MENTAL HOSPITALS OF THE DOMINION (REPORT ON) FOR 1930.

Appendix to the Journals of the House of Representatives, 1931 Session I-II, H-07

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1931. NEW ZEALAND.

MENTAL HOSPITALS OF THE DOMINION (REPORT ON) FOR 1930.

Presented to both Houses of the General Assembly pursuant to Section 78 of the Mental Defectives Act, 1911.

The Director-General to the Hon. A. J. Stallworthy, Minister in Charge of the Department of Mental Hospitals. Sir, — Wellington, Ist July, 1931. I have the honour to present the annual report upon the work of the Department of Mental Hospitals for the year ending 31st December, 1930. At the end of the year 6,293 persons were actually resident in the Government mental hospitals, of whom 5,979 were the subject of a Magistrate's reception order, and 314 were voluntary boarders who had entered the institutions upon their own application. In addition to those actually in residence, 359 patients were out on probation in the care of friends and relatives at the end of the year. Our admissions during the period under review totalled 1,407 persons —1,095 by committal and 312 by voluntary application. We were able to discharge 591 persons during the year, of whom 382 had been committed and 209 were voluntary boarders, the discharge-rate of the two classes being 29-9 per cent, and 66-6 per cent, respectively. " Recovery " from a mental illness cannot always be strictly interpreted as merely the abeyance of the symptoms which necessitated admission, but rather as the fitness of the patient for reabsorption into ordinary civil life, with its occupations, its pleasures, its temptations, and its disharmonies or stresses. The period of rehabilitation often presents great difficulties to our patients, whose initial mental constitution-is in many cases below par, and, although we aim at and have the gratification of seeing many " recoveries " in the true sense of the term, in not a few cases the most we can hope for is a harmonious adjustment between the individual and his environment on discharge. It is always necessary to ensure that the recreative work of weeks or months is not undone by adverse conditions met with immediately on discharge, and detention is therefore sometimes longer than it would be under more favourable circumstances. Taking into account the present depression, with widespread unemployment, the discharge-rate must be considered as highly satisfactory. Facilities for Admission. The alternative method of committal provided under section 8 of the Mental Defectives Amendment Act, 1928, was used in 217 cases, or 19-8 per cent, of the total admissions, as compared with 16-4 per cent, last year. Under this section the necessity for patients having to be taken to the Magistrates' Courts for committal is avoided. The medical examinations of the persons concerned are carried out in the privacy of the home and the legal formalities completed at the hospital. That there is a desire on the part of those affected to avoid unnecessary formality or association with the Courts is reflected in the fact that during the year over 37 per cent, of all our admissions were effected either under section 8 or by voluntary request. Shortage of Accommodation. During the year 1,407 persons were admitted to our hospitals, and in spite of discharges, deaths, and releases on probation our population on 31st December was 336 in excess of that on the corresponding date of the previous year. To meet the increase new additional accommodation was made available for about 300 patients, and at the end of the year we had 748 patients in excess of proper accommodation.

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The following table shows the distribution of patients and the position in regard to overcrowding at the different institutions at the end of the year :

