MENTAL HOSPITALS OF THE DOMINION (REPORT ON) FOR 1915.

Appendix to the Journals of the House of Representatives, 1916 Session I, H-07

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1916. NEW ZEALAND.

MENTAL HOSPITALS OF THE DOMINION (REPORT ON) FOR 1915.

Presented to both Houses of the General Assembly by Command of His Excellency.

The Hon. the Minister in Charge of Department for the Care of Mental Defectives to His Excellency the Governor. My Lord, — Wellington, 2nd June, 1916. I have the honour to submit to Your Excellency the report of the Inspector-General of Mental Defectives for the year 1915. I have, &c., G. W. Russell, 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, Ist June, 1910. I herewith present the report for the year ended 31st December, 1915. A summary and analysis of the statistical tables in the appendix shows : The number of patients on the register at the beginning of the year was 4,111 (m., 2,408; f., 1,703)j at the end 4,200 (m., 2,448; f., 1,752)— an increase of 89 (m., 40; f., 49). The total number under care during the year was 4,991 (m., 2,869; f,, 2,122), being 135 (m., 11; f., 124) more than in 1914; while the average number resident, 4,094 (in., 2,391; f., 1,703), was 144 (m., 82; f., 62) in excess. The ratio of patients on the register to population, exclusive of Maoris, was 3779 per 10,000 (fii., 4305; f., 3229), or 1 patient in 265 (m., 232; f., 310); including Maoris—their number on the register is 32 onlv —the figures are 3644 per 10,000 (in., 4146; f., 31' 16), or 1 in 274 (m., 241; f., 321). The admissions (excluding transfers —in., 11; f., 58) numbered 811 (in., 450; f., 361); the male admissions were 59 lower and the female 2 higher than in the previous year. Among these admissions arc included 12 immigrants (2 with a history of previous attacks) who had been here for less than a year. Of the total admissions, about one-fifth were patients who had previously been treated to recovery in our institutions, leaving the number of first admissions 651 (m., 378; f., 273), a decrease, compared with 1914, of 83 (m., 62; f., 21). The ratio of admissions to population (excluding Maoris) was 720 per 10,000, and for first admissions 587; or, in other words, every 1,388 persons in the general population contributed an admission, and every 1,705 a first admission, figures which are an improvement upon the previous decennial average,

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The total number of patients discharged (excluding transfers) was 438 (m., 238; f., 200), of which 359 (m., 202; f., 157) were discharged as recovered. The remaining 79 (m., 36; f'., 43), though not recovered, were sufficiently well to be placed under the care of relatives or friends. The percentage proportion of recoveries on admissions was 4427 (m., 4489; f., 4321), as against 42-51 (m. 4067; f., 4512) in the previous year, and 3996 (m., 3768; f., 4333) in the average for all years since 1876. This increase of recoveries must, I think, be regarded as satisfactory. The deaths numbered 284 (m., .172; f., 112), giving a percentage of deaths on the average number resident of 694 (m., T l9; f., 658), and on the total number (general register) under care during the year of 579 (m., 601; f., 542). The corresponding percentages for the previous year were 7'll (m., 836; f., 536) and 582 (m., 679; £~ 442) respectively. Not included in the above analysis are 4 males resident at the beginning of the year who had been sent for observation under Magistrates' order, and 72 (m., 52; f., 20) so received during the year. Of that number, 28 (m., 16; f., 12) were formally committed, 1 male elected to remain on as a voluntary boarder, 1 was under observation at the end of the year, and 46 (m., 38; f., 8) after a short period of observation and treatment no longer needed oversight in a mental hospital. Also not included are the voluntary boarders, of which class 21 (m., 6; f., 15) were resident at the beginning of the year, and 36 (m., 17; f., 19) were admitted during the year. Of the total, 24 (m. 9; f., 15) were discharged, 1 female died, and 6 boarders (m., 2; f., 4) were transferred to the register of patients, leaving 26 (m., 12; f., 14) resident at the end of the year. The number of single patients under the Act is as yet too insignificant to include in the general statistics—l male was in single care at the beginning of the year, and 1 was added during the year. The patients on the register at the end of the year were distributed as follows : — Males. Females. Total. Auckland ... ... ... ... ... 581 360 941 Christchurch ... ... ... ... ... 335 351 686 Dunedin (Seacliff and Waitati) ... ... ... 548 399 947 Hokitika ... ... ... ... ... 180 61 241 Nelson ... ... ... ... ... ... 84 103 187 Porirua ... ... ... ... ... ... 542 377 919 Tokanui ... ... ... ... ... ... 90 50 140 AshburnHall ... ... ... ... ... 19 21 40 On probation ... ... ... ... ... 69 30 99 2,448 1,752 4,200 The accommodation in the State institutions was much taxed, except at Hokitika, Nelson, and Tokanui. The new buildings at Auckland were immediately filled on completion, and muchneeded additions to the male infirmary ward are about to be carried out. At Porirua and Sunnyside the delay in the completion of the new reception and hospital blocks, occasioned by the scarcity of skilled labour, has led to a congestion in the main institutions. To relieve this pressure at Porirua 50 women patients were transferred to Tokanui, where provision is being made to relieve other institutions, in which additions cannot be conveniently carried out, of their annual surplus or increase due to the excess of admissions over discharges and deaths. This and the completion of the hospital block will place Porirua in a fairly good position. At Sunnyside the occupation of the new Nurses' Home affords a measure of relief by allowing the vacated rooms to be occupied by patients; further relief will be afforded when the reception and hospital block is ready for occupation, but provision is still required to allow of our abandoning the use of the attics for dormitories. The proportion of aged patients is high, and many could with advantage be segregated, leaving their places in the main institution for patients requiring more oversight and control. Plans have been prepared for a suitable home for such patients under the supervision of the institution staff. Besides the above, a plan for a small cottage for 10 patients has been approved. At Seacliff some relief has been granted by the new building for women and the reception cottage for men, and during the current year it, is proposed to add further accommodation for women patients and a consumptive shelter for men. At Waitati it is proposed to increase the accommodation for epileptics, and to start a substantially built and wallcd-in unit for a class of patients whose supervision at present is necessarily costly, and whose presence in an ordinary ward tends to restrict the amenities of others. Under present circumstances nothing new has been done at Hokitika, where there is accommodation to spare; but at Nelson, where the additions to the auxiliary are now in occupation, the first contribution to the rebuilding of the institution, a new kitchen and a reception cottage, which had to be postponed, will be proceeded with. In addition to the above buildings directly connected with accommodation, other necessary works have been and are being carried out to improve administration and contribute to the well-being of the patients. The farms in connection with the institutions, as usual, show good returns. The produce sold for cash realized £7,378, and the value of produce consumed was estimated at £16,637, making a total of .£24,015, as against £21,583 in 1914. On the other hand, the expenses in regard to wages, cost of feed, &c, were higher. The net profit on the year's working amounted to £9,850.

