7 37 8 8 113 9 6 61 7 2 421 14 1 32" 6 3 59 17 3 Totals 11,668 15 10 683 15 4 1,994 0 7 4,893 2 11 257 18 0 547 10 6 1,936 9 6 1,355 19 0, *

Mental Hospital. Produce sold for Cash. Value of Produce consumed. Total. Auckland Christchurch Seacliff Hokitika Nelson Porirua Tokanui £ s. d. 691 1 3 1,935 2 1 2,201 1 10 258 2 9 1,440 13 3 114 4 4 £ s. 2,670 1 3,112 9 4,433 19 427 1 1,044 13 2,460 15 793 13 d. 3 4 5 5 9 6 3 £ s. 3,361 2 5,047 LI 6,635 1 427 1 1,302 16 3,901 8 907 17 d. 6 5 3 5 6 9 7 Totals... 6,640 5 6 14,942 13 11 21,582 19 5

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Financial Statement. The details of expenditure are given in Tables XX and XXI. Circulars were issued at the beginning of the war drawing attention to the necessity of postponing expenditure which was not regarded as urgent. Even when issuing these one realized that our ordinary expenditure did not go beyond necessaries, and that no appreciable economies could be exercised. The reductions were in the items surgery and dispensary (2|d. per head), wines, spirits, &c. (fd.), and farms (6s. 3-|d.). On the other hand, the new scale of salaries raised that item by £1 3s. 6d. per patient, and the remaining items were influenced by the rise of prices from August onwards, the advance per patient being as follows: Provisions, £1 Is. 2d. ; bedding and clothing, 3s. 7|d. ; fuel, light, &c, 3s. lfd.; building and repairs, 2|d.; and miscellaneous, Bs. s|d. : the net result being an increase of £2 1.35. 7d. per patient. The factors making for increase in the cost of maintenance being those influencing the cost of living, there has been as a natural consequence a drop in the amounts paid for patients, amounting .over all the patients to 7s. llfd. per head per annum. Deducting receipts of all kinds, the total cost per patient exceeded the cost in 1913 by £3 2s. 7|d. Including the items in Table XX, the net cost per patient was £30 4s. 64d., or £3 4s. OJd. in excess of that for the previous year. The Staff. On the whole, the work of the staff has been well done under trying circumstances. A number of good men volunteered for service with the Expeditionary Forces, and their places had to be taken by probationers; and the difficulty of getting suitable single men under present circumstances has merely to be stated to be appreciated. In the past we required single men to remain in the service for two years before marrying, in order to have at night a sufficient number on the premises in case of fire ; but the time-restrictions with regard to marriage have been cancelled in the emergency, notwithstanding the regulation that no married man permanently appointed to the Public Service is to receive less than £140 per annum. Of the male staff 11-7 per cent, are at the front or in training. The proportion rises to 15-7 per cent, when those over forty years of age are excludedLast year I wrote at some length on the paramount necessity for discipline in the interest of the patients, and of the slackness which becomes inevitable when local control is lessened- The Medical Superintendents in conference saw you upon this subject, and also interviewed the Commissioner. It was suggested that the nursing staff should be regarded as probationers until the senior examination was passed, a minimum of three years. In that period nurses or attendants may be deemed to have shown their suitability for the work, temperamentally and otherwise, and would pass into the permanent service after an examination on subjects dealing mainly with the practical side of their duties. The superannuation deductions would be made during the probationary period, which Would count as service, as is now done with respect to the first year. This will require legislation, but as the end in view is entirely in the interests of the patients one may safely presume that there will be no opposition. I would again draw attention to the position of officers in this Department with regard to superannuation. With few exceptions their salary is paid partly in cash and partly by allowances in the nature of salary. It is readily acknowledged that no one Would accept the positions at the cash salary alone, as that is considerably lower than the ruling wage ; but the probationer before making application does a small sum, in which he adds the cost of living to the salary, and then decides that the salary is good enough. To place him in the same position as an officer in any other Department, all that is required is to add the value of the allowances in the nature of salary (accommodation and food) to the cash salary, and deduct the value of the allowances so assessed when payment is made. : The deductions for superannuation Would then be made from the total salary, and the retiring-allowance would be proportional to that of officers in other Departments, and not unfairly and illogically lower. The following nurses and attendants, having served the necessary period and had the necessary training, had their names placed on the Register «nf Mental Nurses on passing the Senior Examination : Agnes Barr, Ethel Winifred Bellamy, Annie Bennett, Clarice Eagle, Annie Julia Eggeling, Jane Pearson Ellwood, Jeannie C. M. Emerson, Mary Gallic, Johannah Kelly, Maud Morris, Mary McDonald, Esther Jane Potter-, Margaret Richardson, James Devine, Robert Henry Gray, William McKenzie, Robert Ryce, Alfred Charles Henry Scott. Visits of Inspection. The following are in addition to the visits paid by District Inspectors and Official Visitors, whose interest in the work and solicitude for the patients is most helpful. On each visit the patients had full opportunity to converse with me, and, if so requested, in private. All possibly rational complaints were investigated, and these Were remarkably few, and were found almost invariably to be due to the mental condition of the patient. The general health and condition of the patients was satisfactory. Auckland. —Visited in January, February, April, June, September, 1914, and January, March, and May, 1915. The removal of the turbulent women patients to a special building, and the near prospect of removing to a separate building a similar class of male patients, will alter the whole character of the main building, and will neutralize to a considerable extent its initial error of being placed too near public roads. These facts, together with the gradual, modernizing of the main building," will give it an air of comfort, which must react beneficially on the patients. It must be a. source of satisfaction to Dr. Beattie, after years of Work carried out under difficulties, to find things running more smoothly. It will not be long before further additions will be needed,, owing to the expansion of Auckland; and probably the first instalment will take the shape of a nurses' home, liberating in the Wards a number of rooms now occupied by the staff. Sunnyside. —Visited in March, April, July, August, November, 1914, and February, March, and June, 1915. Of late, Dr. GoW's health has been indifferent, and I believe the staff has exercised, a special effort to lighten the anxieties of his position. Dr. Lee, who was anxious to offer his services

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at the beginning of the War, loyally set aside his personal desires in this matter until he could be more easily spared, and I cannot allow the genuine good Work he has done to pass without a word of commendation. The reports of Mr. Smail, who is a daily visitor, are very encouraging. Miss O'Flynn, the Sub-Matron, returned to the Old Country to offer her services to the Red Cross. The installation of electric light has added to the general, cheerfulness of the Wards. Seacliff.—i- Visited in March, April, July, August, November, 1914, and in March and June, 1915. Considerable building operations are being carried out by our own staff, assisted by temporary employees. Fifty women patients are at Waitati; but as it will be more expedient and economical •to group all the women patients at Seacliff for some years to come, they will be retransf erred in due course. A felt want is a unit for " criminal " patients, though persons of this class needing segregation from others are very few. In practice one finds that the majority of patients committed under Part IV of the Act are among the better-conducted; there are a few noteworthy exceptions, and these are a source of great anxiety and cost. On the other hand, there are some cases, chiefly epileptics and paranoiacs, just as dangerous as the special cases alluded to, but differing technically in classification merely because they Were placed under supervision in time. The Camp was purchased to accommodate both classes, but in deference to the objections raised in the district it was and is used as an overflow establishment for well-conducted patients. We should now build a secure place at Waitati. to take the more dangerous not alone from Seacliff, but, as far as practicable, from other institutions, Dr. Buchanan, the Senior Assistant Medical. Officer, left with the Expeditionary Force and Was succeeded by Dr. Gray. Hokitika. Visited in March, July, September, 1914, and in June, 1915. Nothing calling for particular comment. Since the Corporation abattoirs have been opened We have bought our own cattle, and the once indifferent meat -supply is now good. Nelson. - Visited in March, November, December, 1914, and April this year. The scheme for gradual rebuilding foreshadowed last year has been put in hand, temporary building being in progress to house those displaced as each section of the old building is pulled down. The site for the reception hospital has been prepared sufficiently far from the main building and the public road to ensure privacy. I mentioned in my -last report that Dr. and Mrs. Howard had taken over the management of the Richmond Home, and am pleased to add there was no break in the continuity of the kindly parental care of the boys. I regret to report that Dr. Howard died recently; but the home continues in the capable hands of Mrs. Howard, Dr. Jeffreys acting as Visiting Medical Officer. Porirua.- Visited in January, March, May, August, December, 1914, and in February and April this year ; moreover, owing to Dr. McKillop, the senior assistant, having left with the Expeditionary Force, and the general, difficulty in getting medical officers, Dr. Gribben, the Deputy InspectorGeneral, has recently been doing relief duty. The buildings in progress now will give accommodation for 100, and a number of patients will be transferred soon to Tokanui. The additional day-rooms are a great boon. Tokanui;— Visited in February, April, May, September, December, 19.14, and in January and May, 1915. The neat cottages of the married staff and the grassed undulations give the approach, quite a settled appearance. Further metalling of the Te Mawhai Road is urgently needed ; a lot of good Work has been done, but. to obtain its benefit it needs completing. Steam is now being led into the main kitchen, and the temporary kitchen Will soon be abandoned. The bakehouse is in use. The drought last season was severely felt; and the progress on the farm, though on the whole satisfactory, Was somewhat checked by the serious illness of Mr. Alexander, the Farm-manager, of whose whole-hearted energy and devotion in the service of the Department, when health permitted it, I cannot speak too highly. Ashburn Hall. —Visited in March, April, July, August, 1914, and March, and June, 1915. On each occasion this licensed institution was in excellent order. ♦ Conclusion. In concluding the report on the work of another year, T have to thank you for the substantial building programme authorized, which is now well on the way, and for your support in all matters for the betterment of the institutions and patients. I have also to express my indebtedness to the Superintendents and staffs of the hospitals and the Head Office staff for a record of work'well done. The duties have been particularly arduous for the senior officers owing to the number of their colleagues who have gone to the front, and there has been no complaint. I would [have been surprised had there"!!becn complaint 1 under theT'circumstanees; nevertheless, the fact that there was not is'gratifying. Frank Hay.

