MENTAL HOSPITALS OF THE DOMINION (REPORT ON) FOR 1927.

Appendix to the Journals of the House of Representatives, 1928 Session I, H-07

H.—7.

1928. NEW ZEALAND.

MENTAL HOSPITALS OF THE DOMINION (REPORT ON) FOR 1927.

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

The Hon. the Minister in Charge or Department for the Care op Mental Defectives to His Excellency the Governor-General. Sir, — Wellington, Ist July, .1928. I have the honour to submit to Your Excellency the report for the year 1927 of the InspectorGeneral of Mental Defectives. I have, &c., J. A. Young, Minister in Charge of Department for the Care of Mental Defectives.

The Inspector-General to the Hon. J. A. Young, the Minister in Charge of the Department for the Care of Mental Defectives. Sir, — Wellington, Ist July, 1928. I have the honour to present my report for the year ending 31st December, 1927. During the first five months of the period under review I was absent from the Dominion on a visit to Great Britain, America, and the Continent of Europe, where I acquainted myself with recent developments in connection with the problems of mental deficiency and the treatment of mental unbalance. My observations and recommendations on these matters have been the subject of a separate report. In October last I assumed control of this Department upon the retirement of Sir Truby King, whose connection with the Government had extended over a period of nearly forty years. It is not necessary that I should refer here to the very valuable work which Sir Truby has rendered to the community during his long term of public service, but it is fitting that I should pay tribute to the breadth of vision, untiring energy, and conspicuously unselfish devotion to duty which he brought to bear upon his direction of the Department, and which are reflected in the provisions made during the past triennium for the reception, classification, and treatment of the mentally afflicted. The Importance of Early Treatment. The importance of getting into touch with cases of mental disorder long befote they are " certifiable," and the assumption of treatment at a stage when there is every chance of a successful issue, is being more generally recognized, and this has resulted in an extension of out-patient clinics, whose functions are preventive as well as curative. These clinics are doing excellent work n the main centres of New Zealand, and there has been a rapid and progressive increase in the number of consultations since their inception. Many cases, however, even in the pre-certifiable stage require observation and treatment of a kind which involves residence in an institution, and in order to ensure success and overcome ingrained popular prejudice the accommodation provided for this purpose must be such as will not entail any association with patients of a degraded type. These requirements are being met in many countries by the erection of entirely detached clinics or psychopathic hospitals, associated, as a rule, with general hospitals, and I visited many of these on my recent trip, such as the Phipps clinic at Baltimore, the Maudsley in London, and that at

I—H. 7.

H.—7.

Utrecht, Holland. In my recently published report upon mental deficiency and its treatment, I said " There is no universal ' best system ' in this or the allied problem of dealing with the insane, and each country must evolve its own method, guided and restricted by its own peculiar racial, geographic, and economic situations." In New Zealand we have tackled this problem in a manner which in many ways is unique, and I am satisfied that we are doing so on sound lines. The reception cottages and neuropathic units established at the main centres are meeting the demand for suitable accommodation for those early cases, and associated, as these already are at Porirua, with a treatment centre, the scheme is much more suited to the needs of our relatively small and scattered population than would be the erection of residential clinics of the types which I have mentioned. Observation Blocks at Hospitals. Arrangements were concluded with the Police Department last year to ensure that no patient should be conveyed to hospitals in police vans, and that officers on escort duty should wear mufti ; but there is still a serious flaw in our system —patients are still occasionally lodged in prison pending examination and committal. This can only be remedied by the erection at the main general hospitals of small observation blocks to accommodate between six and a dozen patients pending determination of their cases. Voluntary Boarders. Many of the cases first seen at the clinics take advantage of the voluntary-boarder section of our Act, which allows them to enter a mental hospital of their own free will. The number of voluntary boarders admitted annually has increased steadily since 1911, when we adopted the principle, and last year no fewer than 197 persons, or 17-25 per cent, of our total admissions, secured early treatment in this way. The advantages of voluntary admission are that the individual does not feel that he is detained against his will; he comes in furtherance of his desire for treatment, in which he, therefore, co-operates. He arrives at an early stage, is more likely to recover, and the duration of his stay in hospital is much shorter than that of the " certified patient." Apart from the benefit to the person concerned, these are matters of considerable economic importance to the community. We are much in advance of Great Britain in regard to this matter. In England the voluntaryboarder svstem is applicable only to those who can afford to pay for .treatment in private mental hospitals. In Scotland there is legal provision for the admission of voluntary boarders to the district (public) mental hospitals, but, as no Government subsidy is payable in respect of persons admitted in this way, the provision is largely non-operative, and the patient has little chance of treatment until he becomes certifiable and therefore less recoverable. Admission as voluntary boarders is strictly limited, and rightly so, to those who can fully appreciate the nature of and the obligations imposed by the request which all applicants are required to sign, but it is important to realize that many persons who are too confused or unbalanced to sign a form would benefit by treatment at an earlier stage than that at which we now receive them. Certification. Under present legislation the only alternative to voluntary admission is (except for minors) the issue of a reception-order after personal examination by a Magistrate and two doctors. This procedure, which is commonly known as certification, was originally devised in the days when custody, not treatment, was the keynote of asylum administration and was framed in order to protect the public from being kidnapped into madhouses. Now that treatment, particularly early treatment, is the objective, this cumbersome, and in any case ineffective, anachronism merely defeats its own object. Instead of protecting the public, it delays the institution of treatment at the stage when it is most likely to be effective. The stigma which looms so largely in the public mind is very much related to certification. Patients on recovery, and their relatives in the early stages, feel humiliated at having to take the patient to Court to see the Magistrate, whose functions are largely related to wrong-doing and the punishment of offenders, and they put off taking the necessary steps until disorder becomes so pronounced as to demand drastic action. The diagnosis of disease and the tendering of advice to the relatives as to appropriate treatment are duties which can be competently performed only by medical men of experience, and nothing is gained by the personal interview between the patient and the Magistrate. Without exception I have always found the Magistrates most kindly and considerate to the patients and their relatives at these interviews, but there are often embarrassing delays and prolonged waiting about Courthouses, which adds greatly to the distress of those most concerned. In remote country districts some difficulty is often experienced in getting the two Justices who may in certain circumstances act for a Magistrate. In Scotland, where one never hears the word " stigma," these difficulties do not exist, because upon the application of the relatives, accompanied by two medical certificates, the patient may be received in the mental hospital and detained for three days. The documents are at once sent to the Sheriff (Magistrate), who sees that the legal formalities have been complied with and then issues a detention-order. I may add that there is no record in the Scottish law-courts during the last seventy years of any person having been improperly detained in a mental hospital. In Scandinavia the procedure is essentially the same. I would strongly urge that an amendment be made to our Act in the direction of adopting a procedure similar to that which works so admirably in Scotland.

2

H.—7

Mkdical Staff Changes. Dr. Macpherson, Acting Medical Superintendent at Tokanui, severed his connection with the service in December owing to ill-health. Dr. Macpherson entered the Department during the war period in order to free a younger medical officer for service abroad. Although he was then at an age when most men seek retirement, Dr. Macpherson has given the Department twelve years of zealous and devoted work, and he demitted office universally beloved by patients and staff. Drs. H. D. Hayes and T. W. J. Childs were selected in England for appointment. Each of these gentlemen holds the Diploma in Psychological Medicine, and from their previous records and their work since arrival in the Dominion, I consider the Department is to be congratulated 011 securing their services. Alterations, Impbovements, and Additions. Auckland. In view of the declared policy of evacuating the present institution within a limited period, capital expenditure is being strictly limited to items which are necessary for the immediate needs of the institution. 1. A cottage in the Wolfe Home paddock has been renovated for occupation by the engineer. 2. An excellent veranda has been added to the Female Sick Ward, and is proving a great boon, especially to the aged sick. 3. Considerable improvements have been effected in the kitchen. 4. Further provisions to ensure adequate ventilation of wards and dormitories. Tokanui. 1. The old airing-court fences have now been removed, thus bringing the institution into line with modern ideas as to the removal of unnecessary restrictions, material as well as regulative. 2. A bowling-green has been constructed and opened for play. 3. A sports-ground is in course of preparation. 4. A canteen has been opened for the use of all patients and their visitors. 5. A morgue has been built. Porirua. 1. An Assistant Medical Officer's cottage has been erected. 2. A treatment centre has been opened at Rauta. 3. A Nurses' Home, is now in course of erection, and its completion will greatly increase the amenities enjoyed by the nursing staff. 4-. A great deal of general maintenance and repair work lias been carried out. 5. The change-over to the Mangahao hydro-electric supply has been completed. 6. Sanitary additions to Male 3 Ward. Christchurch. 1. The new pioneer unit for fifty male patients at Templeton has been finished and should be in occupation shortly, thus permitting of greatly improved classification in the main institution. 2. An Assistant Medical Officer's cottage is in course of erection at Hornby Lodge. 3. The male neuropathic unit at Hornby has been completed, and marks a great advance in the facilities for treating early cases. 4. Rearrangement of laundry and the installation of an additional drying-press. Nelson. 1. A large sleeping-veranda has been added to " El Nido," thus allowing continuous open-air treatment to the weakly boys, who derive much benefit. 2. Alterations to the administrative block at Nelson. 3. Alterations to improve the sanitary arrangements. Seacliff. 1. A commencement has been made with the new stores, laundry, and kitchen blocks, and their completion will remove a. handicap under which Seacliff has laboured for many years. 2. Additions to farm buildings at " Cherry Farm " and Seacliff. 3. Completion of neuropathic unit and reception cottage. 4. Erection of Assistant Medical Officer's cottage. Hokitika. 1. Alterations to Aorangi Ward. 2. Roadmaking and reclamation of farm land. 3. Construction of a bowling-green. The New Institution foe Auckland. We have now entered into active occupation of the estate at Puhitahi on which is to be erected the new Auckland institution. The necessary buildings have been erected for the pioneer patients, twenty of whom, along with staff, are already engaged in the preliminary operations of draining swamps, fencing, and planting shelter-belts.

3

H.—7

Suitable sites have been marked out for the villas of the institution, and there should be little delay in commencing our main building programme. In the meantime surveys have been completed for the water-supply. Overcrowding op Patients. [t is my duty to request that a considerable increase should be granted in the annual financial provisions not only to allow the development of the new Auckland institution, but in order to mitigate in some degree the very serious difficulties resulting from lack of proper accommodation for patients. Overcrowding is not a matter of sudden growth ; it has frequently been referred to by my predecessors, but the slowing-down of building operations during the war and its financial aftermath has rendered the position, present and prospective, very acute. The shortage of space is affecting all the institutions, but particularly Porirua, Auckland, Christchurch, Seacliff, and Nelson. The extreme seriousness of the position will be realized when I state that we have 820 patients in excess of accommodation. Our estimated annual increase is over 200 patients, so that by the end of 1928 the deficiency will exceed 1,000, or the equivalent of a large institution. In the absence of a definite building programme, which must be spread over many years, the position can only become worse, and I submit the following matters for your consideration. The excess of 820 is distributed amongst the various institutions as shown in the following table :— Males. Females. Total. Auckland .. .. .. .. 58 59 117 Tokanui .. .. .. .. 34 20 54Porirua . . .. .. .. 56 200 256 Nelson .. .. .. .. 47 33 80 Hokitika .. .. .. .. 3 3 6 Christchurch .. .. .. .. 64 69 133 Seacliff . . .. .. .. 78 96 174 Totals .. .. .. .. 340 480 820 Auckland. —The Government has given an undertaking to remove this institution within a limited number of years. The number of persons actually resident in the institution on the 31st December, 1927, was 1,163. At a conservative estimate the total population in 1937 will not be less than 1,400. No mental hospital should accommodate more than 1,000 patients, but if in all the circumstances we allow for 1,250 we should still have an excess of 150 at the end of the period. Consideration should therefore be given to the securing of a site for a hospital to serve the needs of North Auckland. Tokanui. —The existing excess is 54, but, as the institution now admits patients direct, building must be carried on to keep pace with the natural increase. A contract has been let to provide for 150 patients, but a large part of this space will be absorbed by patients transferred from Porirua. Porirua. —The worst overcrowding exists at this institution, where we have 256 in excess. The total number of patients actually resident is 1,410. I hope to transfer 100 patients to Tokanui in 1929. and accommodation for 40 more will be set free on the completion of the Nurses' Home, but these steps will leave the position at the end of the year very much the same as at present. There is practically no room left at Porirua for additional buildings, even were such desirable, and the foundation of a new institution in the Manawatu district is necessary. Nelson (with Stoke Farm). —This institution is overcrowded to the extent of 80 patients, but the position is even worse than the figures indicate. The scheme devised by myself seven years ago to dedicate the Nelson Hospital to the use of juvenile patients and to develop Stoke Farm as an up-to-date villa mental hospital received a serious setback owing to the success of a popular agitation against new buildings at Stoke. The Boys' Ward is gravely overcrowded, and the classification at Stoke is disorganized. Plans are in preparation for three villas at Stoke, and their completion should be urgently pressed forward. Hokitika. —The population here tends to decrease, and the present slight excess will gradually be overcome without incurring any expense. Christchurch. —Is overcrowded to the extent of 133 patients. Some relief will come immediately with the transfer of 50 workers to the new building at Templeton, but there will still be considerable excess at the end of the year. Seacliff. —The population of Seacliff actually in residence at the 31st December, 1927, was 1,192, representing overcrowding to the extent of 174 patients. Some temporary relief may be gained by the erection of one or possibly two villas at Waitati ; but there is little room available, and we shall again have to consider the establishment of an institution elsewhere. An undue amount of the work of the medical a,nd nursing staff is devoted to the task of overcoming the discomforts and dangers caused by overcrowding, and this detracts from the effectiveness of their legitimate activities in regard to the treatment of the patients. I desire, in conclusion, to acknowledge the loyal support I have received from the various Medical Superintendents, and my thanks are due to the Head Office staff for their unfailing helpfulness at all times. I have, &c., Theo. G. Gbay.