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Reviewing the average cost per patient during the year, there is an increase of £1 Is. 7d. over 1914, a figure which demonstrates the economy which has been exercised, considering that the extra cost of provisions alone has been in excess of this at every institution, making an average increase on that one item of £1 15s. 6d. Another unavoidable increase, averaging 14s. Id. per patient, was due to salaries; necessary repairs charged to our vote increased by £1 Is. 3Jd., and the increased cost of drugs accounted for 6d. extra in the surgery account. These items total £3 lis. 4d. per head over the cost last year; but against this there was an economy in the other items of £1 13s. 9d., and the receipts (maintenance, sales of produce, &c.) were 16s. in excess of the previous year, leaving the net cost per patient £30 Is., as against £28 19s. sd. in 1914, or an excess of £1 Is. 7d. The decrease in the cost per head at Christchurch is apparent rather than real, being due to an abnormal increase in the previous year. For example, perishable stores were replenished in the last months of 1914 and reduced the average cost for the early months of 1915, and considerable non-recurring expenditure followed upon the destruction of No. 3 attic dormitory by fire in March of that year. Visits of Inspection. The following are in addition to the visits paid by District Inspectors and Official Visitors. As a general note it should be stated that every patient has the opportunity of a private interview, and that every complaint not obviously absurd is inquired into. Should any matter require rectification or adjustment this is done, but complaints, save against loss of liberty on the part of patients who cannot be trusted, are limited, to a very few patients. There have been no epidemics, and the general health of the patients has been good. Auckland. —Visited January, March, May, of 1915, and in February of this year. Both auxiliary buildings are now fully occupied. The renovation of the women's side is proceeding apace; the improved lighting and ventilation and the cheerful effect of repainting and decorating is an agreeable transformation. When the addition to the male infirmary ward is made and a further transfer of patients to Tokanui has been carried out it will be possible to treat the male side, ward by ward, similarly. In the infirmaries are many mentally infirm suffering from senile decay, and Dr. Beattie remarks, " 1 regret that too many senile cases are still admitted to this Hospital, exhibiting, in some cases, a desire to shirk home responsibility." The new drainage system is approaching completion, permitting connection with the city and suburban system and relieving the institution of a difficulty with which it has had to contend for a number of years. Dr. Beattie, Dr. Tizard, and the senior staff have had a strenuous year. Swnnyiside. —Visited in February, March, June, August, December, 1915, and in January and April, 1916. In Dr. Gow's indifferent health the anxiety and responsibility of managing a large institution was too great a strain, and Dr. Gribben changed places with him, at first temporarily, then permanently. Later Dr. Lee went to the front and Dr. Gribben was left single-handed. He had himself put in an application to get to the front, but at my desire permitted it to bo left in abeyance, because I thought that his knowledge and energy were necessary for the administration of this institution, and that he would be serving his country at least equally well by remaining behind. The Nurses' Home is a great boon, and also relieves accommodation on the women's side; but the completion of the reception and hospital block is looked forward to, both to increase the accommodation and means of classification. The fire-alarm system is inefficient and obsolete, and something will need to be done pending a complete automatic installation. The kitchen is now served by women under the control of the Matron. The food is well cooked, and the uniformly excellent quality of' the meat, apart from any question of cost, justifies the change from buying meat to buying stock and fattening for our own use. Without this strain placed upon the farm the land at our disposal was insufficient for our needs, and it will be necessary to add an auxiliary farm within easy distance for its administration and that of an auxiliary institution on the same site. Seacliff. —Visited in March, June, November, December, 1915. Here, as at other institutions, work has been carried out under great stress owing to changes in the staff due to the war. Dr. Boss resigned to enter into private practice, and Dr. Gray was persuaded to defer his application for leave to go to the front. The supply of medical men for our work is limited, and, as a fair proportion of our assistant medical officers have gone on active service, the work of those left behind is correspondingly increased. I consider that in setting aside personal inclinations, in realizing the needs of our patients, and in carrying out extra duties ungrudgingly these men are acting bravely and according to the best traditions of their profession. The medical wants of Waitati are meantime served from Seacliff. In addition to the work of the institution, Dr. King is actively assisting the military authorities in the treatment of special cases. Realizing the great abnormal stress to which soldiers have been subjected, cases of mental shock and allied states are receiving skilled treatment apart from mental hospitals. So well adapted is the environment selected for these cases, with its free open life, that one feels that the best possible is being done. The soldiers visited were happy and getting on well. Where not obviously contra-indicated, the policy is to extend the benefits to all cases in the first instance, but, of course, where for the good of the patient or in the interests of the community it is necessary to admit in the first place or transfer any such patient to a mental hospital, false sentiment is not allowed to stand in the way. Happily the number of soldiers mentally defective in terms of the Act is remarkably few so far. Buildings proposed are included under the heading of accommodation. The completion of these will add greatly to the comfort and well-being of the patients. The water-service from Waitati has not been an unqualified success. There has been no extension of the slip. Apropos of a patient suffer-

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ing from paranoia who escaped and remained in hiding for three months, thereby being discharged. District Inspector Galloway noted that the law should be amended so as to prevent such automatic discharge. The patient in question was recommitted. The killing of our own beef and mutton has proved highly satisfactory, and the fishing-station has augmented the food-supply as in the past. The necessity for a freezing-chamber at Seacliff to receive the freshly caught fish is recognized as necessary both for that institution and for the supply of others. Hokitika. —Visited in June. Mr. Downey has arrived at retiring-age, but has agreed to carry on a little longer in order that the changes inevitable on his retirement may be postponed till they can be more conveniently carried out. The year's doings have the merit of being uneventful. Further experience has confirmed the advantage of buying stock for our own consumption. Nelson. —Visited in April and August, 1915, and in January, 1916. The addition to the annexe is now in occupation, and a start is to be made with the rebuilding of the institution. Tenders have been authorized for the new kitchen, and it is expected that the reception cottage will be soon commenced. Dr. Jeffreys put in an application to be allowed to go to the front, which he withdrew upon my representations as to the necessity for the medical care of the patients. At Richmond, where is located the institution for untcacbable defective boys, there is not much to report. The boys continue to lie woll cared for under Mrs. Howard and the medical supervision of Dr. Jeffreys. Porirua. —Visited in February, April, July, September, 1915, and in February and April, 1916. The matter of accommodation has been dealt with under the special heading. Dr. Hodgson was transferred here as Assistant Medical Officer, and quite recently Dr. McKillop has returned invalided from the front, but able to resume work. Apart from the accommodation, the greatest need here is a remodelling of the drainage system. The septic-tank effluent enters a creek which goes through the township, and was certainly objectionable during the hot, dry weather. Preliminary surveys have been made for piping the effluent into the harbour, and these are now being completed. It is to be hoped that the work will be regarded as urgent. Tokanui. —Visited in January, May, October, 1915, and in January and March, 1916. In addition to the buildings completed and projected for the accommodation of patients, some farm buildings will be necessary. Electric light is installed. The temporary water-service will soon give place to the permanent supply, the pipes for which are new being laid. Under arrangement, with the Justice Department a supplj- of road-metal has been obtained for the Te Mawhai Road. When this is in good order and the even-graded road now under construction from Waikeria joins it many of our pioneering difficulties will be overcome. The Justice Department's Waikeria property adjoins ours, and under arrangement with that Department, Mr. Drysdale, late Manager of the Wcraroa Experimental Farm, has been appointed joint estatemanager. The following is an excerpt from his first report : " from my observation of this farm, after a short residence, I am confident that with good farming the soil will respond profitably and compare very favourably with some of the richer soils in other districts." Ashburn Hall. —Visited in March, June, and November, 1915. Itecently the medical control of this licensed hospital has passed to Dr. Will from Dr. Alexander, who administered it for many years with conspicuous ability, f found everything in excellent order. Conclusion. As in the case of other Departments, this has been a strenuous year; but more particularly so with us, who have the care of irresponsible human beings. At. each of the larger institutions we have been an Assistant Medical Officer short, and the work of administration has been unusually anxious because of the number of attendants who volunteered for active service. Their names, their deeds, and their losses will be recorded elsewhere, but I may state that the Department is proud of their spontaneous response to the call and of their record. In conclusion, sir, I would state that you know of my wishes for the betterment of the institutions, and that 1 know of your desires in the same direction, ami of your intention to carry them out as far as present circumstances permit. Frank Hat.

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APPENDIX.

Table I.-Showing the Admissions, Readmissions, Discharges, and Deaths in Mental Hospitals during the Year 1915.

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 1915.

Ln mental hospitals, 1st January, 1915 Admitted for the first time Readmitted transfers.. M. ii'. T. M. 2,408 F. 1,703 T. 4,111 378 72 11 273 88 58 651 160 69 } 461 419 880 Total under care during the year 2,869 2,122 4,991 Discharged and died— Recovered Relieved Not improved Died 202 26 21 172 157 34 67 112 359 60 88 284 421 370 79.1 itemaining in mental hospitals, 31st December, 1915 2,448 1,752 4,200 increase over 31st December, 1914 40 49 89 10 49 Vverage number resident during the year 2,391 1,703 4,094 2,391