MEDICAL SUPERINTENDENTS' REPORTS. . pf p _ fj| AUCKLAND' MENTAL HOSPITAL. We had 223 admissions during 1914, of whom 1.34 were male and 89 female. The number discharged, and died was 196. leaving a total residue of 923, of whom 60-78 per cent, were male and 39-2 were female. The recovery-rate was above the average—s2-9 per cent, of males and 44-9 per cent, of females. The death-rate Was 8-8 per cent. The number of deaths was 80, and of these 16 were due to general paralysis, 1.2 to phthisis, and 12 to senile decay. For the first time for some years no deaths were due to typhoid fever. The chief causes of the insanity Were heredity, alcohol, senility, and syphilis.

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During the year our Work Was much hampered by overcrowding. On the female side this has now been removed by the opening of the new auxiliary. The male auxiliary will be completed in a few months ; on its completion a total [reorganization will be effected on both sides, and a very much improved classification, adopted. The drainage scheme, which will ultimately connect, us with the new city drainage, is progressing, and should be completed before the end of next year. Our water-supply is good, but the hot-Water service has long required remodelling. The year has been one of hard work under very trying circumstances. During the latter part of the year nurses and attendants wore more readily available than had been the case for some years. I regret, however, that the old type has apparently died out. Few of the nurses stay long enough to undergo a proper training; and the work for the most part, especially on the female side, has been much below the standard that one should reasonably anticipate. Our reliance has still to be placed upon those who joined us years ago, and who all along have exhibited interest and fidelity. My thanks are due to Dr. Tizard, whose knowledge of the work and whose devotion to it have given me a pleasure that I have for years been denied. Our thanks are also due to the District Inspector and the Official Visitors for their continued interest and support; to the proprietors of the Heraldl; to Mr. A. Macpherson for his control of the religious services ; and to several city bands and bowling clubs for contributing to the amusement and recreation of our patients. Special thanks are also due to Miss Fleming, who for some years has provided us with a weekly cab for patients' use. R. M. Brattik. SUNNYSIDE MENTAL HOSPITAL. At the beginning of 1914 there were 652 patients on the books, of whom 339 were males and 313 females. During the year there Were admitted 89 males and 57 females, and at the end of the year there were remaining 683, an increase of 3f patients for the year. There were 51 deaths, which gives a death-rate of 7-5 on the average number resident. The recovery-rate Was less than usual. There were 50 recoveries—3o males and 20 females — giving a rate of 34-4* on admissions. Following on my remarks of last year about lack of accommodation and the requirements, I am u;lad to be able to record that the nurses' home is well under way, and will be finished during the present year. This will release about fifty single rooms, which it is our intention to use not for the noisy, but for the better-class patients, thus giving the deserving a degree of privacy which I feel sure will be appreciated. Besides this, the Public Works Department have in course of erection a large reception and hospital block on the newly acquired site off Martin's Lane. This building when finished will give us much assistance in classification, and also in modern methods of treatment both of the acute mental cases and also of the, ordinary sick cases which are bound to occur amongst a population such as ours. The plans are prepared for the additions to D Ward, and the building will be gone on with as soon as possible. We are now using the Lake Coleridge electric supply as far as we have wired, and We are still pushing on with the wiring. The whole electric supply is furnishing us with much, food for thought, as in the new building we propose to eliminate other sources of lighting, heating, and power as much as possible. The fire-alarm system is inadequate and untrustworthy, and a new system is urgently required. The general health of the patients has been good, and there have been few incidents of note during the year. The annual picnic, fortnightly dances, concerts, cricket, football, and bowling matches have been greatly appreciated by the patients. Thanks are due to the outsiders who have participated in these, and also to the picture and theatre proprietors for free passes for patients to their entertainments. During most of the year I have been ably assisted by Dr. Lee, who has proved himself loyal and capable, and to him and the staff in general I tender my sincere thanks for their assistance during the year. W. Baxter Gow, M.D. SEACLIFF MENTAL HOSPITAL. In the beginning of the year there were 924 patients and at the close 946. Exclusive of transfers from other institutions, 162 patients were admitted, and 82 were discharged, relieved or recovered — being just over half the number admitted. During the year 22 voluntary patients were under treatment, and 18 voluntaries were discharged. The general health of the patients has been good. There were 57 deaths, being practically 5 per cent, of the total number under treatment. More than half the deaths Were among patients between sixty and ninety years of age. Apart from senile decay, the main cause of death was general paralysis ---viz., 10 cases. There was one case of suicide —a quiet demented patient, who had been trusted on parole for many years, unexpectedly hanging himself —without any apparent cause. Extensive and important improvements in the accommodation for patients and staff have been undertaken during the year, and are nearing completion. These include a new ward to accommodate about 50 women patients, a large cottage annex for about 15 of the more sensitive or curable male patients, bedrooms for 20 nurses, and a large dining-room for the attendants.

E.=*

On the side of recreation, a large, attractive, open pavilion has been put up facing the bowlinggreen. A great improvement has been effected in the bakery by installing an up-to-date plant. A, milking-machine apparatus, set up in the main farm buildings, is also doing excellent work. The most urgent needs which ought to be met in 1915 are- (1) Improved bathing facilities; (2) suitable accommodation for patients suffering from tuberculosis; (3) a separate quarter for socalled " criminal lunatics " ; (4) further accommodation for female patients ; (5) additions and improvements to the main kitchen. Farm and garden returns for the year have been very satisfactory. There has been some fallingoff in the fishing returns, and steps have been taken to improve this source of food-supply, which hasHbecome doubly important owing to the war. The Orokonui Branch Mental Hospital has been well and harmoniously run by Dr. Ross and his staff ; but more means should be provided for the adequate development of this institution, as it could then further relieve Seacliff. .. - :.:..; ...?... The Camp Auxiliary at the Peninsula continues to be well conducted. I have to thank Dr. Gray, Dr. Ross, and other colleagues for their loyal help and support at. alltimes. V Religious services have been held by various denominations throughout the year. .:.;.: :.,"', The thanks of the authorities are due to the Otago Daily Times and Witness Company and-to the Evening Star Company for newspapers supplied free, and also to other donors and entertainers who have contributed to the amenities of our institutions,. .. F. Triiby Kino.