4

H.—7

MEDICAL SUPERINTENDENTS' REPORTS. AUCKLAND MENTAL HOSPITAL. Dr. Prins reports : — I have the honour to present to yoii my annual report for the year ended 31st December, 1927. During the year there have been 1,375 patients under care, with a weekly average of 1,105 resident in the Hospital. The new cases numbered 227 ; of these, 179 were admitted for the first time. The general health has been good, the only unusual features being a slight outbreak of measles. The deaths numbered 99, 53 of these being over sixty years of age. Senile decay and heartdiseases were the principal causes. A total of 96 voluntary boarders have been under care, 47 being new cases and 8 readmissions. The discharges amongst these numbered 36, and deaths 7. In only two cases was certification resorted to. The large increase in voluntary boarders, and the number discharged, is very satisfactory, and shows the advantage of a recognition of the illness and a voluntary request for treatment. Apart from these the discharges numbered 91, 67 being recoveries. The two most important improvements during the year have been the opening of the Nurses' Home and the new unit for the treatment of suitable female cases. The nurses now have suitable quarters and conveniences, which have been too long denied them. The Male Hospital Ward continues to be used as an admission ward for every possible case, and the reaction to the freedom allowed continues to be good, there being comparatively little trouble from patients breaking their parole. The Wolf Home is used as an admission ward for every possible female and occasional suitable male cases. The policy of " hospitalization "is being carried out as much as possible. Every effort is made to impress on new cases that they are in hospital because they are ill, and that the object of their being there is to be made well again. During the past year extensive painting has been carried out throughout the whole building not only by our own people, but a.lso by contract. A much needed veranda is being added to the Female Infirmary. The steam-kitchen is being renovated, and rearranged generally. It is hoped to shortly rearrange, enlarge, and provide more up-to-date machinery for the laundry. It is intended also to carry out painting and improvements in Female 3 Ward. Lectures have been given to the nurses and attendants during the year, and a total of nineteen sat for the last final examination. The general recreation of the Hospital has been carried out. The annual picnic to Henderson consisted of a party of 446. During the winter months the usual fortnightly dances were held, concert parties entertained us, and a performance by the Little Theatre Society was much appreciated. The Salvation Army and Avondale Bands have played on Sunday mornings. Tin usual picture parties have visited town, seats being placed at our disjjosal by the management. During the summer months there have been the usual picnic and swimming parties. The bowlers have played their home and away matches, apart from their usual games. Tennis and croquet are very popular, and tournaments were played. The " daylight-saving " is a great advantage to the Hospital generally. The Christmas tree was a great success, the members of the Optimists' Club providing the entertainment. During the year the Auckland Patriotic Society very kindly donated £10 for sports requisites, and Mrs. Winstone was also kind enough to donate a similar amount for general sports requirements. Mr. J. Alexander also kindly provided funds to assist the periodical parties. Papers, periodicals, gramophone records, golf clubs and balls, tennis racquets and balls have been received from various donors, and have all been put to good use. The Auckland Clinical Society held one of their meetings at the Hospital, and a large party of Public Health nurses also visited the Hospital. The clinic conducted at the Public Hospital continues to be well attended. Mr. Blomfield and Mr. Alexander have visited the Hospital frequently. Mrs. Armitage, Mrs. von Sturmer, Miss Jackson, and Sister Hannah have visited the female side. [ have to thank all my staff for their help and co-operation in carrying on the work of the Hospital. TOKANUI MENTAL HOSPITAL. Dr. Childs reports : — I have the honour to submit my report for the year ending 31st December, 1927. On the Ist January there were 337 patients (213 males and 124 females) in the Hospital. The number under care during the year has been 398 (males 259, females 139), the average resident number being 337 (males 214, females 123). The cases admitted numbered 61. Of these, 18 (males 15, females 3) were transfers from other hospitals, while 36 (males 25, females 11) were admitted for the first time. Thirty-eight patients (males 26, females 12) were discharged, 11 of these being transferred to other institutions. The d eaths numbered 15 (males 12, females 3), there being no special contributing factor At the end of the year the number on the register was 345 (221 males, 124 females).

5

H.—7

During the year 17 voluntary boarders (males 6, females 11) have been under treatment, 7 being new admissions (males 3, females 4). One male and 1 female have been readmitted, and 3 males and 3 females have been discharged. One male voluntary boarder died. Dr. Macpherson, whom I relieved in October on account of ill health, resigned on the Ist December. His departure is universally regretted, and on relinquishing his position as Superintendent he was entertained at a social evening, and both he and Mrs. Macpherson received several presents from the staff. No. 2 Camp has been evacuated and handed over to the Prisons Department, and No. 1 Camp has again been occupied by patients, 10 males being accomodated there. A new mortuary has been erected. The ventilation of the Hospital has been improved, and the result noted in the dormitories and side rooms. The picket fences in front of the male and female block have been pulled down, and the shut-in airing-courts done away with. This gives the patients considerably more freedom and improves their outlook. Walking parties have been started and have proved successful, all patients capable of it nowgetting sufficient exercise. The recreation of the patients has been attended to. Occasional concerts and the usual fortnightly dances were held during the winter. A radio set, presented by the Sunshine League, has been installed in B Ward, and loud-speaker extensions have been connected up in F1 and FH Wards. A cinematograph-machine was installed during the year and has proved a great success, a weekly picture entertainment being held, which is regularly attended by the patients from the camp as well as those at the main institution. I have to thank the Australasian Films, Ltd., for their generosity in supplying good-class film programmes free of charge. Croquet sets have been purchased, and the game has proved popular. During the warm weather picnic swimming parties have been frequently held and have been very popular with the female patients. The annual picnic was held at Wai keria, sports and games being indulged in, and an enjoyable day spent. The Official Visitors, Mr. Battson and Mrs. Woods, have given help in providing amusement and gifts for the patients, and thanks are due to them for the interest they take in the patients. The work on the farm has proceeded steadily. In addition to the usual routine work, fencing, draining, and roadmaking operations have been carried on throughout the year. All departments of the staff deserve great credit for the manifest interest they take in the patients' welfare, for their endeavours to make the Hospital as pleasing as possible, and for the ready way they adapt themselves to changing conditions. PORIRUA MENTAL HOSPITAL. Dr. Hayes reports : — I have the honour to present my report for the year 1927. On the Ist January there were 1,322 patients on the register (723 males, 599 females). At the the end of the year there were 1,408 patients (762 males, 646 females). The total admissions for the year were 291 (158 males, 133 females), and the total discharged recovered were 97 (50 males, 47 females). The total under care during the year was 1,613, and the number died was 81. The principal cause of death was senile decay. At the beginning of the year there were 58 voluntary boarders (27 males, 31 females), and at the end of the year 67 (27 males, 40 females). The total of voluntary boarders admitted was 37, readmitted 26, discharged 47, committed 2, and died 5. During the year the following buildings have been completed : The admission cottage, " Bella Vista," the new male villa, and a residence for an Assistant Medical Officer. The opening of the cottage and the villa has completed the neuropathic unit, and the examination and treatment of all admissions is now effected in this unit, excepting such cases as have an obviously hopeless prognosis. Two classes, one for each sex, have been organized for physical exercises and games. These are in the hands of a masseur and masseuse respectively, who supplement their class-work with massage and electrical therapy upon the recent admissions. Their efforts will be greatly helped by the installation and outfitting of a treatment centre at Rauta. In the Main Building there is still considerable overcrowding, particularly on the female side ; and, although some slight relief will be given when the occupation of the Nurses' Home in course of erection takes place, it will become necessary for extension of accommodation or a reduction in numbers. Renovation of the Main Building inside and outside is a pressing need, as also is the structural alteration to the kitchen and dining-hall to accommodate the increased numbers. The removal of the piggeries from the vicinity of the villas still remains a necessity. The store, too, is urgently in need of extension for similar reasons. A sanatorium for the accommodation of seven female tubercular patients has been erected and will soon be occupied. Letter-boxes have been placed in the wards, and ensure the privacy of correspondence to the office. Sitting-up parties have been arranged for parole, and well-conducted patients in the parole villas and wards ; these patients are allowed to sit up later than the others, and appreciate this variation from their routine. Female nurses are in one of the male parole villas and in the new villa of the neuropathic unit,' and their presence in these situations is of considt rable value. The clinic at Wellington Hospital continues io afford a valuable means of treating neurosis and psychoneurosis, arid is a channel for the admissions of suitable voluntary boarders of all types.

6

H.—7

The weekly entertainments have been given as usual, and have been much appreciated. I have to thank the Red Cross Society and the Victoria College Social Service Club for their continued practical interest in the patients' amusements. I wish also to thank Mr. Prosser for affording free passes to the patients for the village cinema. My thanks are due to the ministers of religion for their services. I wish to tender my thanks to the Official Visitors (Mrs. Fraser, Mrs. McVicar, Messrs. Bothamley and Bradey) for their regular visits and helpful interest in the patients' welfare. I have to thank my colleagues, Drs. Blair, Mackv, and McNickle, for their loyal support and assistance. I also wish to thank the Matrons and Head Attendants and the staff generally for their assistance. NELSON MENTAL HOSPITAL. Dr. Jeffreys reports : — I have the honour to forward my report for the year 1927. At the beginning of the year there were 389 patients on the register, and on the 31st December there were 118 (males 283, females 135). The total number under care during the year was 446 (males 306, females 140), and the average number resident was 398. Including three transfers from other institutions, there were 57 admissions, and of these 49 (33 males and 16 females) were admitted for the first time. Fifteen voluntary boarders were under treatment during the year, and of these 7 were discharged and 1 died, leaving 7 remaining at the end of the year. Four male and 3 female patients were discharged as " recovered," and 5 males as " relieved "or not improved." Of the 15 patients who died, no fewer than 9 were defective children of low vitality, who readily succumbed to slight infection. The general health of the patients has been remarkably good. Our numbers have been steadily increasing, and we are urgently in need of more accommodation both at Nelson and Stoke. A new sleeping-porch has been erected at " El Nido," the boys' ward, and is a great boon, for not only has it helped to relieve the congestion but it also enables us to give continuous open-air treatment to a number of the very frail children committed to our care. As [ pointed out in my last report, imbecile boys from all parts of the Dominion are committed to this institution, and at the present time El Nido " is far too overcrowded, and unless further accommodation is provided in the near future it will be impossible to make room for any more ; for although the bigger boys are sent to Stoke Farm, even there the conditions are not much better, for there is not nearly sufficient day-room space, and it is consequently impossible to make a satisfactory classification, as the boys and men are crowded together in the day-rooms on wet days. It is fervently to be hoped that new villas will be erected with as little delay as possible. Conditions at the new villa which was occupied last year are in pleasing contrast to those at the old building. It is in charge of female nurses, and is greatly appreciated by the patients and their relatives. The majority of the Stoke patients are usefully employed on the farm and in the gardens ; a large number are on full parole, and it is a most exceptional occurrence to find any one abusing this privilege. Every week a number of the Nelson patients and every fortnight a number from Stoke are taken to the pictures, and they look to this more than to any of the entertainments provided for them ; and it is to be hoped that before long we will have our own picture plant at Stoke. My thanks are due to Dr. Hay and the other officers and staff for their loyal assistance throughout the year. HOKITIKA MENTAL HOSPITAL. Dr. Buchanan reports : — I beg to submit my report for the year ended 31st December, 1927. At the beginning of the year there were 226 patients on the register ; at the end of the year there remained 152 males and 64 females, making a total of 217 ; also 1 male voluntary boarder. Admissions numbered 14 ordinary patients and 1 transfer. Three voluntary boarders were admitted during the year. Discharges were 13, and deaths 12. Voluntary boarders discharged numbered 2. The general health of the patients continued to be good. The only structural alteration made since my last report is the turning of the old wash and bath rooms of " Aorangi " into a dining-room for the more unmanageable patients, and the turning of the boilerhouse into two much-needed single rooms. Our energies have been directed mainly towards the opening-up of new farm lands. Altogether 8 acres of swamp land have been cleared, drained, and sown down. The stumping of this land has enabled us to put by a laxge store of firewood for the winter months. The formation of all this new pasturage is most valuable work. At present we carry insufficient cows for our need, necessitating our making use of large quantities of condensed milk. Next year we should show a considerable reduction in this expensive commodity. To give access to the new paddocks 32 chains 8 yards of road have been constructed. We have the construction of a bowling-green well on the way, and expect to have it finished by this time next year. Our wants, as you know, are many, and cannot all be gratified owing to the present financial stringency, but I would beg to stress the great need of (1) a new building to take the place of the unsightly ten single rooms attached to " Taupo " ; (2) a water-supply of our own, independent of the borough supply ; (3) an intercommunicating telephone system, to be used for fire-alarm purposes.