In Mental Hos- Admissions in 1915. Total Number lUontal Hospitals. pitals on pnHAnfc 1st January, 1915. ! Admitted fortlie I Readmitted. Total. unto Care. M. If. T. II. V. T. M. If, 'I'. M. Y. T. ' M. K. T. Auckland .. .. 561 362 923 105 67 172 26 23 49 131 90 221 692 452 1,144 Christchurch .. .. 354 329 683 59 53 112 10 25 35 69 7,8 147 423 407 830 Dunedin (Seaoliff) .. 557 380 946 73 +8 121 17 17 34 90 65 155 647 454 1,101 Hokitika .. .. 194 65 259 13 14 27, I .. 1 M 14 28 j 208 79 287 Nelson .. .. 103 112 215 7 11 18 1 1 2 8 12 20 III 124 235 Porirua .. .. 523 423 946 119 77 196 j 27 28 55 146 105 251 ; 669 528 1,197 Tokanui .. .. 94 .. 94 j .. 50 50 .. 50 50 94 50 141 A ah bum Hall (private 22 23 45 2 3 5 I 2 3 3 5 8 25 28 53 inonlal hospital) Totals.. .. 2.408 1.703 4,111 378 273 651 83 146 229 461 419 880 2.869 2,122 4.991 I Patients discharged and died. In Mental HosMcntal Hospitals. —i — i ■tlst'ri'^eml'ir., Discharged Discharged .... Total discharged .list llocemlici, recovered. not recovered. and died. M. K. 'I'. M. V. T. M. Y. T. M. F. T. M. Y. T. Auckland .. .. j 56 50 106 .. 4 4 52 34 86 108 88 196 584 364 948 Christchurch .. .. 37 36 73 5 4 9 33 13 46 75 53 128 348 354 702 Dunedin (Seaoliff) .. I 33 12 45 12 15 27 29 25 54 I 74 52 1.26 573 402 975 Hokitika .. .. j 12 8 20 i 3 1 4 12 3 15 27 12 39 181 67 248 Nelson .. .. 3 7 10 3 3 li 3 li 9 ; 9 Hi 25 102 108 210 Porirua .. ..I 60 44 104 19 67 80 40 31 71 119 142 261 550 386 936 Tokanui .. .. 1 .. 1 2 .. 2 3* . . 3 91 50 141 Ash bum Hal) (private I. 1 4 7 11 1 .. 1 6 7 13 19 21 40 mental hospital) ■ Totals.. .. 202 157 359 47 101 148 172 112 284 421 370 791 2,448 1.752 4.200 Average Number ofBecovSon Percentage of Mental Hospitals. resident during 0 , NuXTresiden't th( ?. «•» the Year. during the Year. j during the Year, j the Admissions. i 12 157 359 47 101 148 172 112 Average Number resident during the Year. Percentage of Recoveries on Admissions during the Year. M. li'. T. M. I'. 'I'. II. P. T. M. Ji-. T, Auckland . . .. .. 576 359 935 43-08 55-05 48-40 9-21 9-44 9-20 40-00 38-20 39-27 Ohristchureh .. .. 338 335 673 55-22 48-00 51-41 9-76 3-88 6-84 49-25 17-33 32-39 Dunedin (Seacliff) .. .. 565 396 961 38-37 19-35 30-41 5-13 6-31 5-62 33-72 40-32 36-49 Hokitika .. .. .. 186 60 246 92-31 57-14 74-07 6-45 5-00 6-10 92-31 21-30 55-55 Nelson .. .. .. 84 109 1.93 42-86 58-33 52-63 3-57 5-50 4-66 42-86 50-00 47-37 Porirua .. .. .. 529 419 948 41-67 41-90 41-77 7-56 7-40 7-49 27-78 29-52 28-51 Tokanui 92 3 95 2-17 2-11 Ashburn Hall (private mental 21 22 43 33-33 .. 14-29 4-76 .. 2-33 33-33 14-29 hospital) ■ ■ Totals .. .. 2,391 1,703 4,094 44-89 43-21 44-27 7-19 6-58 6-94 38-22 3102 3502 M. K. T. 576 359 935 338 335 673 565 396 961 186 60 246 84 109 193 529 419 948 92 3 95 21. 22 43 M. Y. T. 43-08 55-05 48-40 55-22 48-00 51-41 38-37 19-35 30-41 92-31 57-14 74-07 42-86 58-33 52-63 41-67 41-90 41-77 33-33 . . 14-29 2,391 1,703 4,094 44-89 43-21 44-27

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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. I | I 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 „ „ 90 „ 100 „ „ 100 „ 105 „ Unknown Transfers Nut insane M. F. T. 4 4 8 28 16 44 32 26 58 27 19 46 16 10 26 10 7 17 11 2 13 2 0 2 0 4 4 1 1 2 0 1 1 M. Y. T. 0 1 1 oil 4 5 9 9 11 20 | 16 22 38 13 10 23 8 9 17 6 7 13 7 5 12 3 4 7 1 6 1 2 3 5 M. ». T. 0 1 1 1 0 1 3 3 li 20 16 36 20 11 31 15 15 30 12 5 17 7 5 12 6 4 10 0 2 2 2 0 2 4 3 7 St. 0 0 7 1 0 3 2 1 F. 1 1 2 5 2 2 1 0 T. 1 1 9 ! 6 2 5 3 1 M. F. 1 0 i 6 0 4 3 2 0 3 0 1 1 0 1 1 0 1 i ii T. 1 1 4 5 3 1 1 2 1 1 M. F. T. 0 2 2 0 1 1 7 9 16 32 25 57 46 24 70 27 23 50 14 13 27 11 4 15 5 4 9 2 0 2 2 6 2 M. F. T. 0 50 50 M. 1 2 0 0 F. T. i 2 2 4 i 1 i i M. Y. I. 1 2 3 1 2 3 0 2 2 19 22 41 90 74 164 126 89 215 83 75 158 50 41 91 38 25 63 32 17 49 7 7 14 3 4 7 11 58 69 0 1 1 Totals 131 90 221 69 78 147 90 65 155 14 14 28 8 12 20 146 105 251 0 50 50 3 5 8 461 419 880 i I

1 Tokanui. Ashburn Hall (Private Mental Hospital). Total. Auckland. Christchurch. Dunedin (Seacliff]. Hokitika. Nelson. Porirua. First Class (first attack and within 3 months on admission) Second Class (first attaekabove 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) Unknown Transfers Not insane .. .. .. .. M. F. T. ! 78 48 126 15 8 23 ; 25 22 47 12 10 22 1 1 2 0 1 1 31. F. T. 30 24 54 10 11 21 16 29 45 10 11 21 1 0 1 2 3 5 M. Y. T. 43 19 62 5 8 13 13 19 32 25 16 41 4 3 7 M. 8 1 4 1 F. T. 5 13 2 3 7 11 0 1 M. 2 2 2 1 1 Y. T. 7 9 0 2 5 7 0 1 0 1 IC. F. I. 96 44 140 13 21 34 24 21 45 11 19 30 2 0 2 M. F. T. 0 50 50 M. 2 1 0 Y. 1 3 1 T. 3 4 1 M. F. T. 259 148 407 46 ,50 96 84 103 187 60 59 119 1 0 1 11 58 69 0 1 1 Totals 131 90 231 69 78 147 90 65 155 14 14 28 8 12 20 146 105 251 0 50 50 3 5 8 461 419 880

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Table V.—Ages of Patients discharged "Recovered" and "Not Recovered "during the Year 1915.

Table VI.— Ages of Patients who died.

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I i i Ashburn Hall (Private M.H.). Auckland. Christchurch. Dunedin (Seacliff). Hokitika. Nelson. Porirua. Tokanui. Total. Ages. Be- Notre- Be- Notre- ; fie- , Notre- Ee- j Notre- Be- Not recovered, covered, covered, covered. ' covered, covered, covered, i covered, covered. covered. I ' j I Be- Not Be- Not re- fie- Not recovered. ! recovered, covered, covered, covered, covered. Severed, reared. 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 Not insane M. F. T. M. F. T. M. F. T.j M. F. T. I M. F. T. M. F. T. M. F. T.| M. F. T. M. F. T.; M. F. T.j M. F. T. M. F. T. oil '.'. '.'. '.'. '.'. '.'. o "1 l 347101 .. .. .. .. 11 8 19 325 15 9 24 7 4 11 .. .. 10 1 .. 51 35 86 12 9 21 22 13 35 1 3 4 .. .. .. .. i 62 48 110 6 9 15 13 11 24 2 3 5 .. .. .. 1 1 21 45 34 79 4 8 12 2 5 7 4 2 6 .. .. .. 0 1 l! 19 16 35 5 6 11 51 6235 .. .. .. 011 11 10 21 358 011 .. 10 1 .. 12 3235 ..101.. .. .. .. 1 0 lj 1 0 1 1 51 52 .. .. .. 3 4 7 .. 11 59 70 0 11 M. F. T. M. F. T. M. F. T. M. F. T. M. F. T. M. F. T. 4 3 7 .. 3 14 10 1 16 8 24 .. 6 8 14 1 0 1 11 12 23! 0 1 1 11 13 24 1 2 3 15 11 26 0 1 1 8 6 14' 6 8 14: .. -729011 3 5 8.. 044.. 0 1112 3 10 1 10 1.. 12 3;.. Oil.. 112 Oil!.. 10 10 2 2 12 5 17 3 4 7 1 1 2 9 5 14 3 1 47 3 10 1 0 1 527134336 3 0 3 12 3 112 3 0 3.. .. 112 Oil 4 2 6 .. 10 1 10 1 0 4 4 112 2 2 4 0 2 2 112 '.'. 10 1 Totals 56 50 106 0 4 4i37 36 73 5 4 9 33 12 4512 15 27] 12 8 20 3 1 4 3 7 10 3 3 6 60 44 1041 19 67 86 1 0 1 1 0 ~7j 4 7 ll: 202 157 35947101 14!