PORIRUA MENTAL HOSPITAL. During the year 1914 the total number of patients under treatment was 1,159, and the average number resident 908. We commenced with 892 on the register, and ended, with 946 (523 males and 423 females). Of the 267 patients admitted, 219 (138 males and 81 females) were admitted for the first time. 127 patients were discharged recovered, which makes a recovery-rate .of slightly over 48. per cent, of the number admitted. Fifty-six patients died, a ratio of 6-16 per cent, of the average number in residence. The recovery-rate was 8 per cent, and the death-rate 1-1 per cent. less than in the previous year. T observe that after the declaration of War there was a decline in the average number of admissions per month, as far as male patients were concerned, but a fairly Well-marked, increase in the number of female patients admitted. The numbers dealt with, however, are too small to Warrant me in coming to any conclusion on the question whether the war has had any appreciable influence on the incidence of insanity in this part of the Dominion. Dr. McKillop, who has done very good work at this mental hospital since October, 1911, as-Senior Assistant Medical Officer, and who had had training and experience in military duty in England, obtained leave in August to join the New Zealand Military Force. He received a commission, in the Army Medical Corps of the Expedition which went to Samoa. He subsequently returned to Wellington and joined the Second Reinforcements which proceeded to Egypt. Dr. Simpson, the Junior Medical Officer, whose value I appreciated, was transferred to Christchurch Mental Hospital at the end of January. His position here was not filled except for a short time during April and May, when Dr. Davie acted as locum tenons. The difficulty of obtaining medical men to fill vacancies on the staff which was felt in the first half of the year Was greatly accentuated on the outbreak of war. When Dr. McKillop joined the Army in August I was left without any resident assistant. None Was obtainable, but, fortunately, Dr. Graham Robertson, who had just given up general practice in this district, offered to act as a non-resident assistant, which he continued to do until the end of the year. No changes in the higher officials of the various departments of the institution have taken place. Two new appointments were sanctioned —a Sub-Matron and an assistant head.attendant. The former was filled by Miss Hamil, who was a charge nurse at Seacliff, and the latter by Mr. James Brown, who was charge night attendant here. Both, I believe, will do good service in their new positions, which were designed to give more effective supervision of the nursing staff. Among the attendants, changes were brought about by the war. Seven of them on the permanent staff and several of the probationers joined the New Zealand Forces which went to the front, and it is pleasing to note that one of the latter —W. Singleton—has been awarded the Distinguished Service Medal. Another probationary attendant —A. E. Gascoigne, a young man of exceptional promise— who enlisted Was killed in action at the Dardanelles. During the year the two large day-rooms referred to last year—one for male and one for female patients —were in course of building, and have since been completed and occupied. The site for the new auxiliary block containing wards for recent cases and invalids was prepared. T trust that this important addition will be completed and ready for use before the end of 1915, as our present accommodation, especially for female patients, is overtaxed. The general health of the patients has been good, No epidemic of consequence or serious accident has occurred. Gray Hassell. . :

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9

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APPENDIX.

Table I.— Showing the Admissions, Readmissions, Discharges, and Deaths in Mental Hospitals during the Year 1914.

Table II.—Admissions, Discharges, and Deaths, with the Mean Annual Mortality and Proportion of Recoveries, etc., per on the Admissions, etc., during the Year 1914.

M. F. T. M. 2,332 F. 1,632 T. 3,964 In mental hospitals, 1st January, 1914 Admitted for the first time Readmitted Transfers.. 440 69 17 294 65 7 734 134 24 526 366 892 Total under care during the year 2,858 1,998 4,856 Discharged and died— Recovered Relieved Not improved .. .. • .. Died 207 27 23 193 162 29 16 88 369 56 39 281 450 295 745 Remaining in mental hospitals, 31st December, 1914 2,408 1,703 4,111 Increase over 31st December, 1913 76 71 147 Average number resident during the year 2,309 1,641 3,950

Mental Hospitals. „ Admissions in 1914. In Mental Hospitals on J 1st January, 1914. Admitted for the D„.j m in.,i First Time. Kcaclnnttect. Total. Total Number of Patients under Care. iiickland 'hristchurch )unedin (Seacliff) lokitika .. felson 'orirua 'okanui .shburn Hall (private mental hospital) Totals .. M. F. T. 552 344 896 339 313 652 546 378 924 202 68 270 96 101 197 485 407 892 89 .. 89 23 21 44 M. F. 120 69 74 45 79 68 9 8 16 17 138 81 4 6 T. 189 119 147 17 33 219 io M. 14 15 12 4 4 28 8 1 F. 20 12 10 3 5 20 *2 T. 34 27 22 7 9 48 8 3 M. F. T. 134 89 223 89 57 146 91 78 169 13 11 24 20 22 42 166 101 267 8 8 5 8 13 M. F. T. 686 433 1,119 428 370 798 637 456 1,093 215 79 294 116 123 239 651 508 1,159 97 .. 97 28 29 57 2,3321,632 3,964 440 294 734 j 86 72 158 526 366 892 2,858 1,998 4,856 Patients discharged and died. In Mental Hospitals on Hist December, 1914. Mental Hospitals. Discharged not recovered. Total discharged and died. Discharged recovered. Died. Auckland Christchurch Dunedin (Seacliff) Hokitika Nelson Porirua Tokanui Ashburn Hall (private mental hospital) Totals M. 71 30 23 7 2 72 F. T. 40 111 20 50 30 53 5 12 7 9 55 127 M. F. 3 2 9 5 14 22 2 2 1 18 12 2 .. 2 1 T. 5 14 36 4 1 30 2 3 M. 51 35 43 12 11 38 1 2 F. 29 16 15 7 3 18 T. 80 51 58 19 14 56 1 2 M. 125 74 80 21 13 128 3 6 F. T. 71 196 41 115 67 147 14 35 11 24 85 213 3 6 12 M. F. 561 362 354 329 557 389 194 65 103 112 523 423 94 .. 22 23 T. 923 683 946 259 215 946 94 45 2 '5 '7 207 162 369 50 45 95 193 88 281 450 295 745 2,408 1,703 4,111 Mental HospitalB. Average Num resident duri the Tear. iber ing Percei of Eecov Admii during tl ntage 'eries on Bsions he Year. Percentage of Deaths on Average Number resident during the Year. Percentage of Deaths on .he Admissions. M. F. T. Auckland .. .. .. 553 350 903 Christchurch .. .. .. 336 320 656 Dunedin (Seacliff) .. .. 524 378 902 Hokitika .. .. .. 196 62 258 Nelson .. .. .. 82 102 184 Porirua .. .. .. £01 407 908 Tokanui .. .. .. 94 .. 94 Ashburn Hall (private mental 23 22 45 hospital) Totals .. .. 2,309 1,641 3,950 M. F. T. 52.99 45-45 50-00 34-09 35-09 34-52 25-84 40-00 32-31 53-85 45-45 50-00 11-76 31-82 23-08 44-17 5500 46-01 M. F. T. 9-22 8-29 8-86 10-42 5-00 7-77 8-21 3-97 6-43 6-12 11-29 7-36 13-41 2-94 7-61 7-58 4-42 6-17 106 .. 1-06 8-70 .. 4-44 M. F. T. 38-06 32-95 36-36 39-77 28-07 85-17 48-31 20-00 35-37 92-31 63-64 79-17 64-71 13-64 35-90 23-31 18-00 21-29 4000 83-33 63-64 4000 .. 18-18 40-67 45-12 42-51 j 8-36 5-36 7'11 37-92 24-51 32-37

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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. Ashburn Hall (Private Mental Hospital}. Total. M. F. T. M. F. T. M. F. T. 10 1 m. F. T. M. F. T. M. F. T. M. F. T. JC. F. T. M. F. T. 1 0 1 2 1 3 3 4 7 19 21 40 112 82 194 132 94 226 92 69 161 72 50 122 47 22 69 34 18 52 6 2 8 Under five years 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 „ „ 100 „ 105 „ Unknown Transfers 10 1 3 11 14 30 21 51 29 24 53 26 16 42 24 10 34 14 1 15 4 4 8 1 0 1 0 1 1 7 2 9 18 12 30 26 11 37 12 10 22 11 9 20 6 8 14 6 4 10 2 0 2 12 3 12 3 23 21 44 20 13 33 12 17 29 14 13 27 10 6 16 7 3 10 2 1 3 3 4 2 1 0 3 3 4 2 1 1 0 6 8 4 2 1 3 2 2 4 4 6 1 1 0 6 2 2 4 5 9 8 12 3 9 1 2 1 2 2 2 12 3 6 4 10 32 20 52 46 32 78 32 19 51 18 14 32 15 3 18 12 5 17 112 10 1 2 0 2 1 0 1 3 0 3 1 0 1 1 0 1 12 3 12 3 0 2 2 0 2 2 2 0 2 2 13 0 1 1 1 6 1 3 14 2 13 4 2 6 •• Totals 134 89 223 89 57 146 91 78 169 13 11 24 20 22 42 166 101 267 8 0 8 ' I 5 8 13 526 366 892

Auckland. Christchurch. Dunedin (Seacliff). Hokitika. Nelson. Porirua. Tokanui. Ashburn Hall (Private Mental Hospital). Total. M. F. T. 104 48 152 M. F. T. 46 25 71 M. F. T. 39 24 63 M. 7 F. T. 7 14 M. 3 F. T. 6 9 108 52 160 M. F. T. M. 2 F. T. 2 4 M. F. T. 309 164 473 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) Fourth Class (first attack or not, but of more than 12 months on admission) Transfers 7 5 12 13 20 33 8 6 14 23 17 40 7 9 16 24 24 48 2 4 1 3 3 7 4 3 2 6 7 10 6 6 12 30 25 55 2 1 4 6 1 2 36 33 69 98 97 195 66 67 133* 10 15 25 11 9 20 19 18 37 7 7 14 19 17 36 0 1 1 0 1 1 1 0 1 I 3 0 3 3 1 4 8 0 8 17 5 22 2 3 5 Totals 134 89 223 89 57 146 91 78 169 13 11 24 20 22 42 166 101 267 8 0 8 5 8 13 526 366 892

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Table V.—Ages of Patients discharged "Recovered" and "Not Recovered" during the Year 1914.