7

H.—7

Through the generosity of the West Coast public we have now had installed a wireless set, which gives a great deal of pleasure to the patients and staff. I desire to express my thanks to all who contributed to this object, and would like to specially mention the names of Mr. D. J. Evans and Miss James, of G-reymouth, in this connection. Many concerts and plays have been given to the patients. These are always a source of greal interest and pleasure. I would like to record my thanks to all the participants in these events. Mr. A. Clifton and Miss Reynolds, Official Visitors, have paid regular visits to the institution and have been untiring in their attention to the patients. We all regret Miss Hanna's approaching severance from the service. She was always helpful and encouraging, and took keen interest in every branch of our work. Finally, I would like to express gratitude to the whole of my staff for their loyal co-operation in the institution's work. CHRISTCHURCH MENTAL HOSPITAL. Dr. McKillop reports : — I have the honour to forward my report for the year 1927. On the Ist January there were 870 patients on the register —397 men and 473 women. During the year we had 166 admissions —89 men and 77 women. Seventy-eight patients were discharged, and 3 transferred to other institutions. The total number of committed cases under care was 1,036, and 886 (inclusive of 17 makes and 21 females on probation) remained on the 31st December. Forty-five voluntary boarders received treatment during the year : 5 were committed, 3 ordinary patients, 25 were discharged, and 1 died, leaving 5 men and 13 women under this section receiving treatment. The general health of the patients has been satisfactory. There were 69 deaths (37 men, 32 women). Fifteen of the deaths were due to senile decay. During the past year many important additions and alterations have been made to the existing buildings. Ward 3 (female), together with the sewing-room, dormitories, and single rooms attached, have been painted and renovated ; also most of the upper floor on the male side. The Neuropathic Hospital at Hornby has been occupied for the past few months, and is a decided advance. The farm unit at Templeton will shortly be ready for occupation, and will greatly relieve the congestion at Sunnyside. When this unit is available I am hopeful of being able to utilize " North House " solely for epileptic patients. I am deeply grateful for the consideration our wants have received during the past year : the improvements and alterations have greatly added to the comfort and well-being of the patients. I have again to thank Professor Hercus, of the Otago Medical School, and his assistants for their help during the past year. Valuable work is being done in connection with examinations of blood, and with goiter-investigation. For the past six months iodized salt has been used for all purposes, and in many cases there is noticeable decrease of the enlarged thyroid. There have been no toxic symptoms in evidence in any case. We have had a very successful year on the farm, and the prospects for the coming harvest are exceptionally good. The new stables and garages have been completed, and the new piggeries and runs are in occupation. The farm returns show a substantial credit balance. To the District Inspector (Mr. Aoland), to the Official Visitors (Mrs. Williams and Mr. Hanna), and to Mr. Souter (Patients' Friend) I tender my thanks for their visits and kindness to our inmates. I am verv grateful to Drs. Russell and Hart for the valued help they have given me in the medical and general work of the institution. I have also to thank Mr. Thomas and office staff, the Matron, Head Attendant, and other heads of departments for their loyal and efficient assistance, and the staff as a whole for the satisfactory manner in which the work was performed. SEACLIFF MENTAL HOSPITAL. Dr. Gribben reports : — I beg to submit my report for the year ended 31st December, 1927. At the beginning of the year there were 1,132 patients on the register (617 males and 515 females), and at the end of the year 1,176 (643 males and 523 females). The admissions numbered 164 (93 males and 71 females). One hundred and twenty patients were discharged, comprising 67 males and 53 females. Of voluntary boarders, 37 remained from the previous year and 20 were admitted. Eleven voluntary boarders were discharged, 4 committed as ordinary patients, and 3 died. Four patients (male) were admitted on remand for observation. Fifty-four patients died during the year (33 males and 21 females). The average weekly number of patients resident during the year was 1,138 (627 males and 511 females). The health of the patients generally has again been satisfactory. There have been epidemics of influenza and of mumps, both mild in type. One patient developed scarlet fever, but his isolation checked any spread of the trouble. New buildings during the year include quarters for artisans, a motor-garage, a strong-room, a coal-bunker (which is not yet completed), a barn at " Cherry Farm," and the Neuropathic Hospital at Puketeraki. It was hoped to occupy the last-named before the end of the year, but defects in the water-reservoir have necessitated delay in opening this unit. The Admission Cottage was completed in the early part of the year, and is working satisfactorily.

8

H.—7

In the case of existing buildings, in addition to ordinary repairs and replacements, extensive alterations and improvements were made to the draught-horse stable and to the roof of G Ward. - An extension of the water-pipe line at Omimi now takes it up to the spring which is the source of supply. This will eliminate any chance of contamination. Repairs and renovations were also undertaken at the Engineer's residence which, as a result of the moving ground, called for attention. All necessary outside painting has been completed, and similar work is in progress inside the buildings. Work on the farm has been carried out on lines similar to those adopted last year. During the winter a considerable amount of work was done in fencing, and in grading and metalling roads. The liming and top-dressing of the grass-land is already showing good results. The making of butter at the institution was discontinued, and the surplus milk is now sent to the cheese-factory at Omimi. The winter and spring were very wet, but the crops, which are now mostly grown at " Cherry Farm," promise well. An increase in the area of root crops and of grass-land devoted to the production of hay and ensilage will enable the fattening of stock to be extended, and will make for economy in eliminating in some measure the purchase of fat stock in the saleyards. The catches of fish show an increase over last year, but it is still necessary to go a considerable way off shore to obtain most of the varieties formerly found close to the coast. For the amusement of the patients regular picture entertainments throughout the year and dances in the winter months have been held. In addition, concerts have been given by the Commercial Travellers' Association, the Dunedin Male Choir, and the Kaikorai Band. During the summer months regular picnics have taken place at Puket-eraki and Karitane. The annual picnic and sports meeting held in the grounds was much enjoyed by the patients. I have to express my thanks to Mr. Gallaway (District Inspector), Mr. Slater (Official Visitor), and Mr. Cumming (Patients' Friend) for their practical interest in the welfare of the patients and the institution. I also have to acknowledge the material assistance I have received in the loyalty and co-operation of the staff. STATISTICAL. The patients on the register at the end of the year numbered 5,673 (m. 3,147, f. 2,526), or 206 (m. 103, f. 103) more than at the beginning ; and the daily average under treatment during the year was 5,395 (m. 3,022, f. 2,373), or 182 (m. 96, f. 86) more than in the previous year, while the total under care was 6,412. Patients belonging to the Native race numbered 81 (m. 42, f. 39) at the end of the year. The admissions numbered 945 (m. 531, f. 414), or 2 less (m. 23 more and f. 25 less) than in the previous year. Of these, 163 had been previously under care, making the proportion of readmissions 17-25 per cent., and 782 patients (including 15 Maoris) were admitted for the first time. The ratio to population of all admissions (exclusive of Maoris) was 6-74 (m. 7-42, f. 6-03) to 10,000, and of first admissions 5-58 (m. 6-17, f. 4*96), so that 1,482 persons in the general population contributed one patient, and 1,792 contributed a patient admitted for the first time. The discharges (excluding transfers) numbered 390, or 7 more than in 1926. 105 (or 3 more) harmless unrecovered persons were returned to the care of friends, and 285 (m. 157, f. 128) recovered —4 more than last year, representing a percentage of 30-16 (m. 29-56, f. 30-91) on the total admitted. With voluntary boarders added the percentage rises to 36-60. Altogether, 45-79 per cent, of the inmates admitted were able to leave institutional care. Of a total of 6,412 patients under care, 349 (m. 217, f. 132) died, or 6-47 per cent, on the average number resident. An inquest is held in the case of every death, whatever the cause. The causes are detailed in Table XII, and the following is the percentage of causes mainly contributing : Senile decay, 24-63 ; disease of the brain and nervous system group, 24-63 ; heart-disease, 12-60 ; tuberculosis, 6-19. In Table XIII the principal causes assigned for the mental breakdown in the admissions are stated ; but as a matter of fact they are merely approximations, and these, with the small numbers with which we have to deal, show such divergencies from year to year that the proportion assigned to any one cause in any one year cannot be assumed to be our average incidence. Causation is always complex, and the most potent factor is the individual. Hereunder the assigned causations in the table referred to are grouped and shown in their relative proportions : — Males. Females. Total. Heredity .. .. • • • • • • 16-95 9-66 13-75 Congenital 11-67 12-07 11-85 Predisposed by previous attack .. . . .. 9-41 11-09 10-16 Critical periods .. .. .. • ■ 19-39 30-91 24-44 Child-bearing (puerperal, non-septic, and lactation) .. .. 4-10 1-80 Mental stress .. .. .. • • • ■ 10-54 9-42 10-05 Physiological defect and error . . . . .. 2-82 6-04 4-23 Toxic, including m. f. Syphilis .. .. 7-72 0-72\ ] 6-74 5-07 11-64 Alcohol .. .. 7-53 2-41/ Traumatic .. .. • • • • • • 0-56 .. 0-31 Disorder of nervous system, including — M. F. Epilepsy .. .. • ■ 4-52 3-86 7-15 5-79 6-56 Other bodily affections .. .. .. .. 0-18 0-96 0-62 No definite cause assigned .. .. .. 4-59 4-89 4-59 100-00 100-00 100-00

2 —H. 7.

9

H.—7

Voluntary Boarders.

It will be noted that there were 197 voluntary admissions in the year under review, that 133 were discharged, and that 14 boarders, representing 3-80 per cent, of the total under care, had to be transferred to the register of patients (having shown mental disorder in degree sufficiently pronounced and sustained to render it improper for them to be continued as voluntrary boarders), while the proportion of deaths on average number resident was 9-94 per cent. The column devoted to " Not First Admissions " records readmissions on a return of illness in those previously treated to recovery as voluntary boarders. The figures above are an indication of public confidence and of good work being done. The average daily number of voluntary boarders in 1927 was 171 (m. 79, f. 92).

MENTAL NURSES. In December the usual examination was held for the registration of mental nurses, when the following passed : — Auckland : First Grade —Elizabeth Ellen Holgate, Wilmot Jackson, Ernest Edward Potter, Elizabeth Reid ; Second Grade —Robert Randall Crawford, Beatrice May Heath, Sydney John Jones, Robert James Mcintosh, Edward Matsen, Norma Violet Moeller, Alan James Morton, Henry Howard Priestly, Isolene Mary Seales, Finlay Thomson, John Tough Walker, James Arthur West. Tokanui : Second Grade —Karl Carr, Martha Jeanette Henry, Robert Brown Kinnon, Emily McMillan, Tasma Walker. Porirua : First Grade —Isabella Duncan Brand, Jeannie Wilson Dunsmore ; Second Grade— Ada Barker, James Mcßride, John Mullins, Colin Simon, Robert Souter. Nelson : First Grade —Francis Henderson, Howard Sidney Leake, Agnes Louisa Moore ; Second. Grade —Margaret Edith Mona Cussen, Hilda Isabel Ryrie, Aaron Sydney Thomas, Vera Elizabeth Wilkins, Harry Orlando Winnie. Hokitika : First Grade —Henrietta Rubina Hoffman ; Second Grade—Mark Dent, James Arnold Doyle, Rita Annie Morris. Christchurch : First Grade—Lillian May Sprott; Second Grade—Maud Elizabeth Clifton, Winifred Ann Doyle, Mercia Kathleen Flanagan, James Kelly, Rita Charlotte Liggins, Margaret Macrae, Nellie Miriam Minards, Doris Isabel McLean, May Parker, John Simpson, Richard Humphreys Watkins. Seacliff : Second Grade —Roberta Margaret Howie Brown, Annie Chisholm, Martha Hendry Cochrane, Jessie Annie Cumming, Shiela Cumming, Mary Evelyn Daniell, Florence May Dobinson, Evelyn Ethel Edwards, Mary Ogilvie Fleming, Beatrice Fanny Grey, Annie Hocking, David Milne, May Piercy, Dorothy Ranger.

10

I??™* -vr.i. -p,,,.-* i Transferred j Remaining I Admission. Admission. Admissions. »o Eegster | Died. Discharged. I I ! ! M. F. T. M. F. T. M. F. T. M. F. T. M. F. T. M. F. T. M. F. T. 1912 .. .. 6 17 23 0 0 0 6 17 23 1 3 4 0 0 0 4 3 7 1 11 12 1913 .. .. 18 19 37 0 2 2 18 21 39 2 5 7 0 1 1 12 12 24 5 14 19 1914 .. .. 17 19 36 3 2 5 20 21 41 7 5 12 1 1 2 11 15 26 6 14 20 1915 .. .. 15 17 32 1 2 3 16 19 35 3 4 7 0 1 1 8 14 22 11 14 25 1916 .. .. 13 23 36 5 8 13 18 31 49 4 4 8 1 2 3 14- 14 28 10 15 25 1917 .. .. 14 21 35 1 13 14 15 34 49 6 6 12 0 1 1 10 23 33 9 19 28 1918 .. .. 23 38 61 5 11 16 28 49 77 1 4 5 2 2 4 15 30 45 19 32 51 1919 .. .. 31 39 70 5 19 24 36 58 94 3 3 6 0 2 2 26 42 68 26 43 69 1920 .. .. 26 38 64 16 12 28 42 50 92 3 4 7 1 2 3 33 33 66 31 54 85 1921 .. .. 39 39 78 11 15 26 50 54 104 2 3 5 5 1 6 38 41 79 36 63 99 1922 .. .. 47 38 85 10 16 26 57 54 111 6 5 11 4 4 8 40 48 88 43 60 103 1923 .. .. 44 50 94 15 21 36 1 59 71 130 3 6 9 3 3 6 47 47 94 49 75 124 1924 .. .. 38 44 82 16 20 36 54 64 118 4 8 12 6 3 9 39 48 87 54 80 134 1925 .. .. 64 59 123 15 34 49 79 93 172 10 15 25 6 3 9 60 63 123 57 92 149 1926 .. .. 71 60 131 11 29 40 82 89 171 10 11 21 7 2 9 49 71 120 73 97 170 1927 .. .. 70 70 140 | 25 32 57 95 102 197 8 6 14 5 12 17 75 58 133 80 123 203

H.—7.

APPENDIX.