Auckland. Christchurch. Dunedin (Seacliff). Hokitika. Tokanui. Ashburn Hall (Private M.H.). Total. Ages. Nelson. Porirua. I 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 M. 0 2 3 9 12 11 9 5 F. T. 1 1 5 7 3 6 i 6 15 . 4 16 7 18 5 14 2 7 2 M. 1 4 1 7 8 11 1 F. T. 0 1 2 6 1 2 3 10 3 11 4 15 0 1 M. F. T. i 6 i 2 2 4 2 0 2 7 3 10 4 5 9 4 4 8 7 10 17 1 1 2 1 0 1 M. 3 1 2 3 1 2 F. T. 0 3 0 1 0 2 1 4 1 2 1 3 H. 1 1 0 1 0 F. 0 1 1 1 2 T. 1 2 1 2 2 M. F. T. 0 1 1 0 2 2 12 3 8 2 10 7 6 13 5 8 13 6 3 9 11 6 17 2 1 3 M. i i F. 6 o T. " I 1 1 M. F. 1 0 T. 1 M. F. T. 0 1 1 13 4 7 9 16 21 8 29 25 17 42 30 20 50 34 19 53 41 28 69 11 5 16 1 0 1 o i 1 I 1 2 3 Totals 52 34 86 33 13 46 29 25 54 12 3 15 3 6 9 40 31 71 2 0 2 1 0 1 172 112 284 I

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Table VII.-Condition as to Marriage.

Admissions. Discharges. Deaths. AuCKIiAND— Single Married Widowed Unknown Died while absent on trial Transfers M. F. T. 80 30 110 43 50 93 6 9 15 I 0 I M. F. T. 36 10 46 18 38 56 2 4 6 0 1 1 M. F. 30 16 14 II 6 6 1 0 I 1 T. in 25 12 1 2 I 1 2 0 " 1 1 Totals 131 90 221 56 54 110 52 34 86 I HRISTUHURaH— Single Married WidoWed Unknown Transfers 32 29 5 1 2 36 28 11 0 3 68 57 16 I 5 26 II 3 1 I 13 20 6 0 I 39 31 9 I 2 13 16 4 5 4 4 18 20 8 Totals 69 78 147 42 40 82 33 13 46 Dunkdin (Seacliff) — Single Married Widowed Unknown Transfers 59 22 5 30 23 9 89 45 14 28 10 3 Hi 8 1 44 18 4 19 6 4 7 9 9 26 15 13 4 3 7 4 2 6 Totals 90 65 155 45 27 72 29 25 54 Hokitika — Single Married Widowed Unknown Transfers 8 3 2 5 6 3 13 9 5 II 2 1 5 3 1 16 5 2 10 2 3 0 13 2 1 6 1 1 0 1 Totals 14 14 28 15 9 24 12 3 15 Nelson —■ Single Married Widowed Unknown Transfers 4 3 0 3 5 4 7 8 4 4 I 0 2 7 1 li 8 1 3 0 0 2 1 3 5 1 3 1 6 1 I 0 I Totals 8 12 20 6 10 16 3 Porirua — Single Married Widowed Unknown Transfers 77 56 11 47 124 48 104 10 21 52 23 3 22 33 5 74 56 8 16 22 2 9 • 25 16 38 6 8 2 0 2 I si 52 Totals 146 105 251 79 111 190 40 31 71 Tokanui — Single Married Widowed Unknown Transfers 1 1 0 0 I 1 0 50 50 1 0 1 Totals 0 50 50 I 0 I Ashbukn HAf.i. (private mental hospital)— Single Married Widowed Unknown Transfers 1 2 3 2 1 3 0 1 I 1 0 1 I 2 3 0 1 I I 0 I oil 3 -I 7 Totals _ 1 3 5 8 l_ 5 7 12 I 0 1 Totals — Single Married Widowed Unknown Died while absent on trial Transfers 261 1.53 414 158 161 319 29 47 76 2 0 2 158 68 226 86 III 177 12 19 31 I 12 92 42 134 60 41 101 18 28 46 1 0 I I 1 2 I I 58 69 12 59 71 Totals 461 419 880 249 258 507 ! 172 112 284

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Table IX.—Ages of Patients on 31st December, 1915.

Table VIII.— Native Countries.

2-H. 7.

Counti Countries. iries. Auckland. Christehurch. j Dunedin (Sea- i cliff). Hokitika. Nelson. Porirua. _l Tokanui. Ashbuin Hall tw«i (Private M.H.). 10tal England Scotland Ireland Wales New Zealand Australian States FranceGermany Austria Norway Sweden Denmark Italy China Maoris Other Countries Unknown M. F. T. M. F. T. I 145 82 227 93 100 193 27 18 45 42 49 91 75 46 121 24 18 42 .. i 4 0 4 .. ! 195 175 370 160 163 323 .. i 34 11 45 13 11 24 2 0 2 6 2 8 3 14 14 1 15 0 11 2 0 2 10 1 7 18 3 0 3 3 0 3 2 2 4 4 0 4 2 0 2 10 1 10 1 14 7 21 12 3 .. j 23 4 27 3 7 10 ... I 28 17 45 M. F. T. 97 64 161 100 71 171 88 57 145 228 179 407 17 20 37 11 1 12 1 0 1 4 1 5 3 0 3 2 1 3 1 0 1 13 0 13 8 8 16 M. F. T. 32 14 46 I 12 6 18 44 9 53 10 1 54 25 79 8 5 13 6 0 6 1 0 1 5 0 5 : 7 0 7 6 0 6 4 0 4 18 9 M. F. T. 11 25 36 I 4 7 11 12 13 25 68 53 121 1 3 4 1 1 2 0 2 2 1 0 1 2 1 3 2 3 5 j M. F. T. 157 84 241 49 24 73 57 54 111 2 0 2 213 190 403 30 13 43 1 0 1 7 5 12 0 1 1 2 0 2 6 3 9 6 0 6 3 0 3 2 0 2 2 2 4 13 10 23 M. F. T. 25 6 31 3 0 3 11 7 18 1 1 2 39 36 7.5 2 0 2 1 0 1 4 0 4 1 0 1 1 0 1 I 0 1 1 0 1 1 0 1 M. F. T. M. Y. T. 4 6 10 564 381 945 5 2 7 242 177 419 311 204 515 10 1 9 1 10 8 11 19 965 832 1797 0 2 2 105 65 170 3 0 3 35 10 45 19 3 22 11 3 14 26 4 30 14 3 17 17 0 17 23 0 23 20 12 32 10 1 55 32 87 29 25 54 Totals 584 364 948 348 354 702 ! 348 354 702 573 402 975 573 402 975 181 181 67 248 67 248 102 108 210 102 108 210 550 386 936 550 386 936 91 50 141 91 50 141 19 21 40 2448 1752 4200 I 19 21 40 2448 1752 4200 I

Ages. Auckland. Auckland. Christchurch. DUU^ n ? ) . (Sea " Christchurch. " u ( am - Hokitika. Hokitika. Nelson. Porirua. Nelson. Porirua. i Tokanui. Tokanui. Ashburn Hall (Private M.H.). I (Priva urn nan ite M.H.). Total. Total. L I I L L I L J_ L i i From 1 to 5 vears 5 .. 10 ,. „ 10 .. 15 ., „ 15 .. 20 „ „ 20 .. 30 „ „ 30 .. iO „ „ 40 .. 50 ., ., 50 .. 60 „ ., 60 .. 70 „ .. 70 .. 80 ., „ 80 ., 90 „ Upwards of 90 .. Unknown M. F. T. 5 2 7 6 7 13 72 45 117 122 67 189 133 98 231 119 72 191 66 46 112 36 18 54 10 3 13 0 1 1 15 5 20 M. F. T. ! M. F. T. 0 11 112 112 10 1 13 4 14 5 6 7 13 4 6 10 40 35 75 62 48 110 87 80 167 132 81 213 70 76 146 125 99 224 55 69 124 109 72 181 46 48 94 75 52 127 32 24 56 55 28 83 8 9 17 8 11 19 112 10 1 II. F. T. 0 1 1 6 3 9 34 9 43 37 16 53 38 12 50 32 12 44 20 8 28 2 0 2 12 6 18 H. F. T. M. F. T. 10 1 5 16 0 2 2 5 16 6 9 15 10 1 11 8 10 18 17 7 24 i 86 47 133 14 20 34 130 83 213 14 32 46 122 90 212 15 25 40 99 81 180 14 14 28 69 39 108 6 2 8 22 21 43 112: 8 4 12 0 4 4 '.'. M. F. T. 0 1 1 4 5 9 19 8 27 26 15 41 20 10 30 9 11 20 3 0 3 10 0 10 M. 1 1 2 6 4 3 2 F. T. 1 2 1 2 3 5 8 14 2 6 5 8 1 3 M. F. T. 2 2 4 7 4 11 18 19 37 34 33 67 288 191 479 539 349 888 529 429 958 461 349 810 315 224 539 177 106 283 39 29 68 1 2 3 38 15 53 _ Totals 584 364 948 : 348 354 702 573 402 975 181 67 248 102 103 210 r 550 386 936 ; 102 103 210 j, 550 386 936 91 50 141 91 50 141 19 19 21 21 40 ! 40 2448 1752 4200 2448 1752 4200

H.—7.