Table VI.— Ages of Patients who died.

Auckland. Christchurch. Dunedin (Seacliff). Hokitika. Nelson. Porirua. Tokanui. Ashburn Hall (Private; j Mental Hospital). Total. Ages. Ee- | Not re- Re- Not re- Re- Not re- Be- Not recovered. ; covered, covered, covered, covered, covered, covered, covered. Re- Not re- Re- Not Re- Not re- Re- Not recovered, covered. covered, recovered, covered, covered, covered, i covered. | . J M. F. T. M. F. T. M. F. T. M. F. T. M. F. T. M. F. T. M. F. TV M. F. T. 10 1.. 10 1.. ..033101.. 022 .. 13 1124 303 .. .. 112011 123011 26 17 43 268 .. .. 123 112 .. 18 12 30 2 1 3 .. 10 10 2 2 011 .. 98 17 246 .. 101 32 5101 .. .. 011 .. 11 2202 .. .. .. 202 .. .. 0 1 1 .. :: :: :: 5 i 1 6 i :: :: :: :: i Recovered. M. F. T. 1 1 2 1 1 2 1 7 8 48 39 87 65 43 108 38 32 70 24 26 50 16 HO 26 6 ; 2 8 0 1 1 4 0 4 3 0 3 Not recovered. From 5 to 10 vears .. „ 10 ., 15 " „ .. „ 15 .. 20 „ .. „ 20 ,. 30 „ .. „ 30 „ 40 „ .. „ 40 „ 50 „ .. „ 50 ., 60 „ .. „ 60 „ 70 „ .. „ 70 „ 80 „ .. „ 80 „ 90 „ Unknown Transfers Not insane M. F. T. M. F. T. M. F. T. M. F. T. Oil.. Oil.. 14 5 17 10 27 0 1 1 7 5 12 1 0 1 19 11 30 1 0 113 3 16 0 1 1 8 7 15 0 1 1 5 3 8 11 6 17 .. 2 4 6. 0 1 1 6 17.. 246.. 2 0 2.. 101... 4 0 4 2 0 2 .. i 8 3 11 3 0 3.. 71 40 111 3 2 5 30 20 50 9 5 14 M. F. T. M. F. T. M. E. T. M. F. T. " 0 11.. 8 7 15 3 7 102 3 50 2 2 4 8 12 4 4 8 1 0 li 2 0 2 4 6 10 1 4 5 2 1 3l 268437011: 5 3 8 12 3 112 2 0 2; M. F. ,T. 1 1 2 7 11 18 9 12 21 4 6 10 7 8 15 2 2 4 5 1 6 •• ,' ■ —' ■■ 15 4 19 .. | .. Totals 23 30 5314 22 36 7 5 12) 2 2 4 18 12 30 20225 721 3 207 162 369; 50 45 91 2 7 9| 0 1 1 72 55 127

Ages. Auckland. Christchurch. Dunedin (Seacliff). Hokitika. Nelson. Porirua. Tokanui. Ashburn Hall (Private M.H.). Total." I M. F. T. M. F. T. M. F. T. M. F. T. M. F. T. M. F. T. M. F. T. M. F. T. M. F. T. 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 „ While on trial .. Unknown .. •• 1 0 1 4 2 6 8 4 12 13 9 22 7 4 11 11 4 15 5 3 8 0 2 2 1 0 1 3 14 7 0 7 3 1 4 3 6 9 4 2 6 11 5 16 3 1 4 2 3 7 7 7 11 6 4 6 1 4 2 9 2 9 2 9 2 13 2 8 1 0 1 1 2 1 1 1 4 2 3 1 1 2 3 2 6 4 112 Oil 3 0 3 10 1 3 0 3 3 0 3 2 0 2 0 2 2 9 6 15 3 1 4 3 1 4 10 3 13 9 4 13 2 13 1 1 I I 4 0^4 11 10 21 28 13 41 32 14 46 22 14 36 40 13 53: 43 15 58 11 6 17 1 1 2 12 3 1 6 1 1 1 2 1 0 1 o i 1 Oil! Totals 51 29 80 35 16 51 43 15 58 12 7 19 11 3 14 38 18 56 1 0 1 2 0 2 193 88 281

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Table VII. —Condition as to Marriage.

Admission . Discharges. Deaths. Auckland— Single Married WidoWed Unknown Transfers M. 86 38 10 i. 33 43 12 T. 119 81 22 [m. 45 22 3 2 2 i.J 21 17 4 0 0 T. 66 39 7 2 2 M. F. T. 23 9 32 21 13 34 6 7 13 1 0 1 0 i 1 Totals 134 89 223 74 42 116 51 29 . 80 C ! HRISTOHUROH —■ Single Married WidoWed Unknown Transfers 55 26 5 2 1 20 27 10 0 0 75 53 15 2 1 19 10 2 8 7 11 4 3 26 21 6 11 20 5 10 4 5 7 25 14 12 Totals 89 57 146 39 25 64 35 16 51 Dunedin (Seacliff) — Single Married WidoWed Unknown Transfers 63 23 3 42 25 8 105 48 11 24 9 2 29 2.1 1 53 30 3 21 17 5 6 li 3 27 23 8 2 3 5 2 i 3 Totals !M 78 169 37 52 89 43 15 58 iioiuriKA — Single Married WidoWed Unknown Transfers 7 5 1 5 5 1 12 10 2 5 4 3 4 8 8 9 2 I 0 2 1 3 I .11 3 4 L Totals 13 11 24 7 16 12 7 111 Nelson— Single Married Widowed Unknown Transfers 13 3 1 9 12 1 22 15 2 2 0 2 5 4 5 6 5 3 0 9 5 3 0 3 0 1 1 Totals 20 22 42 8 10 II 3 14 PORIRUA — Single Married Widowed Unknown Transfers 97 59 7 36 133 58 117 6 13 52 28 5 23 38 5 75 66 10 15 17 6 6 7 5 21 24 11 3 i 4 5 1 6 Totals 166 101 267 90 67 157 38 18 56 Tokanui —■ Single Married WidoWed Unknown Transfers 2 0 2 1 0' 8 0 8 Totals 0 2 Ashburn Hall (private mental hospital) — Single Married Widowed Unknown Transfers i 3 1 1 3 2 1 6 3 2 2 1 1 4 0 1 6 1 2 1 0 1 0 2 2 0 1 1 1 0 I Totals 8 13 6 10 i 2 Totals— Single Married Widowed Unknown Transfers j 324 148 472 155 172 327 28 39 67 2 0 2 17 7 24 151 74 13 10 9 89 240 96 170 15 28 3 13 4 13 95 73 23 1 1 31 126 31 104 25 48 1 2 0 I Totals 526 366 892 257 207 464 193 88 281

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14

Table IX.—Ages of Patients on 31st December, 1914.

Table VIII.— Native Countries.