Table I. —Showing the Admissions, Readmissions, Discharges, and Deaths in Mental Hospitals during the Year 1927.

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 1927.

11

M. F. T. M. p. T. In mental hospitals, 1st .January, 1927 .. .. .. .. 3,044 2,423 5,467 Admitted for the first time .. .. .. .. 441 341 782 "1 ... Readmitted 90 73 163 / 531 414 945 Total under care during the year .. .. .. 3,575 2,837 6,412 Discharged and died— Recovered .. .. .. .. . . .. 157 128 285 Relieved .. .. .. .. .. ■. 40 42 82 Not improved .. .. .. .. .. 14 9 23 Died .. .. .. .. .. .. 217 132 349 (Not including transfers —Males 32, females 19.) 428 311 739 Remaining in mental hospitals, 31st December, 1927 .. .. .. 3,147 2,526 5,673 Increase over 31st December, 1926 .. .. .. .. 103 103 206 Average number resident during the year .. .. .. .. 3,022 2,373 5,395

In Mental Hos- i Admissions in 1927. j Total Number Mental Hospitals. pitals on | — , — - - j Patients 1st January, 1927. Admitted for the Not First j Transfers I unflnr Oare First Time. | Admission. iransters. unaei care. M. F. T. M. F. T. M. F. T. M. F. T. M. F. T. Auckland .. .. 652 496 1,148 97 82 179 23 14 37 (10 1 11) 782 593 1,375 Christchurch .. .. 397 473 870 71 58 129 16 16 32 (2 3 5) 486 550 1,036 Dunedin (Seaclifi) .. 617 515 1,132 74 54 128 18 15 33 (1 2 3) 710 586 1,296 Hokitika .. .. 159 67 226 9 4 13 1 0 1 (1 0 1) 170 71 241 Nelson .. • • 269 120 389 33 16 49 1 4 5 (3 0 3) 306 140 446 Porirua . ..723 599 1,322 129 109 238 24 22 46 (5 2 7) 881 732 1,613 Tokanui .. .. 213 124 337 25 11 36 6 1 7 (15 3 18) 259 139 398 Ashburn Hall (private 14 29 43 3 7 10 1 1 2 (2 1 3) 20 38 58 mental hospital) Totals .. 3,044 2,423 5,467 441 341 782 90 73 163 (39 12 51) 3,614 2,849 6,463 Patients discharged, transferred, and died. In jyj en^a j jj os : pitals on Mental Hospitals. | r Total discharged, 31st December, Discharged Discharged Transferred. Died. transferred, 1927. recovered. not recovered. , an( j ' M. F. T. M. F. T. M. F. T. M. F. T. M. F. T. j M. F. T. Auckland .. .. 45 22 67 15 9 24 (4 2 6) 63 36 99 127 69 196 655 524 1,179 Christchurcli .. 20 25 45 12 21 33 (2 1 3) 37 32 69 71 79 150 415 471 886 Dunedin (Seaclifi) .. 19 13 32 12 17 29 (3 2 5) 33 21 54 67 53 120 643 533 1,176 Hokitika .. 7 5 12 1 0 1 .. 10 2 12 18 7 25 152 64 216 Nelson .. ..4 3 7 5 0 5 (1 0 1) 13 2 15 23 5 28 283 135 418 Porirua .. .. 50 47 97 6 1 7 (17 3 20) 46 35 81 119 86 205 762 646 1,408 Tokanui .. .. 12 9 21 3 3 6 (11 0 11) 12 3 15 38 15 53 221 124 345 Ashburn Hall (private 0 4 4 .. (1 4 5). 3 1 4 4 9 13 16 29 45 mental hospital) Totals .. 157 128 285 54 51 105 (39 12 51) 217 132 349 467 323 790 3,147 2,526 5,673 Averase Number Percentage Percentage of Mental Hospitals. residfnt during »» ' during the Year. during the Year. M. P. T. M. F. T. M. F. T. Auckland .. .. .. •• ■■ 623 482 1,105 37-50 22-22 31-01 10-11 7-47 S-95 Christchurch .. .. • • ■ ■ • • 395 453 848 23-00 33-78 27-95 9-37 7-06 8-13 Dunedin (Seaclifi) .. •• •• ■■ 627 511 1,138 20-65 18-83 19-88 5-26 4-11 4-74 Hokitika .. .. .. • • .. 156 67 223 70-00 125-00 85-71 6-41 3-00 5-37 Nelson . .. •• •• .. 275 123 398 11-76 15-00 12-96 4-59 1-48 3-58 Porirua .. .. .. •- •• 717 586 1,303 33-98 35-87 34-15 6-41 5-97 6-21 Tokanui .. .. • • • • • • 214 123 337 38-71 75-00 48-83 5-60 2-43 4-45 Ashburn Hall (private mental hospital) .. .. 15 28 43 0-00 50-00 33-33 20-00 3-57 9-30 Totals .. .. .. .. 3,022 2,373 5,395 29-56 30-91 30-16 1 7-17 5-65 6-47

H.—7.

Table IV.—Duration of Disorder on Admission.

Table III.— Ages of Admissions.

12

I ■ ■ ; i I i I •; • . - I Dunedin i 1 Ashburn Hall | Ages. Auckland. Christchurch | (Seacliff) Hokitika. Nelson. | Porirua, Tokanui. i (Private Mental Total. | | I I i 1 ' i Hospital). | _ __ 4 . . _ __ . _ J 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. Under 5 years .. .. .. .. 112 .. 2 0 2 .. 101 .. Oil .. 426 From 5 to 10 years .. .. . ■ 101 .. Oil .. 909 235 .. .. 12 4 16 10 „ 15 „ .. .. .. 4 2 6 1 1 2 .. 0 1 1 6 2 8 1 3 4 .. .. 12 9 21 15 „ 20 „ .. .. .. 6 6 12 6 10 16 - 5 2 7 1 0 1 5 3 8 11 7 18 3 0 3 .. 37 28 65 " 20 „ 30 „ .. .. .. 21 17 38 19 9 28 I 19 11 30 2 0 2 5 7 12 29 20 49 7 3 10 .. 102 67 169 30 „ 40 „ .. .. .. 25 15 40 10 9 19 20 13 33 0 2 2 3 3 6 30 19 49 2 2 4 1 1 2 91 64 155 „ 40 „ 50 „ .. .. • • 20 24 44 15 18 33 ! 14 19 33 3 0 3 1 1 2 ! 29 39 68 12 3 15 1 3 4 95 107 202 „ 50 „ 60 „ .. .. - - 15 13 28 15 12 27 14 13 27 1 0 1 2 2 4 26 19 45 5 3 8 0 2 2 78 64 142 - 60 „ 70 „ .. .. • • 10 11 21 9 7 16 9 4 13 1 1 2 1 1 2 19 10 29 2 0 2 0 1 1 51 35 86 1 „ 70 „ 80 „ .. . • • - 9 4 13 8 4 12 | 6 5 11 .. 1 1 2 I 5 7 12 .. 0 1 1 29 22 51 80 „ 90 „ .. .. .. 5 3 8 2 2 4 2 1 3 1 0 1 .. 0 4 4 .. 2 0 2 12 10 22 „ 90 „ 100 „ .. 0 2 2 1 .. 1 0 1 .. 1 0 1 .. .. 2 2 4 Unknown .. .. •• 303 202ll01 .. .. .. .. 606 Transfers .. .. .. ■■ 10 1 11 2 3 5 1 2 3 1 0 1 3 0 3 5 2 7 15 3 18 2 1 3 39 12 51 Totals .. .. .. 130 97 227 89 77 166 93 71 164 11 4 15 37 20 57 158 133 291 46 15 61 6 9 15 570 426 996 ! ; ; ; ; ; * '

nnnpfiin ! Ashburn Hall Auckland. Christchurch. , aaQ Hokitika. : Nelson. Porirua. I Tokanni. \ (Private Mental Total. (toeaclitf). . , j Hospital). M. F. T. M. F. T. M. If. T. M. F. T. M. F. T. I M. F. T. M. F. T. M. F. T. M. F. T. First class (first attack and within 3 months 44 33 77 30 25 55 31 16 47 4 1 5 6 6 12 90 76 166 15 3 18 1 3 4 221 163 3S4 on admission) Second class (first attack above 3 months and 16 15 31 6 3 9 13 9 22 1 1 2 Oil 19 8 27 1 1 2 0 2 2 56 40 96 within 12 months on admission) Third class (not first attack, and within 12 24 21 45 19 24 43 16 24 40 2 0 2 1 5 6 16 16 32 10 4 14 1 1 2 89 95 184 months on admission) Fourth class (first attack or not, but of more 36 27 63 32 22 54 32 20 52 3 2 5 27 8 35 28 31 59 5 4 9 2 2 1 165 116 281 than 12 months on admission) Unknown .. .... Transfers .. .. .. 10 1 11 1235 123 101 303 527 15 3 18 213 39 12 51 Totals .. .. .. 130 97 227 ; 89 77 166 93 71 164 11 4 15 37 20 57 158 133 291 46 15 61 6 9 15 570 426 996

EL—7

Table V.—Ages of Patients discharged "Recovered" and "Not Recovered" during the Year 1927.

Table VI.— Ages of Patients who died.

13

Ages. Auckland. Christchurch. Dunedin (Seacliff). Hokitika. Nelson. Porirua. Tokanui. (Private 1 ]!^^ 1 ) Total. ■ J i 1 M. If. 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. Under 5 years .... .. ..112 .. .. .. .. .. .. .. 112 From 5 to 10 years .. .. .. 112 101 .. .. 101 .. .. .. 3 14 „ 10 „ 15 ., .. .. . . 1 0 1 .. .. .. 4 0 4 0 1 1 1 0 1 . s 6 17 „ 15 „ 20 „ .. .. .. 4 0 4 .. .. 1 0 1 2 0 2 0 1 1 1 0 1 .. 8 1 9 „ 20 „ 30 „ .. .. .. 3 1 4 2 1 3 1 0 1 .. 2 0 2 4 3 7 .. .. 12 5 17 „ 30 „. 40 .. .. .. 4 2 6 2 2 4 3 1 4 1 0 1 .. 2 3 5 1 1 2 .. 13 9 22 40 „ 50 „ .. .. .. 12 4 16 4 6 10 5 3 8 .. .. 11 8 19 4 1 5 .. 36 22 58 „ 50 „ 60 „ .. .. .. 5 6 11 6 6 12 6 4 10 .. .. 8 3 11 2 0 2 0 1 1 27 20 47 „ 60 „ 70 .. .. .. 15 7 22 6 10 16 5 6 11 1 1 2 3 1 4 7 6 13 2 0 2 .. 39 31 70 „ 70 „ 80 „ .. .. .. 8 8 16 10 3 13 7 4 11 3 0 3 0 1 1 9 7 16 1 1 2 .. 38 24 62 „ 80 „ 90 „ .. .. .. 8 6 14 5 2 7 4 2 6 3 1 4 .. 4 3 7 .. 3 0 3 27 14 41 „ 90 „ 100 „ .. .. .. 1 0 1 0 2 2 1 1 2 1 0 1 1 0 1 1 0 1 .. .. 5 3 8 Unknown .. .. .. .. .. 101 101 .. .. .. .. .. 202 Totals . . .. .. .. 63 36 99 37 32 69 33 21 54 10 2 12 13 2 15 46 35 81 , ! 12 3 15 3 1 4 217 132 349 ■' ■ . ■ . ■ ■ I 1

Auckland. Christehurch. Dunedin (SeaclifE). Hokitika. Nelson. Porirua. Tolianui. (Private Total. lie- Not re- Re- Not re- Re- | Not re- Re- Not re- i Re- Not re- Re- Not re- Re- Not re- Re- Not re- Recovered covered, covered. covered, covered, covered, j covered. covered, covered, j covered. covered, covered, covered, covered, covered, covered, covered. ' recovered. _j J ! 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. X. 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. Under 5 years .. | t. .. .. • • • • ■ • From 5 tb 10 years •• •• Oil .. .. .. .. ] 1 0 1 .. 101 .. .. .. .. .. 213 „ 10 „ 15 „ .. .. .. .. .. .. .. .. .. 10 1.. .. .. .. .. .. .. 101 „ 15 20 „ 2 0 2 .. 3 4 7 1 1 2 .. 1 1 2 1 0 1 .. 0 1 1 .. 2 0 2 .. .. .. .. .. 8 5 13 2 2 4 „ 20 ,i 30 „ |L0 0 10 3 1 4 3 2 5 3 3 6 6 5 11 2 2 4 1 0 1 .. 1 0 1 .. 10 10 20 1 0 1 2 1 3 2 1 3 .. .. 33 18 51 11 7 18 , 30 „ 40 , 12 5 17 2 1 33 2 50 3 33 6 91 4 512 31 0 12 2 4 .. 11 11 22 1 0 12 461 0 1- .. .. 34 22 56 6 8 14 40 ; 50 , 12 10 22 .. 5 8 13 1 3 4 5 1 6 5 3 8 4 1 5 .. 1 0 1 .. 12 14 26 1 0 1 4 2 6 0 2 2 0 1 1 .. 43 37 80 7 8 15 50 60 549235167033213347022 .. .. 202 11 6 17 112314 .. 022 .. 22 22 44 8 11 19 60 70 4 26 .. 426213303011 .. .. .. 101448101112 .. 011 .. 16 10 26 42 6 „ 70 80 „ .. 1. 101 .. 426 .. 022 .. .. .. .. 022 .. .. .. .. .. 022 5 49 „ 80 A 90 „ 12 3 .. 12 3 „ 90 100 „ .... .. .. 011.. .. .. .. .. .. .. .. .. .. .. .. .. 011 Unknown' .. ..01174 11 112011 .. .. .. .. .. .. .. .. .. .. .. .. 12375 12 Transfers : .. .. j L. 4 2 6 .. 2 1 3 .. 3 2 5 .. .. .. 1 0 1 .. 17 3 20 .. 11 0 11 .. 1 4 5 .. 39 12 51 totals .. 45 22 6719 11 3020 25 4514 22 3619 13 3215 19 34 7 5 12 1 0 1 4 3 7 6 0 6 50 47 97 23 4 27 12 9 21 14 3 17 0 4 4 1 4 5 157 128 285 93 63 156

EL—7

Table VII. —Condition as to Marriage.