10

Table XI.—Length of Residence of Patients discharged "Recovered" during 1915.

Table X.—Length of Residence of Patients who died during 1915.

Length of Residence Auckland. ! Christchurch. I 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 vears .. 2 „ 3 ' „ ,. 3 „ 5 „ .. 5 .. 7 ,, „ 7 „ 10 „ ., 10 ,. 12 „ „ 12 „ 15 „ Over 15 years Died while absent on trial I— M. F. T. 4 6 10 7 2 9 1 0 1 4 1 5 3 0 3 9 2 11 5 2 7 2 4 6 3 14 3 5 8 1 2 3 1 0 1 8 8 16 1 1 2 M. F. T. 7 2 9 0 2 2 2 0 2 2 0 2 10 1 3 1 4 1 2 3 4 3 7 4 0 4 112 1 1 2 1 0 1 6 I 7 , M. F. T. 1 1 2 3 3 6 6 0 6 3 0 3 1 1 2 2 1 3 13 4 3 4 7 1 1 2 3 2 5 1 0 1 2 1 3 2 8 10 M. 2 2 4 2 1 0 1 F. T. I 3 0 2 0 4 i 3 ; 6 i 1 1 0 1 I M. 0 1 0 1 0 1 F. T. 1 1 0 1 1 1 1 2 1 1 2 3 M. 5 4 3 3 5 4 2 2 2 1 3 1 5 F. T. 4 9 2 6 2 5 1 4 2 7 1 5 1 3 5 7 3 5 4 5 0 3 0 1 6 11 M. 2 F. 6 T. 2 M. 1 F. 0 T. 1 H. F. T. 17 13 30 14 9 23 12 3 15 12 2 14 11 3 14 20 6 26 11 9 20 15 16 31 10 5 15 13 14 27 7 4 11 6 1 7 22 26 48 2 1 3 Totals 53 34 86 33 13 46 29 25 54 | 12 3 15 3 6 9 40 31 71 2 0 2 1 0 1 i 172 112 284 i I

Length of Residence. I l_ Auckland. Christchurch. j I Dunedin (Seacliff). Hokitika. Nelson Porirua. Tokanui. Ashburn Hall (Private M.H.). Totally 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. 13 9 22 18 14 32 12 9 21 1 8 9 7 7 14 2 2 4 2 0 2 1 0 1 Oil M. 2 12 9 6 4 3 0 0 1 0 F. T. 1 3 7 19 7 16 7 13 4 8 4 7 1 1 2 2 2 3 1 1 M. 0 8 8 6 3 4 1 1 2 F. T. 1 1 4 12 2 10 1 7 1 4 1 5 1 2 i 2 6 2 M. 2 4 0 1 9 0 1 F. 0 1 6 4 2 6 i 6 T. 2 3 4 4 3 2 1 1 M. 1 1 0 1 F. 0 4 3 0 T. 1 5 3 1 M. F. T. 16 3 19 17 15 32 13 10 23 3 7 10 1 2 3 4 5 9 1 0 1 2 1 3 1 6 1 2 i 3 I M. F. T. M. 1 F. 0 T. 1 M. F. T. 21 5 26 53 36 89 49 37 86 31 27 58 9 19 28 20 19 39 4 4 8 6 3 9 3 4 7 1 1 2 3 0 3 2 "l 3 0 1 1 HTotals 56 50 106 56 50 106 37 37 36 73 36 73 33 33 12 45 12 45 12 12 8 8 20 20 3 7 7 10 io ! 60 44 104 60 44 104 ! 1 0 1 i 202 157 359 202 157 359

H.—7

Table XII.—Causes of Death.

11

Causes. Auckland. Christchurch. Dunedin (Seacliff). i Hokitika. Porirua. Ashburn Hall. Nelson. Tokanui. Totals. M. F. M. Y. M. If. M, Y. M. Y. M. F. M. F. M. Y. M. Y. I. General Diseases. Septicaemia Exophthalmic goitre Influenza Tuberculosis — Acute broncho-pneumonia Acute miliary tuberculosis Acute phthisis Of lung Peritonitis 2 2 2 I I 1 I I I 0 2 1 1 I 1 1 1 0 0 1 5 7 3 7 1 0 4 4 1 I 0 1 1 0 0 I I I 3 2 '2 5 0 4 1 0 Cancer Anaemia, pernicious Diabetes Alcoholism I 2 I 0 0 I 2 2 1 0 0 I 1 0 [i.j diseases of the nervous System. Mania, exhaustion from Melanoholia, exhaustion from . . General paralysis of insane Disseminated sclerosis Paraplegia, spastic Organic brain-disease Cerebral hemorrhage (apoplexy) Convulsions Epilepsy Delirious mania, aoute I I 7 0 16 10 0 2 1 2 I I 7 0 3 *> 1 I 0 1 1 0 0 0 0 1 0 1 0 1 5 1 1 0 l" 0 10 2 4 2 3 0 24 3 1 0 0 1 18 10 3 4 0 1 8 5 0 2 16 10 0 2 I 0 1 0 0 I 2 0 I 1 1 2 4 2 1 ' 1 0 2 III. Diseases of the Respiratory System. Broncho-pneumonia Hypostatic pneumonia Lobar pneumonia Empyema Bronchitis Pleurisy Asthma 3 3 I 0 3 3 I I 2 0 o 0 0 2 4 I 1 I 2 4 6 2 1 0 7 7 0 2 0 1 1 0 1 1 1 0 0 1 0 1 1 0 IV. Diseases of the Circulatory System. Valvular disease of heart Heart-failure Fatty degeneration of heart Cerebral embolism Cerebral effusion 3 2 I 0 0 1 1 0 3 2 I 0 1 0 0 2 3 0 2 0 2 4 8 6 4 0 0 2 0 1 1 0 0 1 1 0 V. Diseases of the Digestive System. Duodenal ulcer Chronic gastritis Dysentery Peritonitis Strangulated hernia Enteritis, aoute Colitis 1 I I 0 I 0 1 0 1 0 1 1 1 0 I 0 1 0 1 0 1 0 1 1 1 1 1 0 1 I I 0 VI. Diseases of the Genitourinary System. Bright's disease Nephritis, aoute Sarcoma of kidney I 0 1 0 I 0 1 0 1 0 1 0 1 1 1 0 5 1 0 1 1 0 VIII. Old Age. 11 7 11. 5 7 12 I 0 0 4 10 5 1 0 41 33 Senility II 7 IX. External Causes. Suicide by hanging Asphyxia Shock, following scalding in bath 2 I 1 0 0 0 2 0 1 0 I 0 X. Ill-defined Causes. Asthenia .. • - Died while absent on trial 1 1 52 34 1 1 I 0 1 1 0 0 1 0 3 1 52 34 33 13 oz Hit 29 25 12 3 3 6 40 31 2 °l 1 0 172 112

Ht—lt

Table XIII.—Former Occupations of Patients.