Countries. Auckland. Christchurch. Dunedin (Seacliff). 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. 144 85 229 28 18 46 73 50 123 190 175 365 30 12 42 2 0 2 7 2 9 10 1 11 4 0 4 6 1 7 3 0 3 4 0 4 3 0 3 11 2 13 24 1 25 22 15 37 M. F. T. 101 100 201 24 21 45 49 45 94 149 142 291 11 8 19 3 1 4 1 1 2 2 0 2 3 0 3 2 2 4 2 0 2 1 0 1 1 1 2 5 8 13 M. F. T. 100 59 159 96 66 162 84 65 149 218 167 385 21 20 41 10 1 11 1 0 1 4 1 5 3 0 3 2 2 4 1 0 1 11 0 11 6 8 14 M. F. T. 36 13 49 I 13 7 20 47 9 56 i 57 24 81 11 4 15 6 0 6 1 0 1 6 0 6 7 0 7 6 0 6 4 0 4 0 8 8 M. F. T. M. F. T. 13 25 38 153 98 251 5 7 12 44 28 72 12 15 27 56 60 116 66 55 121 202 205 407 13 4 25 13 38 10 1 10 1 4 5 9 0 11 0 2 2 10 1 10 1 6 4 10 6 0 6 0 11 4 0 4 2 0 2 2 13 4 4 8 2 3 5 15 5 20 M. 26 4 13 39 2 I 4 1 I 1 1 1 F. T. 0 26 0 4 0 13 0 39 0 2 0 1 0 4 0 1 0 1 0 1 6 1 0 1 M. F. T. 5 6 11 6 4 10 9 12 21 0 1 1 1 0 1 M. F. T. 578 386 964 220 151 371 334 244 578 930 780 1710 101 61 162 3 0 3 33 9 42 16 3 19 13 3 16 26 5 31 14 4 18 18 1 19 23 0 23 19 8 27 58 25 83 22 23 45 1 0 1 Totals 561 362 923 354 329 683 557 389 946 ! 194 65 259 I 103 112 215 523 423 946 94 0 94 22 23 45 2408 1703 4111

Ages. Auckland. Christchurch. ' <Sea " Hokitika. Nelson. Porirua. Tokanui. Ashburn Hall (Private M.H.). Total. I .. _ _ .. _ _ I __ _ _ I I From 1 to 5 years 5 ., 10 „ 10 „ 15 „ „ 15 „ 20 „ „ 20 „ 30 „ „ 30 „ 40 „ „ 40 ,. 50 „ „ 50 ,. 60 „ ,. 60 „ 70 ,. „ 70 „ 80 „ Upwards of 80 years Unknown M. F. T. M. F. T. M. I. T. 10 1 112 2 13 4 15 Oil! 134 9 11 20 8 5 13 3 5 8 68 42 110 42 34 76 [ 59 46 105 121 70 191 87 70 157 ! 123 75 198 125 105 230 70 80 150 \ 125 92 217 124 65 189 60 66 126 1 104 74 178 59 40 99 46 44 90 75 49 124 28 19 47 34 24 58 56 35 91 7 5 12 5 4 9 I 10 10 20 15 3 18 M. F. T. 1 0 1 7 3 10 45 13 58 42 13 55 36 10 46 30 11 41 19 8 27 2 13 12 6 18 M. F. T. 5 16 6 17 8 2 10 19 9 28 15 22 37 15 30 45 16 24 40 13 15 28 5 4 9 1 0 1 0 4 4 M. I. T. 2 2 4 6 7 13 8 10 18 86 46 132 114 95 209 106 99 205 105 92 197 62 45 107 27 24 51 7 3 10 M. F. T. H. I. T. M. F. T. 1 0 1 10 5 15 17 13 30 37 33 70 289 180 469 537 345 882 505 426 931 468 337 805 300 210 510 177 117 294 33 24 57 34 13 47 6 31 20 16 11 3 0 6 0 31 0 20 0 16 0 11 0 3 2 1 2 7 4 5 1 0 2 0 1 7 9 6 13 6 10 3 8 1 2 7 6 7 Totals .. 561 362 923 ! 354 329 683 557 389 946 557 389 946 I 194 65 259 194 65 259 103 112 215 103 112 215 | 523 423 946 523 423 946 94 0 94 22 23 45 2408 1703 4111

H.—7.

Table XI.—Length of Residence of Patients discharged "Recovered" during 1914.

Table X.—Length of Residence of Patients who died during 1914.

15

Length of Eesidenee. Auckland. Christchurch. Dunedin ; Seacliff). Hokitika. Nelson. Porirua. Tokanui. Ashburn Hall (Private M.H.). Total. I 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 Died while absent on trial a. 4 10 4 6 4 7 7 5 0 1 1 0 1 6 10 ; 3 13 0 4 0 6 0 4 3 10 1 8 0 5 6 6 2 3 1 2 2 2 4 5 : 1 2 M. 4 1 6 1 3 8 0 1 0 3 2 4 F. 1 2 2 0 0 0 1 3 0 2 0 0 5 T. 5 3 6 1 3 8 1 4 2 2 3 . 2 9 ' M. 5 3 3 2 10 1 5 1 1 5 5 I. T. 2 7 1 4 1 4 0 1 1 3 1 11 1 2 0 5 2 3 1 2 0 1 0 5 5 10 M. 1 1 2 2 F. 1 1 0 0 T. 2 2 2 2 M. 1 2 1 1 0 1 1 0 1 3 F. T. 0 1 0 2 0 1 0 1 1 1 0 1 1 2 1 1 0 1 0 3 M. 6 4 4 5 3 2 5 1 0 2 6 F. t. 3 9 1 5 1 5 0 5 3 6 0 2 2 7 3 4 1 1 0 2 4 10 M. 1 F. 6 T. 1 M. 2 F. 0 T. 2 M. I. T. 21 13 34 20 7 27 18 4 22 9 0 9 15 3 18 34 7 41 12 3 15 17 6 23 4 11 15 4 8 12 9 3 12 8 2 10 21 20 41 1 1 2 2 2 2 1 4 3 2 2 4 Totals 51 29 80 : 35 35 16 51 16 51 I 43 43 15 58 15 58 12 7 19 11 3 14 ; 38 18 56 | 1 0 1 2 0 2 193 88 281 I

Length of Residence. Auckland. Christchurch. i Dunedin (Seacliff). Hokitika. Nelson. Porirua. Tokanui. j 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 Not insane M. F. T. 1 0 1 23 12 35 i 15 10 25 | 9 6 15 2 2 4 12 6 18 ! 2 2 4 2 13 112 1 0 1 3 0 3 M. 1 11 10 3 3 1 0 1 I. T. 0 1 8 19 4 14 3 6 0 3 4 5 1 1 0 1 M. I. T. 1 0 1 7 12 19 . 9 7 16 2 1 3 2 3 5 1 3 4 0 1 1 13 4: 1 3 1 1 1 F. 1 0 2 2 0 T. I 3 3 3 1 M. 1 1 0 F. 3 3 i T. 4 4 1 M. I. T. 20 4 24 22 14 36 11 17 28 6 7 13 3 2 5 5 7 12 2 1 3 2 13 0 2 2 1 0 1 M. I. T. M. 1 1 0 i. 2 2 1 T. 3 3 1 M. F. T. 24 5 29 64 48 112 50 43 93 22 22 44 11 10 21 20 21 41 4 4 8 5 5 10 14 5 1 0 1 1 0 1 1 0 1 I * .. 3 0 3 Totals j 71 40 111 30 30 20 50 20 50 23 30 53 7 5 12 2 7 9 72 55 127 2 5 7 207 162 369

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16

Table XII.—Causes of Death.

Causes. Auckland. 0 , hi ' ist r church. gSSSft Hokitika. Nelson. Porirua. Tokanui. Ashburn Hall. I Total. j M. F. M. I. M. P. M. P. M. I. M. 1. M. F. M. F. M. E. M. F. General Diseases — Enteric fever Influenza Tuberculosis— Of lung (not acuto) Acute phthisis Acute miliary tuberculosis .. Syphilis .. .. Cancer Diabetes Anaemia, pernicious Purpura hemorrhagica Toxaemia, general Alcoholism Diseases of the Nervous System — Locomotor ataxy Cerebral haemorrhage, apoplexy Softening of the brain Paraplegia, spastic Hemiplegia General paralysis of insane .. Acute delirium Mania, exhaustion from Melancholia, exhaustion from Epilepsy Organic brain-disease Diseases of the Respiratory System — Broncho pneumonia Lobar pneumonia Pulmonary congestion Empyema Diseases of the Circulatory System — Pericarditis Valvular disease of tho heart Fatty degeneration of the heart, Aneurism Atheroma Diseases of the Digestive System — Enteritis,simple (and diarrhoea) Gastro-enteritis Gastritis Duodenal ulcer Intestinal obstruction Diseases of the Genito-urinary System — Blight's disease Cystitis , Diseases of Skin and Cellular Tissue — Senile gangrene Old Age — Senility External Causes — Suicide, asphyxia by hanging Ill-defined Causes — Syncope, heart-failure General debility, marasmus, asthenia Died while absent on trial 1 0 16 I) 2 1 2 I 2 2 5 (I 0 I. 7 5 1 1 I 0 I 0 0 4 0 I. 0 I 0 1 1 0 1 0 2 0 1 1 I 0 1 0 2 0 1 0 2 0 I I 5 3 n 1 2 1 1 0 4 2 io 0 1 0 1" 0 0 i 1 0 5 3 2 1 0" 1 0 1 0 1 I 0 4 2 I 0 I I I I) 0 I 2" 0 1 0 0 I 0 1 I 0 I 0 2" I 0 I 2 5 0 1 3 0 0 I 7 0 I 0 I I I. 0 I I) I I) 1 0 I 0 II I II I I 15 17 0 1 2 I (I I 4 2 1 I 1 1 0 I 0 I 0 I 1 0 8 4 I 0 1 I) 0 I 36 0 2 0 4 2 4 2 7 2 0 6 1 1 7 2 1 1 1 0 I 0 0 1 2 1 0 1 2 1 I 0 0 1 5 I 0 I 1 0 I 0 I I) 0 I I 0 l" 0 1 0 I 0 0 I I 1 I 0 I 1 I I I (I 1 0 2 0 I 0 I 0 I 0 I 0 I 0 I 0 I 1 2 0 4 I I 0 1 0 I I) 2 0 7 5 II) 5 12 2 2 0 III 7 47 19 I 0 I 0 2 0 4 6 5 1 1 0 2 4 1 0 2 2 I 0 I.-) 12 I 0 I 1 1 0 2 1 Totals 51 29 35 16 43 15 12 7 II 3 38 18 1 0 2 0 193 88

17

H.—7

Table XIII.—Causes of Mental Defect among Admissions (less Transfers), showing the Correlations or Combinations of Principal or Contributory Causes and Associated Factors.