14

Admissions. Discharges. Deaths. Auckland— m. ir. t. m. t. t. m. f. t. Single .. .. .. .. .. .. 64 36 100 33 8 41 36 10 46 Married .. .. .. .. .. 43 47 90 20 20 40 17 16 33 Widowed .. .. .. .. .. 7 11 18 3 2 5 6 8 14 Unknown .. .. .. .. .. 628 415 426 Transfers .. .. .. .. .. 10 1 11 4 2 6 Totals .. .. .. .. .. 130 97 227 64 33 97 63 36 99 Chbistohuboh—Single .. .. .. .. .. .. 42 33 75 19 23 42 24 14 38 Married .. .. .. .. .. 39 29 68 11 22 33 8 12 20 Widowed .. .. .. .. .. 6 12 18 0 1 1 2 6 8 Unknown .. .. .. .. .. .. 202 303 Transfers .. .. .. .. .. 2 3 5 2 1 3 Totals .. .. .. .. 89 77 166 34 47 81 37 32 69 Dunedin (Seaoliff) — Single .. .. .. .. .. .. 57 29 86 19 17 36 20 9 29 Married .. .. .. .. .. 27 32 59 12 12 24 11 7 IS Widowed .. .. .. .. .. 8 8 16 0 1 1 2 5 7 Unknown Transfers .. .. .. .. .. 123 325 Totals .. .. .. .. .. 93 71 164 34 32 66 33 21 54 Hokitika.— Single .. .. .. .. .. .. 6 17 404 516 Married .. .. .. .. .. 336 257 404 Widowed .. .. .. .. .. .. .. 112 Unknown .. .. .. .. .. 101 101 Transfers .. .. .. .. .. 10 1 10 1 Totals .. .. .. .. .. 11 4 15 8 5 13 10 2 12 Nelson—• Single.. .. .. .. .. 31 12 43 6 1 7 ! 10 1 11 Married .. .. .. .. .. 2 8 10 3 2 5 3 0 3 Widowed .. .. .. .. .. 101 101 011 Unknown Transfers .. .. .. .. .. 303 Totals .. .. .. .. .. 37 20 57 10 3 13 13 2 15 POEIBUA— Single .. .. .. .. .. .. 97 51 148 33 14 47 25 14 39 Married .. .. .. .. .. 51 66 117 20 27 47 18 12 30 Widowed .. .. .. .. .. 5 14 19 3 7 10 3 9 12 Unknown Transfers .. .. .. .. .. 5 2 7 17 3 20 Totals .. .. .. .. .. 158 133 291 73 51 124 46 35 81 Tokanui — Single .. .. .. .. .. . . 15 3 18 9 2 11 10 .. 10 Married .. .. .. .. . . 14 7 21 6 10 16 2 2 4 Widowed .. .. .. .. .. 224 .. 011 Unknown Transfers .. .. .. .. .. 15 3 18 11 0 11 Totals . . . . .. .. . . 46 15 61 26 12 38 12 3 15 Ashburn Hall— Single .. .. .. .. .. .. 257 033 112 Married .. .. .. .. .. 224 011 202 Widowed .. .. .. .. .. 011 Unknown Transfers .. .. .. .. .. 213 145 Totals .. .. .. .. .. 69 15 189 314 Totals— Single .. . . .. .. . . 314 170 484 123 68 191 131 50 181 Married .. .. .. .. .. 181 194 375 74 99 173 65 49 114 Widowed . . .. . . .. .. 29 48 77 7 11 18 14 31 45 Unknown .. .. .. .. .. 729 718 729 Transfers .. ,. .. .. .. 39 12 51 39 12 51 Totals . . .. .. . . . . 570 426 996 250 191 441 217 132 349

H.—7.

Table VIII.— Native Countries.

Table IX.—Ages of Patients on 31st December, 1927.

15

Countries. Auckland. Christchureh. Hokitika. Nelson. Porirua. j Tokanui. Total. I M. r. 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. England and Wales .. .. 119 90 299 68 87 155 93 61 154 29 7 36 12 13 25 161 102 263 48 14 62 4 4 8 534 378 912 Scotland .. .. .. .. 30 23 53 24 14 38 65 54 119 5 2 7 14 6 20 40 28 68 13 3 16 2 2 4 193 132 325 Ireland .. .. .. .. 45 33 78 24 30 54 45 43 88 21 7 28 11 3 14 47 61 108 11 15 26 1 0 1 205 192 397 New Zealand .. .. .. 322 314 636 268 305 573 401 342 743 64 45 109 192 68 260 423 393 816 113 85 198 9 21 30 1,792 1,573 3,365 Australian States .. .. .. 40 23 63 14 14 28 19 27 46 10 3 13 10 5 15 33 24 57 12 3 15 0 2 2 138 101 239 France .. .. .. .. 011 .. .. 101 101 .. 202 .. 415 Germany .. .. .. .. 527 235 404 101 101 77 14 314 .. 23 13 36 Austria .. .. .. .. 17 1 18 022 101 .. 202: 011 303 .. 23 4 27 NorVay .. .. .. .. 505 011 202 101 .. 314 101 .. 12 2 14 Sweden .. .. .. .. 314 404 303 303 303 314 .. .. 19 2 21 Denmark .. .. .. .. 202 213 213 .. 101 628 101 .. 14 4 18 Italy .. .. .. .. 314 .. 101 606 101 527 101 .. | 17 3 20 China .. .. .. .. 101 .. 404 101 .. 213 .. .. 819 Maoris .. .. .. .. 18 19 37 .. .. 3 0 3 5 2 7 13 16 29 3 2 5 .. 42 39 81 Other countries .. .. .. 32 9 41 6 8 14 3 5 8 7 0 7 1 0 1 19 7 26 10 1 11 .. 78 30 108 Unknown .. .. .. . . 13 7 20 3 6 9 .. .. 29 38 67 .. .. .. 45 51 96 Totals .. .. .. 655 524 1.179 415 471 886 643 533 1.176 152 64 216 283 135 418 1 762 6.46 1.408 221 124 345 16 29 45 ' 3,147 2,526 5,673 ; I I

Ages. Auckland. Christchurck. ' Sea ~ Hokitika. Nelson. Porirua. okanui. V Total. ___ ; I 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 1 to 5 years .. .. .. .. 2 0 2 .. 12 0 12 .. Oil .. 14 1 15 5 „ 10 „ .. . . 0 2 2 ft 10 10 1 1 2 .. 29 2 31 0 9 9 .. .. 30 24 54 „ 10 „ 15 „ .. .. 6 7 13 6 6 12 2 3 5 0 1 1 49 5 54 0 14 14 1 2 3 .. 64 38 102 „ 15 „ 20 „ .. .. 16 14 30 12 13 25 17 8 25 .. 24 4 28 13 23 36 8 2 10 .. 90 64 154 „ 20 „ 30 „ .. .. 82 59 141 64 41 105 84 38 122 5 3 8 25 20 45 92 65 157 14 10 24 .. 366 236 602 „ 30 „ 40 .. .. 105 104 209 74 65 139 98 88 186 17 7 24 33 20 53 148 119 267 25 20 45 2 2 4 502 425 927 „ 40 „ 50 „ .. .. 156 119 275 107 129 236 162 132 294 47 19 66 32 19 51 195 160 355 68 27 95 3 6 9 770 611 1,381 „ 50 „ 60 „ .. .. 132 110 242 68 107 175 123 122 245 41 16 57 35 24 59 165 132 297 65 31 96 2 5 7 631 547 1,178 „ 60 „ 70 „ .. .. 91 60 151 46 64 110 80 91 171 25 10 35 28 26 54 87 71 158 27 20 47 7 8 15 391 350 741 „ 70 „ 80 .. .. 41 30 71 30 25 55 58 39 97 7 3 10 13 7 20 49 35 84 5 10 15 2 6 8 205 155 360 „ 80 „ 90 „ .. .. 10 6 16 6 8 14 9 10 19 3 4 7 1 5 6 11 18 29 3 1 4 0 2 2 43 54 97 Upwards of90„ .. .. .. 112 10 1 101 101101 .. .. 516 Unknown .. .. .. .. 16 13 29 123 617 617 134 101 505 .. 36 20 56 Totals .. .. .. 655 524 1,179 415 471 886 643 533 1,176 152 64 216 283 135 418 762 646 1,408 221 124 345 16 29 45 3,147 2,526 5,673

H.—7

Table XI.—Length of Residence of Patients discharged "Recovered" during 1927.

Table X.—Length of Residence of Patients who died during 1927.

16

Length of Residence. Auckland. Christchureh. | (SeaclMf" ' Hokitika - Nelson. Porirua. j Tokanui. J (p^ate"^?!!) Total. 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. Under 1 month .. .. .. .. 84 12 358 022 .. 404 65 11 112 101 23 17 40 From 1 to 3 months .. .. .. 538 123 112 101 .. 448 303 .. 15 10 25 3 „ 6 .. . . . . 5 1 6 j 3 2 5 1 1 2 1 0 1 .. 4 1 5 1 0 1 1 0 1 16 5 21 „ 6 „ 9 .. .. . . 5 2 7 13 2 5 14 2 6 .. .. 3 0 3 .. .. 15 6 21 9 „ 12 .. .. .. 325 516 033 .. 011 022 202 .. 10 9 19 1 „ 2 years .. .. .. 96 15 628,123 .. 314 437 .. 011 23 15 38 2 „ 3 „ .. .. .. 3 2 5 1 0 1 | 2 2 4 .. 1 0 1 3 2 5 .. 1 0 1 11 6 17 „ 3 „ 5 „ .. .. .. 404 1341303 .. 202 112 112 .. 12 5 17 „ 5 „ 7 „ .. .. .. 4 2 6 2 0 2 1 0 1 .. 1 0 1 3 2 5 .. .. 11 4 15 „ 7 „ 10 „ .. .. .. 314,123 314 202 101 145 011 .. 11 9 20 „ 10 „ 12 „ .. .. .. 1 0 112 3 5 1 1 2 1 0 1 .. 3 1 4 .. . . 8 5 13 „ 12 „ 15 „ .. .. .. 0 3 3 1 0 1 1 0 1 .. .. 3 1 4 1 0 1 .. 6 4 10 Over 15 years .. .. .. .. 13 8 21 8 10 18 12 6 18 5 1 6 1 0 1 9 6 15 3 0 3 .. 51 31 82 Died while absent on trial .. .. 022 .. 3 0 3 011 .. 235 .. .. 5611 Totals .. .. .. .. 63 36 99 37 32 69 ! 33 21 54 10 2 12 13 2 15 46 35 81 12 3 15 3 1 4 217 132 349

Length of Residence. Auckland. Christehurch. (Seacliil? Hokitika. Nelson. Porirua. Tokanui. Total. M. F. T. M. F. T. M. F. T. M. F. T. M. F. T. M. T. M. F. T. M. F. T. M. F. T. Under 1 month .. .. .. .. 3 2 5 .. .. 303 101 202 202 .. 11 2 13 From 1 to 3 months .. .. .. 10 1 11 358 404 101 011 7 10 17 718 033 32 21 53 3 „ 6 .. .. .. 3 6 9 5 4 9 4 4 8 1 1 2 .. 12 4 16 2 5 7 0 1 1 27 25 52 „ 6 „ 9 .. .. .. 9 7 16 4 4 8 5 1 6 1 0 1 .. 10 7 17 0 2 2 .. 29 21 50 „ 9 „ 12 „ .. .. .. 5 0 5 2 5 7 2 1 3 1 3 4 1 0 1 10 7 17 1 1 2 .. 22 17 39 1 „ 2 years .. .. .. 12 3 15 3 5 8 3 4 7 .. 2 1 3 8 15 23 .. .. 28 28 56 „ 2 „ 3 „ .. .. .. 202 .. 022 .. .. 022 .. .. 246 „ 3 „ 5 „ .. .. .. 022 3 14 .. 011 .. 022 .. .. 369 5 „ 7 „ .. .. ..101 .. .. .. .. .. .. . . 101 „ 7 „ 10 „ .. .. .. 0 11 0 11 0 11 .. 0 11 .. .. .. 0 4 4 „ 10 „ 12 „ .. .. .. .. I „ 12 „ 15 „ .. .. .. .. | .. 10 1 .. .. 10 1 Over 15 years .. .. .. .. .. 101 .. .. .. .. .. 101 Totals .. .. .. . . 45 22 67 20 25 45 19 13 32 7 5 12 4 3 7 50 47 97 12 9 21 j 0 4 4 157 128 285 I

H.—7

Table XII. —Causes of Death.

3—H. 7.