12

I H <g Occupations. s & •— 4-j Tl "rt fl C fl j M <£ <D .h o b *' 8 h fl- o rs o O \< 5 a a I a s o — &H X* e|; a 8 1 1— to I ' H •- £hh> . U —'& — * ; — CC Occupations. I|® DC J f.:| *.i-«. S § a| . <_ S I p [ W |iz; j Oh Eh EMal 1B8. Aboriginals .. . . i 8 Agents .. .. ! 2 .. 1 Baker .. ..I Bank-manager 1 Barber .. 1 . . Barman . . .. 1 .. j . . Blacksmiths .. 21 . . Bootmakers . . .. . . 2 Brewer ... .. .. 1 Bricklayers .. .. 1 2 . . Brickmaker .. 1 Builders .. .. .. 1 1 .. .. 2 .. Bushman .. .. 1 Butcher .. .. 1 { .. Cabinetmaker .. .. 1 Caretaker .. 1 .. Carpenters and joiners.. 3 1 2 1 .. 2i .. Carriers .. 2i .. Carters .. .. . . 2 3 ! .. Cattle-dealer.. .. 1 .. Cellarman .. .. ; .. . . 1 Chairmaker .. .. 1 Chemist .. .. I 1 Child .. 1 .. j .. Chimney-sweep .. 1 ..] Clerks .. .. 5 3 5.. 1 (i .. Compositors . . .. I 2- 2 .... I .. Cooks . . .. 3 1 2 . . Cordial-manufaoturer .. I Cycle-manufacturers I Dentists .. .. .. I .. .. 1 1 .. Dealers .. .. . . 2 Draper .. 1 Draughtsman '■ 1 Driver .. . • • . 1 Electrician .. .. I Engine-driver .. ., I; Engineers .. .. 2 . .'■ 1 .. .. 4J .. Factory hand .. .. 1 j j .. Farmers .. .. 13 41 9 I 113.. Firemen . . j I . . . . 2 . . Flax-mill hand j 1 .. Gardeners . . .. 2 4 I .. .. 4 .. Grocers .. 2 .. Grooms .. I .. .. I .. Gum-diggers .. 3 . .! .. .. ; Hotclkeeper . . . . I . . iron-moulders .. I 1 Jockey .. I I .. .. 1 .. i i i l '.'. i '2 2 3 1 3 '.5 2! 2 I .. i 8 3 1 1 1 1 2 2 .. 1 3 1 4 1 1 1 .. 1 9 2 5 1 1 1 1 I 20 6 6 I 2 3 2 I I I 1 1 7 I 42 3 I 11 2 2 3 I 2 I Labourers .. .. 40:25 31 2 I 52 .. .. 151 Laundry man .. .. I .. 1 I Dighthouse-keeper .. ..! .. 1 .. •• 1 Mason . . .. ........... 1 .. .. 1 Masseur . . .. 1 I Master mariner .. I 1 Meat-inspeotor .. .... 1 I Mechanics .. . . 12 1 .. .. 4 Medical practitioner .. ..' I I Merchant . . .. I; 1 Messenger . . 1' I Miners .. .. 2 .. .. 7 .. 1 10 Mining engineer .. I I Moulder .. 1 .. .. 1 No occupation .. 8 2 6 . . .. 3 .. . . 19 Old-age pensioners .. 4 . . 4 .. 1 1 .. .. 10 Painters . . .. 1 1 1 .. .. 3 Paper-seller .. .. .. I I Plumbers .. 3 .. .. 3 Police constable . . I Porter . . .. 1 ' Prisoner . . . . 1 lUbbitcr . . . . I 1 Saddler . . 1 . . . . I Salesman . . 1 . . ■.. I Sawmill hands .. 2 .. 2 Schoolboys . . .. I I 1 3 ; School-teachers .. 1 ., .. 1 .. 3 .. .. 5 Seamen • • • • ■ • 1 . . . . 1 4 . . . . 6 Settler . . . . I j Showman .. .. . . 1 1 Solicitors .. .. I . . 1 2 Soldier (returned) I ' Soldiers .. .. I .. 1 ..... 15 ..[ ,. 17 Stationers .. . ■ I I . . . . 2 Storekeeper .. I . . . . I Storemen .. 2 . . .. I .. .. 3 Sugar-boiler . . . • • • 1 ' Tailors .. 2 .. . . 2 Tannery hand .. 1 Tile-layer .. .. .. I ■• ' Tinsmiths .. . . 1 I . . . . 2 Upholsterers 2 .. 2 Wheelwright .. .. I Wool-sorter . . . . •. I ' Transfers . . . . I 2 4 I .. 2 .... 10 Unknown . . • ■ 2 I > I 2 1 8 4 I I 1 I I 2 1 2 31 I 1 1 1 6 4 1 ■> 7 I 1 1 52 1 1 1 1 3 I I 3 1 1 1 1 3 4 1 .. 1 I .. I l .. .. i 1 '.'. I .. i 2 .. 1 I 1 ■• l ! .'. .. 1 1 .. 4 9 ••I ' I I .. i .. .. 15 1 1 I 4j '.'. 2 2 'i 'i 13 '.. 2 I '.'. 4 .. 2 I " I 1 2 i I I 2 I I 2 I I 1 2 4 I . . I 2 1 .. I '.'. 2 . . I Totals .. ..131 69 90 14 8 146 .. 3 461 131 69 69 90 14 8 14 8 146 . . 3 Aboriginals . . - .. 2 . . 1 Clerk .. ' 1! . . Cooks .. .. .. 2| I .. Domestic duties .. 83 62: 50 12 II 91 .. Dressmakers . . .. .. 2 1 j .. Housekeepers .... 1 .. 1 .. Journalist .. . ■ 1 .. Knitter .. .... I '■ .. Machinist .. .. I . . Minors .. .. 2 12 ii i '.'. ?EM. lLES. . . |] ..' ... 7 5 . . 1 . . 3 . . . . . . 1 .. .. 2 ..! .. i .. ll 5 .. 3 .. .. I .. 1 .... . . 50 I 105! 50 5 I 2i 62! 50 o ll '.'. i! .. oil:: i .. 4 2 I 2 313 3 2 I I I 2 Music-teachers .. .. 1 .. I .... Ij 2 No occupation ■. 2 7 5 . , 1 5. . . . . 20 Old-age pensioners . . .. .. 3 ., • . 3 Schoolgirl .. ■ • • ■ j • ■ 1 1 .. .. 1 School-teachers 2 .. . . 3 .. .. 5 Sisters of Mercy I . . 1 ■ • • • 2 Telephonist .. 1 .. . . I Transfers 3 3 . J .... 50 I 57 2 7 2 20 3 I 5 .j 1 57 I .. 3 3 .. ..| .. i .'. 78 65 14 12 I Totals .. •• 90 78 65 II 12 105; 50 5 419 I ! 90 419

13

H.—7

Table XIV.— 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.