Three new villas at Stoke for which contracts were let in October, 1928, were completed and occupied in November, 1930, and this, with the occupancy of three villas at Tokanui last year, has rendered less acute the congestion at Porirua ; but the planning, the arranging of contracts, and the erection of such buildings involves much time, and if the evils of overcrowding are to be avoided it is necessary to lay down, and adhere to, a programme well in advance of immediate needs. It is a generally accepted view that the efficiency of an institution becomes increasingly impaired as its patient population increases beyond one thousand, and for this and other reasons I consider that it would be a bad policy to add to the existing larger institutions. In addition to the inherent disadvantages of a large institution population, a factor which must be considered is that at Porirua, Auckland, and Christchurch all the land not already occupied by buildings is required for farm and garden production in order to lessen the cost of maintenance, and also that so far as Seaclifl is concerned the considerable movement of the ground makes it increasingly difficult to find safe sites for building. In order to avoid immediate capital expenditure for land, the policy has been adopted for some time of erecting villas at our smaller institutions, such as Hokitika and Waitati, and transferring patients to them from the larger and overcrowded hospitals. This policy is a sound one from an economic as well as an administrative point of view, but it is limited by the small amount of land available at the lesser places, as well as by the number of patients whose relatives are agreeable to such transfers. The overcrowding at Auckland should be gradually overcome by the complet : on of villas at Kingseat, our new hospital near Papakura, and I would strongly urge that a similar policy be carried out in connection with Porirua. As I have pointed out, a great amount of preliminary work has to be done before any estate purchased can be put into effective occupation by patients, and, so far as cost is concerned, the present time would be a very opportune one to purchase. So far as the South Island is concerned, both Seacliff and Christchurch are taxed for room, and an estate for the erection of a new institution should be acquired about half-way between the main cities. While the table given above sets forth the number of patients in excess of actual room-space, it does not convey in any adequate way the ill results of overcrowding in the institutions. The provision during recent years of admission cottages, neuropathic units, and detached villas, and the modernization generally of our mental hospitals, have gained for us the confidence and cooperation of the public of New Zealand, and, in my opinion, there is not a better system anywhere in the world ; 'but the progressively increasing handicap imposed upon us by lack of accommodation is tending to prevent full advantage being taken of our resources, and unless the rate of building is accelerated our classification system is likely to be thrown out of gear at no distant date. Alterations, Improvements, and Additions. Our capital expenditure on alterations, improvements, and additions during the year was £134,140, and the following summary shows the principal items, as well as new works completed or in progress : —■ Auckland, including Kingseat (£19,502). The first two residential villas at Kingseat are approaching completion, and should be ready for occupation by next August. Tenders are being called for another two similar villas, the specifications in the meantime having been revised in view of the need for earthquake-proof structures. At Avondale verandas have been added to Oakleigh Hall and one of the female wards, and these have proved of value in the nursing of senile and infirm patients. A new residence has been built for the Medical Superintendent. Tokanui (£27,787). The new Nurses' Home is approaching completion. There is accommodation for sixty nurses and domestic workers. Porirua (£3,129). No additions of any consequence have been made to this institution, but extensive renovations and redecoration have been carried out during the year. The electrical installation requires rewiring, and this will be done immediately.

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M , Accommodation Number actually Deficiency of Surplus of en a ospi^a. provided. resident. Accommodation Accommodation. . 1 I Auckland .. .. .. 1,145 1,338 193 Tokanui .. .. .. 497 553 56 Porirua .. .. .. 1,270 1,446 176 Nelson (and Stoke) . . .. 525 423 .. 102 Hokitika .. .. .. 267 278 11 Christchurcli .. .. .. 859 1,017 158 Seaclifl (and Waitati) .. .. 952 1,208 256 Total .. .. .. 5,515 * 6,263 850 102

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Nelson, with Stoke (£26,494). Three new villas at Stoke were completed and occupied in November, and this enabled us to put into effect the policy of making Stoke the main mental hospital, and setting apart the whole of the old Nelson institution for the accommodation of mentally deficient children. A new bakehouse was erected at Stoke. The homestead cottage on the property acquired from Yorks has been altered and enlarged for occupation by the Assistant Medical Officer. Hokitika (£14,764). A new villa of the Templeton type has been erected, and is in occupation by forty-eight female patients, mainly transfers from Christchurch. Sites have been chosen for two similar buildings, which it is hoped will be completed during the ensuing year. New machinery was installed in the laundry, and we are now doing our own washing. Christchurch (£23,993). The old B block, originally the Medical Superintendent's house, was demolished during the year and replaced by a new villa to hold sixty patients. Another villa for children was erected at Templeton Farm. Seacliff, with Waitati (£18,471). Consequent upon the completion of the new kitchen, stores, and laundry blocks, the central portion of the main building is now ready for alterations to provide additional workrooms, staff sleepingaccommodation, and other desirable improvements. This work is now proceeding. An additional villa for fifty women was built at Waitati, and further sites have been selected. The old main building at Waitati is no longer safe for occupation, and plans are under consideration for its replacement by a hospital admission ward. Dangerous Patients. With the gradual extension of parole and the " open door " system in our mental hospitals it is becoming increasingly desirable that a separate institution to serve the needs of the whole Dominion should be erected for the safe custody of dangerous patients. By " dangerous patient " I do not necessarily refer to the so-called " criminal lunatic," and I do not suggest the establishment of an institution like Broadmoor, in England, to which those acquitted of serious crime on account of insanity would be automatically committed. The great majority of those committed to our care under the part of the Act dealing with criminals are not violent or dangerous patients if provided with proper occupation, environment, and treatment, and, instead of causing any trouble or anxiety in our institutions, they are not infrequently amongst the most amenable and industrious of our patients. On the other hand, in every institution there is a small proportion of patients whose hallucinations, persecutory ideas, sexual, fire-raising, or other abnormal proclivities render them a source of great danger to their fellow-inmates and to the staff whilst in the institution, and to the community if they happen to escape. The results of their detention in an ordinary mental hospital are doubly unfortunate. In the first place, they render necessary structural precautions and restrictions which could otherwise be dispensed with to the benefit and increased liberty of the other patients, and, secondly, they have themselves to be guarded and restrained with a strictness which could be mitigated in an institution specially designed for the needs of this small group. The number for whom this purely custodial care requires to be provided is not large —certainly not more than a hundred —but their segregation in this way would be of manifest advantage, to the ordinary run of patients in our mental hospitals. Psychiatric Clinics. The out-patient clinics conducted by our medical officers at the general hospitals in the main centres continue to carry on useful work. Established over five years ago by my predecessor in order to afford early consultation and treatment to those suffering from incipient mental and nervous affections, the clinics have in each successive year shown an increasing number of attendances, particularly in Wellington and Auckland, where the two sessions held weekly are found to be hardly sufficient to deal with the cases presenting. During the past year two additional clinics were opened — one at Invercargill and one at Greymouth —and the figures for them are not available, but those relating to the main centres will indicate the extent of this branch of our work : —