17

i i lit CaU8es - I ! II i § it III 3 5 S 2 8 ■£ a « o -r; n M £2 TI 4*1 . - r 3 5. 3 V O O rf O <j Q fi M CH H -atS.* 5 H 1. General Diseases. Tuberculosis M. E. M. F. M. P. M. P. M. P. M. E. M. E. M. P. M. P. General .. .. ..30 .. 11 .. .. .. .. .. 41 Of lungs .. .. ..221120 .. .. 53 .. 01 10 7 Diabetes .. .. .. .. .. .. .. .. .. 01 .. 01 Typhoid fever .. .. .. 01 .. .. .. .. 01 .. 02 Rheumatic fever .. .. .. .. .. .. .. 01 .. .. 01 Cancer .. .. ..2 1 4 2 1 1 1 0 1 0 2 1 .. .. 11 5 Pyaemia .. .. .. .. .. .. .. .. 03 .. .. 03 Septicaemia .. .. .. .. .. .. .. .. 01 .. .. 01 Toxaemia .. .. .. .. .. .. .. .. 02 .. .. 02 Measles .. .. ..12 .. .. .. .. .. .. .. 12 Pernicious anaemia .. .. .. 10 .. .. .. .. .. .. 10 Syphilis .. .. .. .. 01 .. .. .. 20 .. 21 II. Diseases oe the Nervous System. Melancholia, exhaustion from ..410101 .. .. .. .. 43 Mania, exhaustion from ..11 .. 2110 .. 01 .. .. 43 Confusional insanity, exhaustion .. .. .. .. .. 3210 .. 42 from General paralysis of insane .. 61 71 70 .. .. 61 10 .. 27 3 Organic brain-disease .. ..11 .. 01 .. .. .. .. .. 12 Epilepsy .. .. ..4 0 1 1 1 1 .. 1 0 4 0 .. .. 11 2 Qidema of brain .. .. .. .. .. .. .. 11 .. .. II Locomotor ataxia .. .. .. .. .. .. .. 10 .. .. 10 Cerebral haemorrhage .. .. 44 .. .. 1001 ,. .. .. 5 5 Cerebral abscess .. .. .. 01 .. .. .. .. .. •• 01 Lateral sclerosis .. ..10 .. .. .. .. .. 10 .. 20 Apoplexy .. .. .. .. .. 4 0 .. .. .. .. .. 4 0 III. Diseases op the Respiratory System. Pneumonia .. .. ..0241 102050 1140 .. 17 4 Pleurisy .. ... ..10 .. .. .. .. .. •• 10 Empyema .. .. .. .. .. .. •• 10 .. .. .. 10 Bronchitis .. .. ..30 .. .. 01 .. .. .. .. 31 (Edema of lungs .. .. .. .. ■ ■ • ■ .1 0 2 0 .. .. 3 0 IV. Diseases oe the Circulatory System. Heart-disease .. ..32 4 8 45 10 .. 33 10 .. 16 18 Arterio-sclerosis .. ..1234 .. .. .. 21 .. .. 67 Cerebral embolism .. ..10 .. .. .. .. .. •• 1 0 Thrombosis .. .. .. .. 11 • • • • • • 1 2 .. .. 2 3 V. Diseases oe the Digestive System. Enteritis .. .. ..10 .. 01 .. 10 .. .. .. 21 Peritonitis .. .. ..10 .. .. .. .. •• •• •- 10 Haemorrhage pancreatitis ..01 .. .. .. .. •• •• ■■ 01 Cirrhosis of liver .. ..01 .. .. .. .. •• •• •• 01 Intestinal obstruction .. .. •• 10 .. .. .. ... •• 10 Chronic diarrhoea .. ..10 .. .. .. .. .. •• •• 10 Ulcer of stomach .. .. 10 .. .. .. .. .- •• •• 10 VI. Diseases oe the Genitourinary System. Nephritis ... .. •• •• 2 1 .. .. 2 1 Ovarian tumour .. ..01 .. .. .. .. •• •• •• 01 Uraemia .. .. •• 01 .. .. .. •• 01 VII. Old Age. Senile decay .. .. .. 18 12 9 6 6 8 3 0 0 1 11 8 0 1 3 0 50 36 VIII. Diseases oe the Bones. Osteomyelitis .. ..10 .. .. .. •• •• •• •• i ? Osteoma of skull .. .. •• 01 .. .. .. •• •• 01 IX. Ill-depined Causes. Coma .. . ■ • • • • • • 10 • • • • ■ • • • • • 1 ° Asthenia .. .. .. •• •• •• 01 • • " " " on Marasmus .. .. •• •• •• •• •• 2 0 .. ID .. d 0 X. External Causes. Suicide 1 1 0 1 .. 1 0 .. .. .. 2 2 Traumatic haemorrhage .. .. •• •• 10 .. T ;! Asphyxia .. .. •• •• •• 10 XI. Died while on Trial ..22 .. 30 .. .. 23 .. .. 75 Totals .. .. 63 36 37 32 33 21 10 2 13 2 46 35 12 3 3 1 217 132

H.—7.

Table XIII. —Principal Assigned Causes of Insanity

18

Causes. Auckland, ell jseaohff" Hokitika. Nelson. Porirua. Tokanui. Total. M. F. M. F. M. F. M. F. M. F. M. F. M. F. M. F. M. F. Heredity .. .. .. 11 7 22 7 9 8 2 0 8 1 25 14 12 3 1 0 90 40 Congential .. .. .. 18 12 3 7 11 4 0 2 18 6 7 16 5 3 .. 62 50 Previous attack .. 0 2 14 11 17 21 .. .. 19 12 .. .. 50 46 Puberty or adolescence 18 10 8 6 6 2 .. .. 10 0 .. .. 42 18 Climacteric .. .. 0 2 0 15 0 16 .. 0 2 0 18 .. 0 3 0 56 Senility .. .. 19 16 13 8 13 8 2 1 1 1 10 19 1 0 2 1 61 54 Lactation .. .. .. .. .. .. .. .. .. 01 .. 01 Puerperal .. .. ..0602 .. 010106 .. .. 0 16 Sexual .. .. .. .. .. .. .. .. 0 1 .. 1112 Mental stressSudden .. .. .. .. .. 11 .. .. .. .. .. 11 Prolonged .. .. .. 18 14 6 5 8 4 2 0 0 3 21 12 .. .. 55 38 Alcohol .. .. 44 52 11 0 20 30 13 3 20 01 40 10 Syphilis .. .. 7 0 6 0 10 1 .. .. 15 1 3 1 .. 41 3 Drug habit .. .. ..10 .. 10 .. .. 10 .. .. 30 Isolation .. .. .. .. 1020 .. .. .. .. .. 30 Post-operative .. .. ... .. .. .. .. 02 .. .. 02 Traumatic .. .. ..1010 .. .. .. .. 10 .. 30 Overwork .. .. .. .. .. .. .. .. 10 .. .. 10 Epilepsy .. .. ..4 1 3 6 2 1 .. 0 1 12 7 3 0 .. 24 16 Arterio-sclerosis .. ..8 3 1 1 .. .. .. 3 0 .. .. 12 4 Exhaustion .. .. ..01 .. .. .. .. .. .. .. 01 Encephalitis .. .. .. .. 01 .. .. .. .. .. .. 01 Influenza .. .. .. .. 11 .. .. .. .. .. 0112 111 health .. .. 8 10 .. .. .. .. 5 9 .. .. 13 19 Toxic .. .. ..0 1 0 2 1 1 .. 0 1 .. 4 3 .. 5 8 Cerebral hemorrhage .. .. .. .. .. .. .. 01 .. .. 01 Hemiplegia .. .. .. .. .. .. .. .. .. 010102 Organic brain-disease .. ..01 .. .. .. .. 20 .. .. 21 Heart-disease .. ..04 .. .. .. .. .. .. .. 04 Diabetes .. .. .. .. 10 .. .. .. .. .. .. 10 Thyroid deficiency .. .. .. .. 02 .. .. .. .. .. 02 Privation .. .. .. .. .. .. .. .. 11 .. .. 11 Unknown .. .. ..3220 .. 204489 .. .. 19 15 Transfers .. .. .. 10 1 2 3 1 2 1 0 3 0 5 2 15 3 2 1 39 12 Totals .. .. 130 97 89 77 93 71 11 4 37 20 158 133 46 15 6 9 570 426

H.—7.

Table XIV.—Former Occupations of Patients.

19

~ s * a „• t a • « - 'S O: ■g S ~ * S ~ OeoupationB. ' . u cn «> Occupations. g & "3 t3 3 • •'t! rn P ' ffl | | I I a g 1 | J 1 I a £ g | g .2 2 *3 2 - 0 «® 3.2®£°>-ca :3, 3 £ £ ' § 3 * g 3 3 o SjjS-SI'glSl Males. Accountants .. .. .. 1 1 2 Journalists .. .. 2 2 Apprentices .. .. I 1 2 Labourers .. .. 31 30 32 1 8 48 11 .. 161 Bank-manager 1 .. .. 1 Linesman .. .. 1 1 Bakers .. .. 3.. 1 4 Machinists .. .. .. 1 2 1.. 2.... 6 Barman .. .. .. 1 1 Manager .. .. .. 1 1 Bath attendant 1 .. .. 1 Miners .. 2 3.... 2.. 7 Blacksmiths .. .. 1.. 2 3 Motor-driver .. 1 1 Bootmakers .. .. .. 1 1.... 4.... 6 Motor-mechanics .. .. 1 1.. .. 2 Bus-proprietor 1 .. .. 1 Musician .. .. .. 1 1 Butchers .. 2 .... 2 Naval officer .. 1 .. I Canvasser .. 1 ... .. 1 Orchardists .. .. .. 1 .. .. J 2 Carpenters .. .. 4 2 5.... 2 1.. 14 Packer .. . . 1 X Carrier .. ' .. 1 1 Painters .. .. 1.. 3.... 2 .... 6 Chemists .. .. 2.. 1.... 3.... 6 Pensioners .. .. 5 6.. 1 .. 1 .. .. 13 Civil servants .. 1 1 1.... 3.... 6 Plumbers .. .. 2 1 3 Clergymen .. 1.. 1 2 Point-cleaner .. 1 1 Clerks .. .. 3 2 1.. 6 Porters .. 1 1.. 2 Coachbuilder .. .. 1 1 Poultryman .. .. .. 1 X Compositors .. .. .. 1 2 1.. 4 Printer .. 1 1 Confectioner .. 1 .. . . 1 Prisoners .. .. 4..| 2 .... 6 Cooks .. .. 3 2 2..i.. 7 Railway employee 1 .. .. 1 Custodian .. 1 .. .. 1 Salesmen .. .. 2 1.... 3 Customs agent .. . . .1 J. School-teacher 1 .. .. 1 Drapers .. .. .. 1 1 2 Seamen .. 1.. 4.... 5 Electricians .. .. 1 1.... 2 Settler .. .. 1 1 Engineers .. .. 1.. 2 .... 3.... 6 Shepherd .. 1 1 Engine-driver.. 1 1 Shipwright .. .. .. 1 1 Factory manager 1 .. 1 Slaughterman 1 .. .. 1 Partners .-. 14 10 9 2 1 1 5 2 44 Stewards .. 2 .... 2 Farriers .. 2 .... 2 Storekeeper .. . . .. 1 1 Farm hands .. .. .. 3 20 3 . . 26 Storemen .. .. 1.. 3 4 Firemen .. .. 1 2 .... 3 Students .. .. 1111.. ).... 5 Fisherman .. 1 .. . . I Surveyor .. .. .. 1 1 Fruiterers .. .. 1.. 1 2 Tailors .. 1.... 2 .... 3 Gardeners .. .. .. 3 2 .... 3 1 .. 9 Travellers .. .. .. 1 1.... 1.... 3 Grocer .. 1 .. .. 1 Warder .. 1 1 Gum-diggers . . .. 3 3 Wool-classers .. .. 1 1.. .. 2 Hairdressers .. .. 2 2 Wool-buyers .. .. .. 1 1.... 2 Hawker .. 1 1 No occupation .. 18 7 15 .. 24 16 3 .. 83 Horse-trainer 1 1 Unknown .. .. 5 1 1.... 7 Herd-tester .. l! .. 1 Transfers .. .. 10 2 1 1 3 5 15 2 39 Indent agent .. .. 1 j .. I Insurance agent .. .. 1 ..I I .. 1 Totals .. 'l30 89 93 II 37 158 46 6 570 Females. Barmaid .. 1 .. .. 1 Prisoner .. 1 > .. I .. 1 Cook .. .. 1 1 Retoucher .. .. 1 .. 1 Clerk .. .. .. 1 1 School-teachers .. I 1 1.. .. 3 Domestic duties .. 82 48 64 3 15116 9 8 345 Shop-assistants .. .. 1 1.. 1 3 Dressmaker .. 1 1 Typists .. .. 2.. 1.... 1.... 4 Factory employee .. 1 1 Student .. .. .. 1 1 Home missionary 1 . . .. 1 No occupation .. 8 13 1 1 4 9 1 .. 3? Laundress .. 1 .. 1 Transfers .. .. 1 3 2.... 2 3 1 1^ Machinist .. 1 . . . . 1 Nurses .. .. .. 2 1 1 .. 4 Totals .. 97 77 71 4 20133 15 9 426 Pensioners .. .. .. 7 7

H.—7

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.