i ; " I I I Discharged. Discharged. Not Improved. Died. I I Remaining Average Numbers 31st December in resident, each Year. Percentage of Recoveries on Admissions. Percentage of Deaths on Average Numbers resident. Year. Admitted. Recovered. Relieved. Not Recovered. Relieved. 1876 1877 .. i 1878 1879 1880 1881 .. | 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 1914 1915 M. 221 250 247 248 229 232 267 255 238 294 207 255 215 230 230 234 231 281 320 379 296 300 355 264 335 373 352 454 340 399 401 421 434 447 639 455 593 543 526 461 F. T. 117 338 112 362 131 378 151 399 149 378 127 359 152 419 166 421 153 391 160 454 165 372 161 416 . 146 • 361 i 161 391 i 160 390 201 435 158 389 179 460 i 256 576 i 302 681 i 170 466 I 244 544 i 258 613 i 247 511 i i 263 598 I 224 597 192 544 237 691 i 240 580 280 - 679 277 678 279 700 325 759 376 823 ] 371 1,010 322 777 394 987 349 892 366 892 419 880 51. F. T. j M. F. 129 79 208 17 8 123 57 180 20 9 121 68 189 14 14 112 76 188 | 15 13 100 67 167 36 25 93 65 158 41 : 36 95 59 154 49 ; 32 102 78 180 13 : 20 89 | 77 166 17 9 95 76 171 10 5 99 60 159 11 17 103 78 181 34 17 116 92 208 31 28 93 53 146 31 30 98 88 186 23 17 88 74 162 33 24 89 . 76 165 21 17 101 89 190 17 12 107 76 183 ! 15 11 105 77 182 i 24 19 104 70 174 j 25 16 102 73 175 26 32 114 110 224 13 23 88 99 187 15 25 ! 103 96 199 39 10 125 104 229 40 17 135 99 234 26 15 144 101 245 41 25 157 106 263 24 13 149 121 270 ! 45 32 157 126 283 28 22 160 139 299 31 19 180 146 326 9 13 179 170 349 17 22 182 145 327 30 29 163 168 331 23 16 184 141 325 j 17 44 175 162 337 i 35 48 207 162 369 ' 27 29 202 157 359 , 26 34 T. 25 29 28 28 61 77 81 33 26 15 28 51 59 61 40 57 38 29 26 43 41 53 36 40 49 57 41 66 37 77 50 50 22 39 59 39 61 S3 56 60 3 8 8 5 10 18 73 12' • -i 2 3 . 12 14 8 9 55 128 20 17 104 7 25 33 10 84 9 23 6 53 9 29 164: 11 146 78 23 21 F. T. M. 6 12 36 2 9 42 if 3 6 51 :] 3 11 55 i-2 7 54 1 9 49 7 12 60 i 9 19 65 i 12 30 68 29 102 73 8 20 57 | .. .. 74 2 4 78 1 4 70 5 17 76 30 44 79 2 10 74 9 18 78 84 139 64 139 267 101 12 32 86 31 48 105 47 151 88 42 49 114 65 ! 90 99 3 36 102 9 19 : 120 12 96 ! 129 2 11 120 21 44 147 14 i 20 146 32 85 168 6 15 148 68 97 136 j 55 219 186 7 18 198 18 164 193 36 114 ; 196 16 39 ! 193 67 88 \ 172 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 93 892 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 72 174 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! 74i 222 ] 1,997 68! 204 ■ 2,083 97 283 2,1601 105 303 2,220! 87 280 2,273! 111 307 2,332 88 281 2,408: 112 284 2,448 F. T. M. F. T. M. F. T. M. F. T. 264! 783 491 257 748 54-53 66-01 57-56: 8-21 3-58 6-70 291 872 541 277 818 49-20 5080 49-72 7-76 : 758 : 770 : 319 957 601 303 904 4898 51-90 5000 848 \ 561 : 752 i 361 1,056 666 337 1.003 45-16 5033 47-11 825 4 74 ; 7'07 i 396 1,125 703 371 1,074 43-66 44-96 44-17 7-68 5-39 , 6-89 1 406 1,175 747 388 1.135 4008 51-10 44-01 629 360 5-55 442 1,269 796 421 1.217 35 58 38-81 36-75 7-53 451 6-49 :: 483 1,375 860 475 1,335 40-00 46-98 4275: 7-55 3-78 6-21 514 1,452 911 497 1,408 37-39 50-32 42-45 7'46 < 4-82 6-53 : 542 1,523 965 528 1.493 32-31 47-50 37-66 756 4-16 6-36 : 604 1,613; 984 559 1,543 4782 36-36 42-74 579 3-39 4-91 643 1,6961,034 613 1,647 40-39 4875 4361 715 440 6-13 640 1,6811,045 641 ,1,686 53-95 6301 57-62 756 4-05 6-16 687 1,7611,046* 660)1,707 40-43 32 92 37-34 669 4-54 586 702 1,7971,078 685 11,763 42-61 55-00 4769 705 511 6-29 734 1,8491,0891 699*1, 789J 3761 36-82 37-24 1 7-25 I 5-86 6-71 763 1.917 1,125 714§ 1,839$ 38-53! 48-10 42-42; 6-58 476 587 810 2,0391,172 758 1,930 35-941 49-72 41-30! 6-66 333 : 5-23 '■ 860 2,168 1,241 812 2,053 3963 4518 4103 516 4-31 482 1 885 2,214 1,313 849 2,162 41-27: 46-66 43-40! 769 4-94 661 925 2,3151,347 882 2,229 3741 44 02 39-82 6-38 3-63 5-29 990 2,43011.411 944 2,355 35-92 3782 3669 7-44 455 628 1.008 2,4801,438 973 2.411 44-88 5189 48-07 6-12 6-17 , 6-14 1,045 2.557 1,487 1,004 2,491 32-31 44 33 37-58 767 4-28 ; 630 1,091' 2,6721,534 1,049 2,583 30-74 36 50 3327 6-45 : 4-38 ! 5-61 1,119 2,7731,622 1,094 2,716 39-06! 46-64 42-17 6-29 6-58 : 6-41 1,133 2,8481,671 1,114 2,785 38 35 51-56 43-01 718 4-94 6-28 1,188 2,9591,741 1,160 2,901 40-56 44-69 42-17 7-41 3-79 5-96 1,237 3,0381,780 1,198 2.978 46-18 44-17 45-34 6-74 5-84 6-38 |1,276 3,1121,796 1,232 3,028 4139 48-21 44-19 818 5-44 707 1,306 3,2061,823 1,265 3,088 39 75 47-73 42-94 8-01 6-71 7-48 1,331 3.2401,851 1,285 3,136 , 44-29 57'68 4967 908 \ 4-98 7-39 1,417 3,4141,894 1,346 3,240' 4225! 4591 4382 7'81 ' 550 6-85 1.465 3,548 1,970 1,404 .3.374 42-72 57-24: 48-74 6-90 4-84 6-00 1,510 3.6702,028 1,445 3,473 38-40 46-18! 41-50 9-17 6-71 8-15 1.536 3.7562.105 1.496 3.601 36-38 53-00: 43-27 9'41 7-02 8-41 !l,640 3,913 2,146 1,551 3,697 40-17: 37-01 3874 8-99 5-61 757 1,632 3,9642,252 1,597,3,849 37 55' 50-94 42-98 8-70 696 7-98 1,703 4,1112,309 1,641 3,950 40-67! 45-12 42-51 8-36 5-36 7-11 ,1,752 4,2002,391 1,703 4,094 44-89 4321 44-27 7-19 658 ; 6-94 cterty -i 13,4519,140 22,591 9.140 22.591 t |5,068 .3,960 9,028 1,009 847 1,856 .1,258, 917 .2,175 4,150 1,918: 5.068 3.960 9,028 1,009 847 1, ,856 1 ..258, 16,068 In mental hospitals, 1st January, 1876 In mental hospitals, 1st January, 1916 M. F. T. 482 254 736 .. 2,448 1,752 4,200

H.-7

14

Table XV.—Principal Assigned Causes of Insanity.

Table XVI. —Showing the Admissions, Readmissions, Discharges, and Deaths from the 1st January, 1876, to the 31st December, 1915.

Table XVIII.—Expenditure, out of Public Works Fund, on Mental Hospital Buildings, etc, during the Financial year ended 31st march, 1916, and Liabilities at that Date.

Causes. 1 t •a 3 1 1 1 II 3 « «J W ■< t a i i I i 1 o to '3 cl 1 o H W HhS gaSS 1 3 01 o ■3.in 1 § Heredity Congenital Previous attaek Puberty and adolescence Climacteric Senility Pregnancy Puerperal state Mental stress, sudden . . ,, prolonged Privation Sexual excess Alcohol Drug habit Syphilis Influenza Toxaemia Traumatic Organic brain-disease . . Epilepsy Apoplexy Arterio-sclorosis 111 health (undefined) . . Unknown Transfers M. F. M. [•'. M. V. .. 14 17 2 3 11 9 . . 15 7 5 8 8 6 8 II 7 13 4 4 5 0 0 2 0 5 0 I .. 21 8 17 12 8 II 0 4 0 4 0 5 14 .. 11 11 2 3 3 2 10 '.'. '.'. .. 20 3 7 2 16 0 .. 7 1 '5 0 6 0 5 2 0 1 10 10 2 0 2 1 5 5 1 1 5 2 3 1 10 0 2 j 4 7 6 14 .. 23 13 : 10 I I 10 7 112 3 4 3 M. V. 0 4 1 II M. I''. 2 7 M. I'\ 40 27 10 6 9 14 5 8 0 11 9 5 0 I 0 4 F. M. Y. M. H'. M. F. 2 2 71 69 39 27 24 38 15 12 0 26 0 I 58 41 0 1 0 19 15 20 26 0 1 10 74 13 10 10 32 2 5 3 0 1 8 0 2 1 15 12 6 1 3 1 10 23 0 I 65 40 0 I 11 58 2^ 7 4 0 1 2 2 1 0 ! 0 2 1 2 5 !) I 5 0 I 0 1 1 3 „" I •• ! I 0 I 2 "7 0 I 7 3 I 2 0 26 7 7 I 0 18" I 0 I I 0 I 1 0 ! ■' 3 0 c 0 4 4 3 0 2 I i 4 I I I 0 i o 18 7 2 0 0 50 0 I o I Totals .. 131 90 69 78 90 65 14 14 8 12 1.46 105 0 50 3 5 3 5 461 419

Persons admitted during period from 1st January, 1876, to 31st December, 1915 .. .. .. ... Readmissions M. F. T. 10,741 6,937 17,678 2,710 2,203 4,913 M. F. T. Total cases admitted 13,451 9,140 22,591 Discharged cases— Recovered Relieved Not improved Died 5,068 3,960 1,009 847 1,258 917 4,150 1,918 9,028 1,856 2,175 6,068 Total eases discharged and died since January, 1876 11,485 7,642 19,127 Remaining, 1st January, 1876 482 254 736 Remaining, 1st January, 1916 2,448 1,752 4,200 Table XVII.—Summary of Total Admissions : Pi IRCMNTAGE OF CASES SINCE THE YEAH 1876. Males. Females. Both Sexes. Recovered .. .. .. 37-68 Relieved .. .. .. 7-50 Not improved .. .. .. .9-35 Died .. .. .. .. 30-85 Remaining .. .. .. 14-62 10000 43-33 39-96 9-27 8-21 10-03 9-63 20-98 26-86 16-39 15-34 1UUUU 100-00 100-00 100-00

Auckland 'I'okanui .. Porirua .. Christchurch Seacliff .. vVaitati .. Nelson .. Mental Hospitals. Net Expenditure for Year . ended 31st Marcb, 1916. £ 2,774 10,640 17,518 15,157 6,721 671 1,417 Liabilities on 31st March, 191H. £ 5 176 1,000 750 "5 Totals 54,898 1,936

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, 1916.