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Number of AT , £ , Number of m i. i n , „ o, -v, 4- -d ~ Number of First 0 , , Total Centre. separate .Persons i, ,. {Subsequent 1x ,. r Consultations. n . Consultations, seen. ConsuJtations. Auckland .. .. 266 242 459 701 Wellington .. .. . . 444 287 532 819 Christchuroli .... 39 39 98 137 Dunedin . . . . . . 175 175 6 181 Total .. .. 924 743 1,095 1,838

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As showing the preventive nature of the work at the clinics, it may be mentioned that, of the 242 first consultations at Auckland, only seventy-nine resulted in the persons concerned having to enter a mental hospital, and, of these, thirty-seven became voluntary boarders. Most of those attending the clinics do so on the advice of their private medical attendants, but many come spontaneously, and others are referred by Government Departments and semi-public social organizations. The Eugenics Board. Two psychological clinics are now being conducted under the auspices of the Eugenics Board— the Wellington one, inaugurated in 1929, and another established at Auckland last year. During the year psychological investigations have been carried out at these clinics upon 712 new cases, in addition to many special examinations arranged in the other centres. The following table shows the source of these cases :— (1) Department of Education — Wellington. Auckland. (a) Children in special classes . . .. .. 44 119 (b) Children in ordinary classes . . ... 38 104 (c) Referred by Child Welfare Branch .. .. 115 14 (2) Department of Health —Division of School Hygiene 60 59 (3) Prisons Department . . .. .. . . 16 (4) Magistrates' and Children's Courts .. . . 10 2 (5) Parents, guardians, and medical practitioners . . 105 26 Total .. .. .. .. ..388 324 It will be seen that in the meantime the main work of the psychological clinics lies in the direction of co-operating with the Department of Education in resolving problems which have arisen in regard to the education or behaviour of children under its control, but it is gratifying to note that the services offered by the clinics are becoming better known to parents, who are consulting us with increasing frequency. At the Wellington clinic the number of such consultations has risen from 35 to 105 during the year. These psychological investigations do not begin and end with the personal examination of the children concerned ; they involve a visit to the home by our social-service workers, who report upon any domestic circumstances which are adverse to the child and which may, indeed, be the fundamental cause of the child's appearance at the clinic. ■ It is our policy to avoid taking children into institutions unless such a course is really necessary in their own interests, and we are greatly assisted in this aim by the social-service workers, whose advice and explanations to the parents are often all that is required. In this connection our social-service workers—Mrs. Dick in Wellington and Miss Watkin in Auckland —have paid 1,021 visits during the year, and their assistance appears to be greatly appreciated by the parents. Accommodation foe Feeble-minded Children. Where institutional care becomes necessary for these children it should be provided in institutions apart from mental hospitals, and this is one of the most urgent problems of our mental-hospital system. As I have previously pointed out, the problem of training the feeble-minded is very different from that involved in the care and treatment of persons suffering from mental disorders, and the segregation of these two groups in the same institution is mutually disadvantageous. Some years ago a first step in the direction of separating these groups was taken by the acquisition of Stoke Farm, near Nelson, the intention being to build a new villa institution at Stoke and to reserve the old Nelson Mental Hospital for defective children. For various reasons the erection of the villas at Stoke has been delayed, but they were completed this year, and the old institution at Nelson has now been set apart for the needs of the lower-grade feeble-minded children. For the higher grades we reserve the Templeton Farm Colony, near Christchurch, where a new villa was added this year —the present population being 144 children (96 boys, 48 girls). In order to maintain Templeton as a training rather than as a custodial institution it is necessary to insist upon a certain standard of mental receptiveness, and those who do not attain this go to Nelson. Unfortunately, both the institutions are now full, and we have a waiting-list of children who have been examined and found suitable for vacancies when they occur. The utilization of Nelson Mental Hospital for this purpose was no doubt the best solution available at the time it was proposed, but its situation within the city area, its limitation as to size, and the expansion of our numbers beyond that originally contemplated raise the question as to whether or not it would be advisable to remove this institution altogether to some more sparsely populated district. I am aware that this is not an opportune time to propose such a scheme, but the matter will have to be faced at some future time. Appreciation. In conclusion, 1 desire to acknowledge my indebtedness to my colleague, Dr. John Russell, the Medical Superintendents, the Assistant Medical Officers, and the other officers of the service for their unfailing loyalty and help at all times. To Mr. Holder and the Head Office staff my thanks are due for good work done throughout the year. I have, &c., • Theo. G. Gray.