3—H. 7.

Causes and Associated Factors of Mental Defect among Admissions during 1914. s3.§h1-s K -h r-l 1 |Q I i 2 w s •a a, a o © o w _ p a oc o a IJ fl si M ft) cc: 4* +B < 3 © 4 .£ "5 PM I '3 e I c 1 a a — o aw •a ° A a, a si 3 I -I & o« rj 05 <fl >, O « S K *> 8 * § S.I .3 g .= Q a £ s » 2T ■ ate o g rS * V^ 3 rS-'lxr His Heredity .. Congenital Deprivation of special sense Previous attack Critical periods— Puberty and adolescence Climacteric Senility Child-bearing— Puerperal state Mental stress— Sudden : Shock „ Grief Prolonged : Worry, domestic „ „ financial „ Religious excitement „ Solitude „ Nature undefined Physiological defect and error— Privation Over-exertion, physical Masturbation Sexual excess Toxic— Alcohol Drug habit Lead-poisoning Tuberculosis Enteric fever Syphilis (acquired) Constipation Traumatic — Injury Diseases of nervous system— Organic brain-disease Epilepsy Apoplexy Chorea Neurosis (undefined) Other bodily diseases— Anaemia, pernicious Goitre Arterio sclerosis Bright's disease Rheumatism 111 health (undefined) Unknown M. F 69 77 41 42 M. F. 0 I 0 1 M. F. M. I. 0 1 M. F. 0 1 M. I. 0 I F. M. F. 1 I M. F. M. F. 0 1 M. F. M. F. 0 1 M. F. M. F. M. F. 70 81 41 43 0 1 35 29 35 28 14 12 1 25 69 37 0 1 0 2 14 13 I 27 80 37 0 27 0 1 0 1 0 28 0 1 0 2 1 4 3 0 0 2 10 0 1 ::> r 0 3 27 21 10 3 11 9 0 1 0 1 1 0 1 1 4 0 2 2 I 0 1 I 4 0 2 2 97 14 1 1 I 0 1 1 0 1 44 4 0 I 0 1 1 0 I 0 99 15 1 I 1 0 1 I 0 I 44 5 0 I 9 2 9 2 2 0 18 9 2 0 0 1 1 0 10 2 0 19 9 2 0 0 I 1 0 1 0 1 1 1 0 1 0 1 0 9 22 52 19 I II I I I II I 0 I 0 9 22 52 19

H.—7.

Table XIV.—Former Occupation of Patients.

18

s A S O CO Occupations. E co i T3 3 " ; a a a * ° io 3g« 3 a b ■< § a_ c3 j ! "!"3 M ri r3 3 ,-S o 2 S rM « S rM o © o o w z -h b a. id 'SJ r-l (fi HS a « Sa *5 ■o«s CO «? Occupations. © C P 3 DO 'C O I "o ccl 9 2 a CO a a 0 9 3 O sr£ S o o % <0 If ~- P. — CO fl d pa ~ ■°.S $ Art, o J * 0 h •a a a 3 o a < cS 8 0 W 2 a M o EApiarists .. .. 1 .. ] Aboriginals .. .. 1 .. .. Bakers, &c. .. .. 1 .. .. Banker .. Barman ., .. 1 .. .. Billiardmarker Blacksmith .. ] Boardinghouse-keoper I Bootmakers .. Bricklayer .. .. 1 .. ., Brickmaker • ■ • • • • I ■ ■ Bushmen .. Butcher .. Cabman .. .. .. 1 ., Caretakers .. J Carpenters and joiners 6 1 .. Carters, drivers, &c I Caterer .. Chairmaker .. .. .. 1 .. Civil servants Clerks, accountants, &c. 1 5 1 Coach-trimmer .. I .. Compositors .. .. 11.. Cooks .. .. 2 2] Cooper .. .. .. 1 .. Cycle mechanic 1 Drapers, &c.. .. 1 .. .. Draughtsman .. 1 .. Dealer .. .. .. 1 ., Dredge hand.. I Engine-driver .. .. 1 ., Engineers .. .. 1 1 J Farmers .. .. 18 16 ( Farm hands .. .. 2 3] Fishermen .. .. .. 1 ., Fishmonger .. . . .. 1 ., Fitter .. Flour-miller .. ] Fruit-hawker I Gardeners .. .. 2 2 i Gasfitters .. .. 2 .. .. Glass-cutter .. .. .. 1 .. Grocers .. .. 1 .. J Grooms .. .. 2 1.. Gum-diggers.. .. 4 .. .. Hairdresser .. 1 Hotelkeepers .. .. 1 .. Jockey .. 1 Ma ,ES. i 5 1 1 2 1 i i i 1 1 ■1 4 1 1 1 '2 1 "2 1 4 4 3 :: 2 5 2 3 6 1 2 1 1 1 2 2 I 3 1 1 2 11 6 1 1 3 11 1 4 10 1 1 3 1 1 1 1 7 63 Id 3 1 1 1 1 8 2 1 2 3 4 1 2 1 Journalists Labourers Malster Master mariners Medical practitioner .. Merchant Mill hands Miners Minors Musicians No occupation Old-age pensioners Painters Plasterer Plumbers Porters Rabbiter Rigger Saddlers Sailmaker Schoolboy Seamen Settlers Shearer Shepherd Shipwright Shop assistants Slaughterman Stewards Stock agent Stonemason Storekeepers Storemen Student Sweep Tailors Teamster Territorials Transfers Travellers Upholsterer Warder Watchmaker.. Weaver Wharfinger 55 1 i 3 3 4 2 1 2 I 2 2 31 i i 4 i i "2 32 4 2 '0 "2 h 4 1 1 1 7 7 2 i i 2 k 3 190 1 4 1 1 2 9 2 5 26 11 3 1 4 2 1 1 3 1 1 7 2 1 2 1 3 1 2 1 1 5 2 1 1 3 1 2 14 2 1 1 1 1 1 1 i 2 I I 1 1 "2 1 i 1 1 I 1 1 IS 2 I I Hi 3 1 1 3 it 1 i '2 1 2 II :i 2 3 i 1 •I 3 3 1 1 1 1 3 i 1 8 2 2 2 i i i 1 2 4 l 1 i 1 134 89 91 8 526 1 1 Totals .. 13 20 166 5 O.ES. 19 1 I 1 1 4 1 7 2 2 Barmaid .. .. .. 1 . Cook .. .. .. 1 . Domestic duties .. 80 27 6! Dressmakers ] Factory hand Housekeeper.. .. .. 1 .. Housemaid .. Housewives .. .. .. 24 .. Industrial school . . .. 1 .. Maori .. ,. 1 .. .. Minors .. 5 Music-teacher 1 Nurses .. .. 1 .. 1 80 1 1 27 i 63° 1 Ifi 1 1 1 85 2 3 Fem. 1 1 284 4 1 1 1 24 1 1 2 1 5 No occupation Old-age pensioner Professional singer Servant Schoolgirl School-teachers Tailoress Transfers Typistes Waitresses 1 1 i 6 i 3 i I 8 .. 1 .. 1 .. 1 .. 1 .. 1 i 21 1 1 1 2 .3 '2 2 1 1 Totals 89 67 78 11 22 101 .. 8 366 i 2 i

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.

H.—7.

4—H. 7.