20

D ' 3chaJ g ed - Remaining, Avenue Percentage Percentage of Deaths Year. Admitted. Died. 31st December in resident of Recoveries on on Average Numbers Recovered. Relieved. Not Improved. each Year. " ' Admissions. resident. M F. T M. F T. M. F. T. M. p. T. M. F. T. M. F. T. M. F. T. M. F. T. M. F. T. 1875 .. .. 482 254 736 1876 .. 221 117 338 129 79 208 17 8 25 2 8 10 36 12 48 519 264 783 491 257 748 54-53 66-01 57-56 8-21 3-58 6-70 1877 .. 250 112 362 123 57 180 20 5 25 3 2 5 42 21 63 581 291 872 541 277 818 49-20 50-80 49-72 7 76 7-58 7-70 1878 .. 247 131 378 121 68 189 14 14 28 4 4 8 51 17 68 638 319 957 601 303 904' 48-98 51-90 50-00 8-48 5-61 7-52 1879 .. 248 151 399 112 76 188 15 13 28 9 4 13 55 16 71 695 361 1,056 666 337 1,003 45-16 50-33 47-11 8-25 4-74 7 07 1880 .. 229 149 378 100 67 167 36 25 61 5 2 7 54 20 74 729 396 1,125 703 371 1,074 43-66 44-96 44-17 7-68 5-39 6-89 1881 .. 232 127 359 93 65 158 41 36 77 9 2 11 49 14 63 769 406 1,175 747 388 1,135 40-08 51-10 44-01 6-29 3-60 5-55 1882 .. 267 152 419 95 59 154 49 32 81 5 6 11 60 19 79 827 442 l,269i 796 421 1,217! 35-58 38-81 36-75 7-53 4-51 6-49 1883 .. 255 166 421 102 78 180 13 20 33 10 9 19 65 18 83 892 483 1,375 860 475 1,335' 40-00 46-98 42-75 7-55 3-78 6-21 1884 .. 238 153 391 89 77 166 17 ' 9 26 18 12 30 6S 24 92 938 514 l,452i 911 497 1,408 37-39 50-32 42-45 7-46 4-82 6-53 1885 .. 246 133 379 95 76 171 10 5 15 25 2 27 73 22 95 981 542 1,523 965 528 1,493 38-62 57-14 45-12 7-56 4-16 6-36 1886 .. 207 165 372 99 60 159 11 17 28 12 7 19 57 19 76 1,009 604 1,613 984 559 1,543 47-82 36-36 42-74 5-79 3-39 4-91 1887 .. 255 161 416 103 78 181 34 17 51 74 27 101 1,053 643 1,696 1,034 613 1,647 40-39 48-75 43-61 7-15 4-40 6-13 1888 .. 215 146 361 116 92 208 31 28 59 2 3 5 78 26 104 1,041 640 1,681 1,045 641 1,686 53-95 63-01 57-62 7-56 4-05 6-16 1889 .. 230 161 391 93 53 146 31 30 61 3 1 4 70 30 100 1,074 687 1,761 1,046 660 1,707 40-43 32-92 37-34 6-69 4-54 5-86 1890 .. 230 160 390 98 88 186 ' 23 17 40 12 5 17 76 35 111 1,095 702 1,797 1,078 685 1,763 42-61 55-00 47 69 7-05 5-11 6-29 1891 .. 234 171 405 88 74 162 33 24 57 14 .. 14 79 41 120 1,115 734 1,849 1,089 699 1,789 37-61 43-27 40-00 7-25 5-86 6-71 1892 .. 231 158 389 89 76 165 21 17 38 8 2 10 74 34 108 1,154 763 1,917 1,125 714 1,839 38-53 48-10 42-42 6-58 4-76 5-87 1893 .. 281 179 460 101 89 190 17 12 29 10 8 18 78 23 101 1,229 810 2,039 1,172 758 l,930j 35-94 49-72 41 30 6-66 3-03 5-23 .1894 .. 270 176 446 107 76 183 15 11 26 5 4 9 64 35 99 1,308 860 2,168 1,241 812 2,053 39-63 43-13 41-03 5-16 4-31 4-82 1895 .. 252 165 417 105 77 182 24 19 43 1 2 3 101 42 143 1,329 885 2,214 1,313 849 2,162 41-67 46-66 43-64 7-69 4-94 6-61 1896 .. 278 159 437 104 70 174 25 16 41 2 1 3 86 32 118 1,390 925 2,315 1,347 882 2,229, 37-41 44-02 39-13 6-38 3-63 5-29 1897 .. 284 193 477 102 73 175 17 12 29 10 .. 10 105 43 148 1,440 990 2,430 1,411 944 2,355 35-92 37-82 36-69 7-44 4-55 6-28 1898 .. 254 212 466 114 110 224 13 23 36 7 1 8 88 60 148 1,472 1,008 2,480 1,438 973 2,411:44-88 51-89 48-07 6-12 6-17 6-14 1899 .. 259 199 458 88 99 187 15 19 34 2 1 3 114 43 157 1,512 1,045 2,557 1,487 1,004 2.491 33-98 49*49 40-83 7-67 4.28 6-30 1900 .. 300 202 502 103 96 199 29 10 39 4 4 99 46 145 1,581 1,091 2,672 1,534 1,049 2,583 34-33 47.54 39-64 6-45 4-38 5-61 1901 .. 320 223 543 125 104 229 20 17 37 .. 2 2 102 72 174 1,654 1,119 2.773 1,622 1,094 2,716 39-06 46-64 42-17 6-29 ! 6-58 6-41 1902 .. 352 192 544 135 99 234 26 15 41 10 9 19 120 55 175 1,715 1,133 2,848 1,671 1,114 2,785 38-35 51-56 43-01 7-18 I 4-94 6-28 1903 .. 355 226 581 144 101 245 26 24 50 2 2 129 44 173 1,771 1,188 2,959 1,741 1,160 2,901' 40-56 44-69 42-17 7-41 [ 3-79 5-96 1904 .. 332 236 568 157 106 263 24 11 35 1 1 120 70 190 1.801 1,237 3,038 1,780 1,198 2,978 47-59 44-91 46-30 6-74 1 5 84 6-38 1905 .. 360 251 611 149 121 270 29 24 53 147 67 214 1,836 1,276 3,112 1,796 1,232 3,028 41-39 48-21 44-19 8-18 5-44 7-07 1906 .. 395 264 659 157 126 283 28 22 50 1 1 146 85 231 1,900 1,306 3,206 1,823 1,265 3,088 39-75 47-73 42-94 8-01 6-71 7-48 1907 .. 359 241 600 160 139 299 22 13 35 168 64 232 1,909 1,331 3,240 1,851 1,285 3,136 44-29 57-68 49-84 908 4-98 7-39 1908 .. 426 318 744 180 146 326 9 12 21 1 .. I 148 74 222 1,997 1,417 3,414 1,894 1,346 3,240 42-25 45-91 43-82 7-81 5-50 6-85 1909 .. 419' 297 716 179 170 349 17 11 28 1 1 136 68 204 2,083 1,465 3,548 1,970 1,404 3,374 42-72 57-24 48-74 6-90 4-84 6-00 1910 .. 474 314 788 182 145 327 29 27 56 186 97 283 2,160 1,510 3,670 2,028 1,445 3,473 38-40 46-18 41-50 9-17 6-71 8-15 1911 .. 448 317 765 163 168 331 23 16 39 4 2 6 198 105 303 2,220 1,536 3,756 2,105 1,496 3,601 36-38 53-00 43-27 9-41 7-02 8-41 1912 .. 458 381 839 184 141 325 17 44 61 11 5 16 193 87 280 2,273 1,640 3,913 2,146 1,551 3,697; 40-17 37-01 38-74 8-99 5-61 7 57 1913 .. 466 318 7S4 175 162 337 35 48 83 1 5 6 196 111 307 2,332 1,632 3,964 2,252 1,597 3,849 37-55 50-94 42-98 8-70 6-96 7-98 1914 .. 509 359 868 207 162 369 27 29 56 6 9 15 193 88 281 2,408 1,703 4,111 2,309 1,641 3,950 40-67 45-12 42-51 8-36 5-36 7-11 1915 .. 450 361 811 202 157 359 26 32 58 10 11 21 172 112 284 2,448 1,752 4,200 2,391 1,703 4,094 44-89 43-21 44-88 7-19 6-58 6-94 1916 .. 518 361 879 160 171 331 35 34 69 7 8 15 209 80 289 2,555 1,820 4,375 2,483 1,768 4,251 30-89 47-37 37-66 8-42 4-52 6-80 1917 .. 470 374 844 171 152 323 32 20 52 6 5 11 205 113 318 2,611 1.904 4,515 2,543 1,825 4,368 36-38 40-64 38-27 8-06 6-19 7-28 1918 .. 437 402 839 142 141 283 17 36 53 12 12 24 274 174 448 2,603 1,943 4,546 2,602 1,899 4,501 32-49 35-07 33-73 10-53 9-16 9-95 1919 .. 512 371 883 190 147 337 37 44 SI 9 13 22 212 130 342 2,667 1,980 4,647 2,620 1,907 4,527 37-11 39-62 38-17 8-09 6-82 7 55 1920 .. 455 418 873 162 148 310 27 37 64 6 10 16 210 166 376 - 2,717 2,037 4,754 2,674 1,980 4,654 35-63 35-32 35-51 7-85 8-40 8-08 1921 .. 479 402 881 178 193 371 30 21 51 15 9 24 201 117 318 2,772 2,099j 4,871 2,723 2,031 4,754 37-23 47-88 42-11 7-38 5-76 6-69 1922 .. 453 386 839 156 157 313 32 20 52 10 8 18 211 184 395 2,816 2.116 1 4,932 2,747 2,062 4,809 34-44 40-67 37-31 7-67 8-92 8-21 1923 .. 442 366 808 168 151 319 42 38 80 15 5 20 194 131 325 2,839 2,157| 4,996 2,789 2.079 4,868 38-00 41-25 39-48 6-95 6-30 6-67 1924 .. 446 377 823 152 128 280 30 42 72 9 11 20 221 95 316 2,873 2,258: 5,131 2,808 2,146 4,953 34-08 33-95 34-02 7-87 4-42 6-37 1925 .. 445 430 875 144 175 319 29 37 66 23 17 40 201 123 324 2,921 2,336 5,257 2,830 2,203 5,033 32-36 40-69 36-45 7-45 5-57 6-43 1926 .. 508 439 947 136 145 281 27 35 62 15 25 40 207 147 354 3,044 2,423 5,467 2,926 2,287 5,213 26-18 30-75 29-67 6-16 6-42 6-77 1927 .. 531 414 945 157 128 285 40 42 82 14 9 23 217 132 349 3,147 2,526 5,673 3,022 2,373 5,395 29-56 30-91 30-16 7-17 5-65 6-47 18,032 13,036 31,068 6,984 5,796 12,780 1,307 1,190 2,497 364 268 632 6,712 3,510 10,222 Excluding transfers between institutions —1,515 males, 1,031 females.

H.-7

Table XVI. —Showing the Admissions, Discharges, and Deaths from Ist January 1876, to 31st December, 1927 (excluding Transfers). M. F. T. In hospitals, 31st December, 1875 .. . . .. 482 254 736 Admissions .. .. .. .. .. 18,032 13,036 31,068 18,514 13,290 31,804 Discharged— M. F. T. Recovered .. .. .. 6,984 5,796 12,780 Relieved .. .. .. 1,307 1,190 2,497 Not improved .. .. 364 268 632 Died .. .. .. .. 6,712 3,510 10,222 15,367 10,764 26,131 Remaining on 31st December, 1927 .. .. .. 3,147 2,526 5,673

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

21

Males. FemaJes. Both Sexes. Recovered .. .. .. .. .. 38-77 4446 41-13 Relieved .. .. .. .. .. 7-77 8-12 8-03 Not improved .. .. .. .. .. 2-01 2-05 2-03 Died .. .. .. .. .. .. 37-22 26-91 33-63 Remaining .. .. .. .. .. 14-23 18-46 15-18 100-00 100-00 100-00

H.—7

Table XVIII.— Debits for the Financial Year, 1927-28.