Table XX.—Showing the Expenditure for the Year 1915.

15

Mental Hospitals. 1877-1908. i 1908-9. 1909-10. 1910-11. 1911-12. 1912-13. 1913-14. 1914-15. 1915-16. Total Net Expenditure. 1st Julv, 1877, to 31st March, 1916. I i I I I i I Auckland Reception-house at Auckland .. Motuihi Island Tokanui Wellington Wellington (Porirua) Christchurch Seacliff Waitati Dunedin (The Camp) Napier Hokitika Richmond Nelson £ £ 105,687 1.318 468 62 29,549 107 123,167 2,247 117,114 4,144 146,418 5,598 573 87 4,832 59 147 3,465 1,097 17,275 1,675 549,792 15.297 £ 1,524 1,788 10,348 1,133 2,797 256 1,992 19,838 £ 463 2,531 166 8.121 1,063 4 6 353 12,707 £ 105 105 4,303 1,762 412 1,480 442 200 8,809 £ 135 105 21,935 9,550 4,867 5,382 4,007 200 46,181 £ 8,908 561 8,874 1,951 616 3,257 1,634 200 26,001 £ 23,434 10,379 6^552 5,107 7,413 911 200 53,996 i £ 2,774 10,640 17,518 15,157 6,721 671 1,417 54,898 £ 144,318 5,059 561 56,297 29,656 181,216 149,613 179,070 8,325 4.891 147 3,727 1,097 23,512 787,519 Totals 19,838 12,707 53,996 I 54,898 787,519 8,809 46,181 26,001

Items. Auckland. Christchurch. Dunedin (Seacliff). Hokitika. Nelson. Porirua. Tokanui. Total. Inspector-General Deputv 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 £ s. d. 25 4 0 700 0 0 315 0 0 394 2 11 197 18 4 9,490 5 0 11,139 6 3 2,271 19 1 2,474 1 8 136 17 6 12 0 0 534 15 4 381 9 8 2,570 6 9 £ s. d. 6 6 0 700 0 0 237 2 6 432 10 0 184 3 4 11,048 14 4 9,186 2 6 2,826 7 6 2,542 18 0 123 4 11 5 16 0 789 16 9 471 15 1 3,661 14 8 £ s. d. £ s. d. 14 14 0 17 17 0 700 0 0 260 0 0 1,005 17 4 225 0 0 454 18 2 207 1 8 98 6 8 16,353 6 1 3,366 18 1 10,602 8 3 3,484 15 9 2,936 13 3 115 18 6 2,873 5 4 269 2 2 278 8 2 1 14 7 2 17 6 1 13 0 3,073 8 1 109 7 5 I 2,515 2 10 3 5 0 5,889 2 6 444 5 6 £ s. d. 7 7 0 455 0 0 121 9 5 125 0 0 3,004 5 10 2,525 16 6 441 12 3 568 1 4 74 16 11 248 2 9 627 17 9 802 9 0 £ s. d. 25' 4 0 700 0 0 418 1 2 418 17 5 148 15 0 13,984 13 9 10,368 14 7 2,238 1 1 2,585 1 5 199 17 5 8 18 6 2,340 4 0 527 7 7 3,715 12 9 £ s. d. 737 10 0 3,171 8 3 1,802 18 10 298 4 2 236 17 4 7 15 0 1.883 8 11 154 15 7 650 14 11 £ s. d. 1,000 0 0 750 0 0 1,114 10 0 1,120 10 2 598 6 0 96 12 0 4,252 10 0 1,976 1 0 225 0 0 1.821 17 11 961 5 0 60,419 11 4 49.110 2 8 11,128 15 10 11,549 7 3 822 14 6 31 5 0 8,979 3 3 4,681 13 6 17,734 6 1 Totals Repayments, sale of produce, &c. 30,643 6 6 10,674 16 6 32,216 11 7 46,907 3 2 9,919 4 3 ! 14,412 3 8 8,398 3 8 1,670 9 4 9,001 18 9 : 37,679 8 8 2,077 8 3 j 12,145 18 3 8,943 13 0 178,373 11 6 886 3 5 51,786 3 8 Actual cost - .. -- i 19,968 10 0 22,297 7 4 32,494 19 6 | 6,727 14 4 6,924 10 6 I 25,533 10 5 8,057 9 7 I 126,587 7 10 * Not included in Table XXI.

H.—7.

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

Approxfanate ('out of Paper. —Preparation, not givun ; printing (UOO copies), t!7 Ills.

By Authority : Marcus F. Marks, Government Printer, Wellington.—l9l6,

Price 6d.]

16

Mental Hospital. I Bedding SpMtflle Provisions. Salaries. and ?„*• and Dis- sprnts Ale, Clothing. Cle a a^ g pensary. ,«£,_ Farm. Necessaries Renav Total CoBt ! Total Cost I Total Cost Buildings f,r„^ a ™!7 Total Cost " e L ?„,. perHead.lees; per Head, ipei-Head.less Decrease and =Sh lid Per merit 3 toi Eepavmcnts , ]ess - Heceipts of in Repairs. e 5ia„eo U s Patient. 1 " for Main- Receipts of I all kinds pre- 1915. cenaneous. tenance. tenance. all kinds. ' vious Year. Increase in 1915. Auckland Christchurch Dunedin (Seacliff) Hokitika Nelson • Porirua Tokanui . £ s. d. .. ; 11 17 6 .. 13 12 11} .. , 10 19 3} .. 14 3 3f .. , 13 1 9 .. 10 18 9 .. ! 18 19 6f I £ s. d. 11 17 2 18 14 8} 19 7 6 16 2 7} 19 4 9} 16 11 1} 41 2 11 £ s. d. £ s. d. ' £ s. d. 2 12 9 2 8 5} 0 2 11 3 15 6f440 03 8 219 5 3 0 9 0 5 9 1 1 10J 0 9 5 0 0 1| 2 18 10} 2 5 9} 0 7 9 2 14 6* 2 7 2} 0 4 2} 2 9 10} 3 2 9} 0 1 7} £ s. d. I £ s. d. £ s. d. £ s. d. £ s. d. £ s. d. £ s. d. £ s. d. £ s. d. £ s. d. £ s. d. 0 0 3 0 11 4f 0 8 If 2 14 9f 32 13 4} 10 6 10} 22 6 6 21 5 9}j 19 8 9} .. 1 16 11} 0 0 2 13 5f, 0 14 0J 5 8 9f 47 17 4f 10 4 9}! 37 12 7} : 33 2 7} 35 19 3} 2 16 7}i 0 0 0} 3 3 0} 2 12 0} 6 1 9} 48 10 If 11 11 8} 36 18 5} j 33 12 Of! 32 1 2} .. j 1 10 10} 0 0 1} 0 8 lOf 0 0 3} 1 16 IJ 34 2 9} 5 15 9 28 7 0} I 27 6 11 24 0 4§ .. 3 6 6} 1 5 8} ; 3 5 Ofi 4 3 If! 46 12 10 9 16 6}j 36 16 3f I 35 17 6fl 33 17 If . . 2 0 5 0 0 2} 2 9 4* 0 11 1} 3 18 4fJ 39 14 11 11 6 Of! 28 8 10} j 26 18 8 ' 25 7 2} .. 1 11 5J 19 16 6} 1 12 7 6 17 0 94 2 10} 3 6 3}! 90 16 7} | 84 16 3f! 81 8 4} .. ! 3 7 11} ■ : ■ . Averages ..12 1 11 17 3 7} 2 10 10} 2 14 9} 0 4 1 0 0 If 1 3 Of 2 4 2} 4 7 41 42 16 1J10 7 7Jj 32 8 5| 30 1 0 | 28 19 5 1 1 7 Table XXIa. Including first five items in Table XX 43 18 «i : 31 3 7 I 30 4 6} 0 19 Oi Table XXIb. i I ; Richmond Home for 15 6 1' 43 3 11 0 17 2}j 3 1 11 Feeble-minded Patients on probation 14 17 8 37 13 9}! 1 10 4f! 1 12 6} 0 2 at The Camp ! j H 1 18 2} 2 9 10} 0 2 5 14 4 70 1 4f 6 2 5} 64 11 8410 16 6 5J 59 5 24, 54 9 3f 63 10 10 64 11 5} 61 16 llf 9 1 6} .. 2 14 5f