19

Year. Admitted. Discharged. Died. Remaining Average Numbers 31st December in resident, each Year. Percentage of Recoveries on Admissions. Percentage of Deaths on Average Numbers resident. Recovered. Relieved. Not Improved. 1876 1877 1878 1879 1880 1681 1682 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 1914 I i M. F. T. M. I F. ! T. 221 117 338 129 ! 79 ! 208 250 112 362 123 ! 57 180 247 131 378 121 j 68 189 248 151 399 112 ; 76 188 229 149 378 100 67 167 232 127 359 93 i 65 158 267 152 419 95 ! 59 154 255 166 421 102 78 180 238 153 391 89 I 77 166 294 160 454 95 76 j 171 207 165 372 99 60 159 255 161 416 103 78 | 181 215 146 361 116 92 j 208 230 161 391 93 53 146 230 160 390 98 88 j 186 234 201 435 88 ! 74 162 231 158 389 89 | 76 165 281 179 460 101 89 190 320 256 576 107 ! 76 183 379 302 681 105 77 182 296 170 466 104 70 174 300 244 544 102 73 175 355 258 613 114 110 224 264 247 511 88 99 187 335 263 598 103 96 199 373 224 597 125 ! 104 229 352 192 544 135 j 99 ! 234 454 237 691 144 ' 101 j 245 340 240 580 ' 157 106 263 399 280 679 149 ' 121 270 401 277 678 j 157 126 283 421 279 700 ! 160 139 ', 299 434; 325 759 180 146 i 326 447' 376 823 179 j 170 | 349 639 371 1,010 182 ! 145 I 327 455; 322 777 163 : 168 ] 331 593 394 ■ 987 i 184 '■ 141 325 543; 349 892 175 ; 162 337 526; 366 892 207 162 369 12,990 l 8,721 |21,711 4,866 j 3,803 8,669 ! I M. F. T. M. 17 8 25 6 20 9 29 7 14 14 28 3 15 13 28 8 36 25 61 5 41 36 77 8 49 32 81 , 5 13 20 33 10 17 9 26 18 10 5 15 73 11 17 I 28 12 34 17 51 31 28 59 I 2 31 30 61 3 23 17 40 1 12 33 24 57 14 21 17 38 8 17 12 29 9 15 11 26 55 24 19 43 128 25 16 41 20 26 32 53 17 13 23 36 104 15 25 40 7 39 10 49 25 40 ! 17 57 33 26 15 41 10 41 25 66 84 24 13 37 9 45 32 77 23 28 22 50 6 31 19 50 53 9 ! 13 22 9 17 22 39 29 30 j 29 59 164 23 16 39 11 17 44 I 61 146 35 48 83 78 27 ; 29 56 23 ! 983 813 1,796 1,2371 F. 6 2 3 3 2 1 7 9 12 29 8 *2 1 5 30 2 9 84 139 12 31 47 42 65 3 9 12 2 21 14 32 6 68 55 7 18 36 16 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 39 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 j 99 102 j 120 j 129 | 120 j 147 | 146 168 148 136 186 198 193 196 193 F. T. M. 12 48 519 21 63 581 17 68 638 16 71 695 20 74 729 14 63 769 19 79 827 18| 83 892 241 92 938 22 95 981 19 76 1,009 27 101 1,053 26! 104 1,041 30J 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 1- 46; 145 1,581 72j 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 74J 222 1,997 68 204 2,083 97 283 2,160 105 303 2,220 87 280 2,273 111 307 2,332 88 281 2,408 f. 'i; t. 264 783; 291, 872' 319, 9571 361 1,056,: 396; 1,125! 406| 1,175! 442 1,269' 483 1,375 514 1,452; 542 1,523! 604 1,613: 643 1,696| 640 1,681 687 1,761 702 1,797 734 1,849 763 1,917 810 2,039 860 2,168 885 2,214 925 2,315 990 2,430 1,008| 2,480; 1,045 2,557! 1,0911 2,672; l,119l 2,773j 1,133. 2,848 i,i88; 2,959; 1.237 1 3,038; 1,2761 3,112 1,306 3,206 1,331 3,240.' 1,417 3.414J 1,465 3,548! 1,510 3,670j! 1,536 3,756!' 1,640 3,913! 1,632 3,964! 1,703 4,111! 1 I M. I 491 I 541 1 601 J 666 J 703 ; 747 i 796 860 li 911 965 984 |l,034 1,045 1,046* 1,078" 1,0891 1,125 1,172 1,241 1,313 1,347 1,411 1,438 11,487 !l,534 ,1,622 1,671 1,780 1,796 1,823 1,851 1,894 1,970 ,2,028 2,105 j ! 2,146 ! -2,252 j 2,309 ' 1 F. : T. M. 257 748 54-53 277 1 818 49-20 303 ! 904 4898 337 1,003 45-16 371 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 47-82 613 1,647 40-39 641 11,686 53-95 660411,707 40-43 685 1,763 42-61 699J 1,7894. 37-61 714} 1,839} 3853 758 1,930 35-94 812 2,053 3963 849 2,162 41-27 882 37-41 944 2,355 35-92 973 2,411 44-88 1,004 2,491 32-31 1,049 2,583 30-74 1,094 2,716 39-06 1,114 2,785 3835 1,160 2,901 40-56 1,198 2,978 46-18 1,232 3,028 4139 1,265 ;3,088 39 75 1,285 3,136 , 44-29 1,346 ,3,240 42-25 1,404 !.3,374 1 42-72 1,445 .3,473 38-40! i 1,496 '(3,601 36-38 1,551 !3,697 40-17 j 1,597 3,849 37 55 1,641 ;3,950 F. T. 66-01 57-56 5080' 49-72 51-90 5000 5033 47-11 44-96 44-17 51-10 44-01 38-81 36-75 4698 : 42-75 5032 42-45 4750 37-66' 36-36 42-74 4875 43-61 6301 57-62 3292 37-34 55-00 4769 36-821 37-24 48-10 1 42-42 1 49-72! 41-30 I 45-18 41-03 , 46-66 43-40 ! 4402 39-82 j 37-82 36-69 I 51-89 48-07 j 44 33 37-58 36 50' 33-27 1 46-64! 42-17 51-56 43-01 4469' 42-17 44-17 45-34 48-21 44-19 47-73 42-94 57-68 49 67 45-91 4382 57-24; 48-74 46-18: 41-50 53-00; 43-27 37 01 ; 38-74 50-94 j 42-98 M. F. T. 8-21 [ 3-58 6-70 7-76 i 7-58 770 8-48 I 5-61 7-52 825 J 4-74 7-0T 7-68 j 5-39 6-89 6-29 ! 3-60 5-55 7-53 ! 4-51 6-49 7-55 j 3-78 6-21 7-46 I 4-82 6-53 7-56 I 4-16 6-36 579 '■ 3-39 4-91 ! 7-15 j 440 6-13 j 7-56 405 j 6-16 ! 6-69 4-54 5-86 ! 7-05 511 6-29 7-25 5-86 6-71 658 4-76 587 666 303 5-23 5-16 4-31 4-82 7-69 4-94 6-61 6-38 3-63 5-29 7-44 j 455 6-28 6-12 6-17 6-14 7-67 ! 4-28 6-30 6-45 ! 4-38 5-61 6-29 I 6-58 6-41 7-18 ! 4-94 6-28 7-41 3-79 5-96 ' 6-74 5-84 6-38 ! 8-18 5-44 i 7-07 \ 8-01 I 6-71 7-48 ! 9-08 ! 4-98 7-39 1 7-81 I 5-50 6-85 i 6-90 I 4-84 6-00 9-17 ; 6-71 8-15 9-41 i 7-02 8-41 899 : 5-61 7-57 8-70 i 6-96 7-98 850 I 2,087 3,978 1,80615,784 1,3371 .. I .. •• I In mental hospitals, 1st January, 1876 In mental hospitals, 1st January, 1914 M. 482 .. 2,408 F. T. 254 736 1,703 4.111

H.—7

20

Table XVI.—Showing the Admissions, Readmissions, Discharges, and Deaths from the 1st January, 1876, to the 31st December, 1914.

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, 1915, and Liabilities at that Date.

Persons admitted during period from 1st January, 1876, to 31st December, 1914 .. Readmissions M. F. 10,363 6,664 2,627 2,057 T. 17,027 4,684 M. F. T. Total oases admitted Discharged cases— Recovered Relieved Not improved Died 12,990 8,721 21,711 4,866 3,803 983 813 1,237 850 3,978 1,806 8,669 1,796 2,087 5,784 11,064 7,272 18,336 Total cases discharged and died since January, 1876 Remaining, 1st January, 1876 482 254 736 Remaining, 1st January, 1915 2,408 1,703 4,111

Males. Females. Both Sex Both Sexes. Recovered lolieved rot improved )ied .. Remaining 37-48 7-56 9-53 30-61 14-82 43-61 9-32 9-75 20-71 16-61 39-93 8-27 9-62 26-64 15-54 10000 100-00 100-00

Mental Hospitals. Net Expenditure for Year ended 31st March, 1915. Liabilities on 31st March, 1915. Auckland Tokanui .. Porirua .. Christchurch Seacliff .. Waitati .. Nelson .. £ 23,434 10,379 6,552 5,107 7,413 911 200 £ 2,567 831 1,519 264 789 Totals .. 53,996 5,970

21

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, 1915.