22

Auckland. Christchurch. Dunedin. Hokitika. Nelson. Porirua. Tokanui. Head Office. Total. £ s. d. £ s. d. £ s. d. £ s. d. £ s. d. £ s. d. £ s. d. £ a. d. £ s. d. Salaries .. .. .. .. .. •• 33,161 18 0 37,303 11 5 49,469 8 3 13,811 13 2 17,299 1 4 45,727 5 6 16,867 8 6 6,718 18 6 220,359 4 8 Official Visitors .. .. .. . . .. 50 8 0 25 4 0 23 2 0 13 13 0 .. 45 19 9 17 2 9 .. 175 9 6 Advertising, books, &c. .. .. .. .. 2 2 0 12 5 9 16 16 6 11 3 9 3 17 6 8 6 0 4 16 6 62 11 2 121 19 2 Bacteriological research .. .. .. .. .. 710 070 .. 1116 17 06 3 13 6 .. 29 13 6 Bedding and clothing .. .. .. .. 5,196 18 4 3,655 13 4 5,259 19 5 948 11 4 3,469 4 3 6,812 1 2 2,403 5 7 .. 27,745 13 5 Buildings : including additions, &c. .. .. 1,279 2 10 1,539 19 8 1,550 5 5 348 8 10 71 6 0 961 19 9 983 7 0 .. 6,734 9 6 Dental services .. •• •• [ 62 10 0 ] 12 8 6 10 11 6 2 15 0 100 0 7 178 2 2 36 4 8 .. 411 9 5 Developmental .. ■■ .. .. •• •• .. •• •• •• 1,179 17 7 .. 1,179 .17 7 Fares and expenses of medical officers from United 211 16 9 .. .. .. .. 250 12 0 .. .. 462 8 9 Kingdom Farms, maintenance of .. .. .. .. 1,451 10 6 705 18 4 2,452 6 1 398 1 1 1,284 18 10 1,822 0 0 1,829 8 11 .. 9,944 3 9 Fencing, draining, and roading .. .. .. 170 ,6 4 125 10 0 537 0 6 51 4 9 53 14 6 211 1 10 329 9 11 .. 1,478 7 10 Freight, cartage, and transport .. .. .. 107 15 1 219 6 5 495 17 6 49 15 10 128 1 3 262 8 11 179 14 11 1 4 1 1,444 4 0 Fuel, light, water, &c. .. .. .. .. 5,017 14 0 5,242 16 3 5,387. 1 4 938 12 2 2,525 6 0 5,282 13 11 1,723 0 6 .. 26,117 4 2 Funerals, expenses of .. .. .. .. 79 15 0 60 10 0 22 10 0 9 15 0 33 10 0 89 2 6 27 13 0 .. 322 15 6 Furniture and furnishings .. .. .. .. 422 9 9 379 17 8 308 15 0 205 4 4 157 2 6 625 8 0 251 15 9 4 8 6 2,355 1 6 Gardens and shrubberies, expenses of .. .. 52 15 7 166 16 4 32 18 9 25 18 11 24 18 11 30 5 0 44 7 7 .. 378 1 1 Laundry .. .. .. .. .. 316 12 4 323 3 5 1,978 15 0 936 19 9 248 9 2 536 1 9 249 16 6 .. 4,589 17 11 Legal and inquiry costs .. .. .. .. .. .. 75 17 5 .. .. .. .. 108 19 9 184 17 2 Machinery, repairs, and stores .. .. .. 97 4 1 243 2 5 193 13 10 22 12 1 62 19 9 315 6 4 184 4 9 .. 1,119 3 3 Medical fees for certificates, &c. .. .. 471 5 0 395 9 4 394 8 6 36 10 6 87 5 6 667 1 5 88 10 0 .. 2,140 10 3 Motor-vehicles, maintenance of .. . . .. 35 18 4 35 5 0 104 12 0 10 11 5 85 17 4 264 16 10 63 4 6 .. 600 5 5 Motor-vehicles, purchase of .. .. .. .. 281 1 3 .. .. 277 1 6 .. 210 6 5 .. 768 9 2 Nursing Staff — Engagement of .. .. . • .. . ■ ■ ■ .. ■. .. 20 0 0 .. .. 20 0 0 Uniforms, purchase of .. .. .. .. 354 6 11 513 18 6 522 8 4 146 8 1 135 19 0 537 10 0 136 9 3 .. 2,347 0 1 Office equipment.. .. .. .. .. 0 11 6 6 1 11 0 11 0 5 8 0 4 14 9 0 10 6 0 10 6 28 12 10 47 1 0 Patients' expenses connected with — " Patients' friends" .. .. .. .. 100 0 0 100 0 0 .. .. .. .. .. 200 0 0 Gratuities .. .. .. .. .. 94 18 0 4 14 0 264 4 4 31 14 6 76 14 11 78 18 2 21 16 1 .. 573 0 0 Recreation .. .. .. .. .. 1,301 5 11 1,095 8 7 1,767 19 11 420 12 7 545 2 11 695 14- 4 711 4 10 .. 6,537 9 1 Transfers .. .. .. .. .. 48 14 10 14 0 0 27 15 7 .. .. 85 4 0 11 5 8 .. ' 187 0 1 Postages and telegrams .. .. .. .. 63 7 6 93 11 3 123 3 11 11 0 0 33 19 1 111 13 3 40 14 8 197 16 7 675 6 3 Printing and stationery .. .. .. .. Ill 2 11 162 18 3 174 12 3 44 11 6 61 10 1 117 7 9 62 6 9 109 4 6 843 14 0 Rations .. .. .. .. .. 16,654 10 1 11,830 4 5 20,465 12 9 4,186 2 11 5,286 13 0 15,527 19 7 2,726 18 5 .. 76,678 1 2 Rents and rates .. .. .. .. .. .. 1,963 18 9 148 0 9 .. .. .. .. .. 2,111 19 6 Stores .. .. .. .. .. 1,020 12 8 876 7 5 1,089 5 0 149 12 10 333 8 8 887 9 11 345 2 10 .. 4,701 19 4 Surgery and dispensary — Drugs and instruments .. .. .. .. 396 8 6 528 12 3 397 0 4 57 12 0 187 1 5 1,041 1 1 102 13 6 .. 2,710 9 1 Wines, spirits, ales, and porter .. .. .. .. 7 18 0 25 16 8 1 17 6 5 2 0 28 6 8 5 19 7 .. 75 0 5 Telephone services .. .. .. .. 54 18 11 84 1 0 206 8 9 17 14 3 41 17 10 134 2 11 57 18 0 80 0 6 677 2 2 Transfer and removal expenses .. .. .. 98 48 203 .. .. 400 38 19 8 155 12 10 .. 298 17 5 Travelling-allowances .. .. .. .. 62 8 11 54 11 3 54 9 2 .. 63 4 2 9 0 8 11 10 11 295 9 9 550 14 10 Travelling-expenses .. .. .. .. 96 14 2 73 6 0 249 17 11 20 4 11 45 9 7 85 14 9 91 8 8 296 4 2 959 0 2 Treatment and maintenance in General Hospitals — Patients .. .. .. .. .. 19 10 0 3 5 6 59 7 0 12 12 0 6 16 6 78 0 6 5 8 0 .. 184 19 6 Staff .. .. .. .. .. 36 80 220 3 10 0 28 10 0 440 : 420 220 .. 80 18 0 Contingencies .. .. .. .. .. 121 0 18 5 4 15 5 126 206 190 080 .. 11 15 11 Official trip abroad, Deputy Inspector-General .. .. .. .. .. .. .. .. 487 17 5 487 17 5 Total expenditure .. .. .. 68,612 4 6 68,152 17 10 93,999 5 1 22,956 14 6 32,752 4 10 83,590 18 1 31,166 19 4 8,391 7 9 409,622 11 11 Credits .. .. .. .. .. 22,503 1 11 23,158 11 2 30,645 11 6 3,516 6 8 9,434 0 11 32,068 3 8 13,478 2 2 1 4 0 134,805 2 0 Net expenditure .. .. .. 46,109 2 7 44,994 6 8 63,353 13 7 19,440 7 10 23,318 3 11 51,522 14 5 17,688 17 2 8,390 3 9 274,817 9 11

H.—7.

Table XX.—Expenditure, out of Public Works Fund, on Mental Hospital Buildings, etc., during the Financial Year ended 31st March, 1928, and Liabilities at that Date.

Table XVIIIa.— Credits for the Financial Year, 1927-28.

23

Auckland. Christchurch. Dunedin. Hokitika. Nelson. Porixua. Tokanui. Head Office. Total. j j i £ s. d. £ s. d. £ s. d. £ s. d. £ s. d. £ s. d. £ s. d. £ s. d. £ s. d. Receipts for maintenance .. .. •• •• 21,086 8 6 17,792 15 10 : 25,277 3 3 2,554 2 3 ! 7,326 4 10 29,365 16 1 7,883 1 4 .. 111,285 12 1 Receipts for farms .. .. . ■ •• 735 10 5 3,332 18 4 1,501 0 0 111 16 4 1,512 15 4 1,058 8 3 4,921 4 10 .. 13,173 13 6 Miscellaneous .. .. .. -■ ■■ 681 3 0 2,032 17 0 ! 3,867 8 3 850 8 1 595 0 9 1,643 19 4 673 16 0 1 4 0 10,345 16 5 ' 1 . Totals .. .. .. .. •• 22,503 1 11 23,158 11 2 30,645 11 6 3,516 6 8 9,434 0 11 32,068 3 8 13,478 2 2 14 0 134,805 2 0 Table XIX. —Average Cost op each Patient pee Annum. Average Bedding Buildings Fuel, Light, Surgery Wines, whSS?? Tot®' Cost Other Net Cost Net Cost Decrease Increase Mental Hospital. Number Salaries. and and Parm. Wa er, and Provisions. and Spirits, Ale, ?■ per Si He- per previous in in resident. Clothing. Repairs. Cleaning. Dispensary, and Porter. ' kneous Patient. tenance payments. Patient. Year. 1927-28. 1927-28. £ s. d. £ s. d. £ s. d. £ s. d. £ s. d. £ s. d. £ s. d. £ s. d. £ s. d. £ s. d. £ s. d. £ s. d. £ s. d. £ s. d. £ s. d. £ s. d. Auckland .. .. 1,162 28 11 7£ 4 9 5J 1 2 0 1 5 0 4 6 4$ 14 6 7f 0 6 10 .. 4 13 0 59 0 11 i 18 2 11JI 1 4 4$39 13 7$37 13 9£ .. 1 19 S Christchurch .. 857 43 13 5f 4 5 3J 1 15 10J 0 16 5J 6 2 4 13 16 1 0 12 4 0 0 2 8 8 5| 79 10 6 20 15 3 | 6 5 2J52 10 2 If 2 12 1J Dunedin (Seaolifi) .. 1,187 41 15 7 48 7J16H214 4 10 9J 17 4 10 0 6 8| 0 0 5£ 7 9 5 79 3 9J21 5 10J! 4 10 5$53 7 5457 16 Hi 4 9 6 Hokitika .. .. 220 62 16 10J 4 6 2f 1 11 8 1 16 3 4 5 4 19 0 5f 0 5 3 0 0 2 10 4 9 104 6 11J 11 12 2J; 4 7 5$ 88 7 4 ,90 4 7J 1 17 3J Nelson .. .. 407 42 10 1' 8 10 5} 0 3 6 3 3 1| 6 4 1 12 19 9£i 0 9 2J 0 0 3 6 8 11 80 9 5 118 0 0 5 3 7 |57 5 10 53 1 6i .. 4 4 3J Porirua .. .. 1,387 33 0 0J 4 18 3 0 13 9| 1 6 3J 3 16 2 11 3 11 i 0 15 0 0 0 5 4 11 5J 60 5 4 21 3 5 | 1 19 0 37 2 11 41 4 5f 4 1 6J Tokanui .. .. 350 48 4 10 6 17 4 2 16 2| 8 11 11| 4 18 7 15 10 I 0 5 10$ 0 0 4 9 10 2 89 0 11J22 10 5$ 15 19 8$50 10 9|50 19 10f 0 9 lj Head Office (Wellington) .. 141 .. .. .. .. j .. .. 060 1 10 1 .. j .. 1 10 1 1 11 0 0 0 11 Totals .. 5,570 39 12 7 4 19 7£ 1 4 2 1 19 11 4 13 9J 13 15 4 0 9 9 0 0 3ji 6 15 4J 73 10 9} 19 19 7 4 4 5J49 6 9J51 6 2$ 1 19 5J I . I I 1 I 1

XJ AXJJ1. Mpntnl Hnsnitals 1 Net Expenditure for Year Liabilities Mental Hospitals. ended 31st March, 19J8. i on 31st March, 1928. | I £ £ Auckland .. .. .. .. .. .. 12,213 859 Christchureh (Sunnyside) .. .. .. .. 10,164 ' 408 Hokitika.. .. .. .. .. .. .. 141 Nelson and Stoke.. .. .. .. .. .. 753 14 Porirua .. .. .. .. .. .. .. 16,315 1,065 Seaclifi .. .. .. .. .. .. 9,408 1,369 Tokanui .. .. .. .. .. .. .. 2,124 237 Waitati Total .. .. .. .. .. 51,118 3,952

H.—7

Table XXI.—Total Expenditure, out of Public Works Fund, for Buildings and Equipment at each Mental Hospital from 1st July, 1877, to 31st March, 1928.

By Authority: W. A. G. Skinner, Government Printer, Wellington.— 1928.

Approximate Cost of Paper.—Preparation, not given; printing (625 copies), £37 10s.

Price 9d, J

24

Total Mental Hospitals. 1877-1919. 1919-20. 1920-21. 1921-22. 1922-23. 1923-24. 1924-25. 1925-26. 1926-27. 1927-28. to 31st March, 1928. it £ £ £ £ ££££££ £ Auckland .. .. .. .. 146,643 543 8,040 9,013 777 5,188 2,393 2,073 19,988 12,213 206,871 Reception-house at Auckland .. .. 5,059 .. .. .. .. .. .. .. .. .. 5,059 Christchurch (Sunnyside) .. .. 182,844 2,490 5,139 3,494 2,245 1,497 6,272 2,901 7,229 10,164 224,475 Dunedin (The Camp) .. .. .. 4,891 .. .. .. .. .. .. .. .. .. 4,891 Hokitika .. .. .. .. 3,727 .. .. 984 4,789 10,216 16,013 8,034 1,745 141 45,649 Hornby .. .. .. .. .. 7,370 928 2,682 122 .. .. .. .. .. 11,102 Motuihi Island .. .. .. 561 .. .. .. .. .. .. .. .. .. 561 Napier .. .. .. .. 147 .. .. .. .. .. .. .. .. .. 147 Nelson .. .. .. .. 26,045 208 3,496 3,316 1,929 1,429 2,389 1,182 805 .. 40,799 Richmond .. .. .. .. 1,097 .. .. .. .. .. .. .. .. .. 1,097 Seaclifi .. .. .. .. 181,630 2,069 40 3,389 1,602 1,246 3.016 4,767 17,888 9,408 225,057 Stoke .. .. .. .. .. .. .. .. 337 1,450 3,095 12,568 2,691 753 21,704 Tokanui .. .. .. .. 76,229 4,111 5,381 9,774 515 2,743 16,076 8,097 1,658 2,124 126,708 Waitati .. .. .. .. 8,935 848 3,620 3,217 848 194 .. .. 637 .. 18,299 Wellington .. .. .. .. 29,641 .. .. .. .. .. .. .. .. .. 29,641 Wellington (Porirua) .. .. .. 205,799 638 724 5,969 688 2,578 18,374 38,213 16,004 16,315 305,302 Totals .. .. .. 873,248 18,277 27,368 41,838 13,852 26,541 68,438 77,835 68,635 51,118 1,267,152