Mental Hospitals. 1877-1907. 1907-8. | 1908-9. 1909-10. 1910-11. 1911-12. 1912-13. 1913-14. 1914-15. Total ■ Net Expenditure. 1st Julv, 1877, jto 31st March, 1915. I I I Auckland Reception-house at Auckland .. Motuihi Island Tokanui Wellington Wellington (Porirua) Christchurch Seacliff Waitati Dunedin (The Camp) Napier Hokitika Richmond Nelson £ 105, 434 5 £ 253 463 £ 1,318 62 £ 1,524 1,788 £ £ 463 105 2,531 105 £ £ 135 8,908 105 561 21,935 8,874 9,550 1,951 4,867 616 5,382 3,257 4.007 1,634 £ 23,434 10,379 6,552 5,107 7,413 911 200 £ 141,574 5,059 561 45,657 29,656 163,698 134,456 172,349 7,654 4,891 147 3,727 1,097 22,095 29,351 120,797 115,096 145,104 321 3,913 147 3,465 1,097 17,075 541,805 198 2,370 2,018 1,314 252 919 107 2,247 4,144 5,598 87 59 •• 166 4,303 10,348 1,133 2,797 8,121 1,762 1,063 412 4 1,480 442 - 256 6 200 1,675 15.297 1,992 353 200 .. 200 200 46,181 26,001 Totals 7,987 19,838 12,707 8,809 53,996 732,621

H.—7.

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

Table XX.— Showing the Expenditure for the Year 1914.

Approximate Ootl oi Paper. —Preparation, not given; printing (1,000 copies), £21 10s.

By Authority : John Maukay, Government Printer, Wellington.—l9ls. Price 9d.~\

22

Items. Auckland. Christchurch. I I Dunedin (Seacliff). Hokitika. Nelson. Porirua. Tokanui. Total. £ s. d. £ s. d. £ s. d. £ s. d. £ s. d. £ s. d. £ s. d. £ s. d. 1,000 0 0 742 13 6 1,137 14 3 1,394 9 0 637 15 6 77 14 0 4,332 18 4 2,206 0 4 212 8 4 1.728 2 6 923 9 0 55.008 0 8 40,394 13 11 11.040 1 1 11.972 3 7 703 14 9 35 2 8 7.574 4 4 4.492 16 5 19,480 8 1 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 0 734 10 0 389 15 10 355 12 6 249 15 8 8,648 15 5 8.489 12 4 1.921 19 8 2.496 12 0 102 14 9 12 0 0 433 7 6 411 4 4 2,687 8 6 ■■ 2 2 0 737 10 0 306 13 0 407 10 0 142 10 0 10,264 18 7 i 7,992 7 11 3,089 10 7 2,776 11 0 135 2 3 5 14 0 1,089 5 11 679 9 6 4,677 3 7 .. 16 16 0 4 4 0 698 0 0 253 15 0 1,022 11 8 212 8 4 448 6 8 159 5 0 92 18 4 14.549 15 4 2,965 0 8 8.874 15 6 3,040 15 11 2,690 5 6 81 15 3 3.267 11 1 265 19 7 231 0 5 5 4 0 0 4 4 2.676 9 11 44 6 6 2.329 14 5 35 9 9 5.875 19 3 665 15 4 .. 4 4 0 25 4 0 530 0 0 700 0 0 22 11 8 464 8 2 118 15 0 397 18 4 131 10 0- 147 10 0 2,459 0 3 13.297 8 2 2,061 13 8 8.415 18 8 537 19 7 2.411 18 8 373 19 3 2.485 10 2 41 13 4 181 11 7 11 15 4 286 18 8 1.462 14 10 286 4 1 642 11 0 970 13 5 3.757 18 2 •• 679 3 4 2,823 2 3 1.519 9 11 306 11 10 306 0 6 11 12 5 0 5 0 1.581 1 0 108 3 4 845 9 10 : :_ : Totals Repayments, sale of produce, &c. 26.958 12 6 9,307 6 232,306 8 4 42.845 14 9 7.662 13 0 8,714 10 9 13,800 1 4 I 1,465 7 10 7.825 2 11 1,595 9 0 34,402 7 1 11,376 2 2 8,180 19 5 527 12 7 165.094 10 3 46,786 9 10 A Actual cost 17,651 6 4 23,591 17 7 29,045 13 5 6,197 5 2 6,229 13 11 | 23.026 4 11 ! 7,653 6 10 118,308 0 5 * Not included in Table XXI.

Mental Hospital. I Bedding Surgery Sp^ e A ' le Provisions. Salaries. and 5*f' and Dis- &Pi«ts,Ale, Clothing. c ,i g . pensary. p*^. Farm. Necessaries " Reoav Total Cost Total Cost I TotaI Cost Buildings Total Cost "„ffL_ per Head, less per Head, per Head, less: Decrease Increase ancJ »nrl \?is " P er M.iV Repayments less 1 Receipts of I in in Repairs. Patient. J n a ' n ~ for Main- Receipts of all kinds pre- i 1914. t9U. celianeous. tenance. tenance . ; a n kinds. \ vious Year. Auckland Christchurch Dunedin (Seacliff) Hokitika Nelson Porirua Tokanui £ s. d. ..'970 ..12 3 8 .. i 9 15 11 .. 11 15 8} .. 11 4 li 9 5 4i .. 16 3 34: £ s. d. £ s. d. £ s. d. £ s. d. 11 9 If 2 15 0 2 2 3| 0 2 3J 18 1 7J 4 4 7f 4 14 2J 0 4 1J 18 12 11£ 3 12 14. 2 19 41 0 5 1J 13 13 6 1 0 7J 0 6 4 17 15 0 2 0 7f 2 18 5f 0 4 64 16 11 1J 2 14 9 2 13 14 0 4 0 37 5 2 ■ 3 5 lj 3 5 2f 0 2 5} £ s. d. £ s. d. £ s. d. £ s. d. i 0 0 3i 0 9 6|: 0 9 0| 2 19 2i 0 0 2 1 13 24, 1 0 8| 7 2 7J 0 0 li 2 19 1 2 11 5 6 9 8J 0 0 0i : 0 3 oi 0 2 9 2 11 1\ 1 11 2| 1 11 H 5 5 6 0 0 3 1 12 2f 0 14 If 4 2 9i 0 0 0AJ16 16 4f: 1 3 0\ 8 19 lOf £ s. d. ! £ s. d. £ s. d. 29 13 9J 9 16 0 19 17 9J 49 4 llj 9 18 6f| 39 6 4J 47 5 9f 12 13 10| 34 11 ll| 29 14 0 5 4 34 24 9 8J 42 10 6j 7 8 Of 35 2 6 37 17 9 10 14 lOf 27 2 10i 87 0 7i 3 18 5 83 2 21 £ s. d. £ x. d. £ s. d. £ s. d. 19 8 9£ 19 1 0 .. 0 7 94 35 19 3i 27 4 0J .. 8 15 3 32 1 2i 28 4 6* .. 3 16 7f 24 0 4|j 23 4 6| 0 15 10i 33 17 If! 25 1 Hi . . 8 15 24 25 7 2* 23 15 94, .. 1 11 4f 81 8 4J| 85 11 2 4 2 9f Averages .. 1 10 6 5 16 9 6j ! 3 1 2 2 16 5 0 3 7 0 0 2j- 1 18 84 1 2 llij 4 19 64/ 40 18 6 10 1 10JI 30 16 7f 28 19 5 j 25 16 94 ' 4 2 9j 3 2 7j Table XXIa. Including first five items in Table XX I 42 3 7i 1 I 30 4 6i 27 0 6 3 4 0; Table XXIb. Richmond Home for 13 9 8J- 41 3 6£ 2 5 5i 2 14 9£ .. Feeble-minded Patients on probation 14 16 4 32 11 6* 1 13 0J 2 17 7 0 5 5f at The Camp 2 19 4 5 14 7| 7 17 1\\ 76 5 1 8 18 8 1 12 5f 0 5 I 7 15 5 61 16 \\\ 67 6 5 63 10 10 60 15 0 61 16 114 53 0 2 I 2 15 10 I 8 16 9;