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MEDICAL SUPERINTENDENTS' REPORTS.

AUCKLAND MENTAL HOSPITAL. Dr. Buchanan reports : — I have the honour to present to you my annual report for the year ended 31st December, 1930. The total number of cases under care during the year has been 1,508, with a weekly average of 1,223. The admissions have numbered 247 (136 males, 111 females). Of this number, 191 were admitted for the first time. Eighty voluntary boarders were admitted during the year, making a total of 149 under care, and of these 55 were discharged. The increased number of admissions now taxes our accommodation to the utmost, and we already have to look round to find which wards will best carry the surfeit. At the end of the year 72 patients were on probation, 48 on full parole, and 303 on limited parole. Ninety-nine patients were admitted under section 8 of the Mental Defectives Amendment Act, 1928. The general health of the patients has been good, although there have been 12 cases of dysentery in M. 2 Ward. The number of consultations at the Psychiatric Clinic was 701, showing an increase of 208 over last year's figures. The details of these numbers have been forwarded to you in a separate report. In April we were fortunate, through the courtesy of Dr. Gilmour, Bacteriologist of the Auckland Hospital, in procuring benign tertian malarialy infected blood, with which we treated eight general paralytic patients. Unfortunately, the patients available were mostly too advanced in this progressive disease for us to expect a cure. One definite cure was effected, and one man was decidedly improved. Of the remaining six, five have shown no improvement and one died. Infected blood was passed on to Porirua Mental Hospital. The new residence for the Medical Superintendent has been completed and is now in occupation. This leaves the old house vacant and ready to be occupied as a residential clinic as soon as money is available for the necessary alterations and furnishings. In view of the overcrowding in the other parts of the institution, I hope money will be forthcoming in 1931 for this work. Verandas have been built on to F. 7 Ward and Oakleigh Hall. These provide additional nursing facilities, besides improving the appearance of both wards. A circular walk has been constructed through the more picturesque parts of the grounds, and makes a promenade full of interest and gives greatly appreciated shade for walking parties during the hot weather. In August the boiler supplying hot water to the main building broke down irreparably, and we have had to depend since then on an extempore method of heating water by discharging steam into two cylinders. This is not satisfactory, and lam of opinion that, the installation of another but larger boiler will best meet our requirements. Among other changes and alterations, the main male bathroom has been reconstructed ; showers have been installed in M. 3 ; curtains have been hung between the individual baths in the main female bathroom, providing much appreciated privacy. Steam-heated boilers for the making of tea are now in several wards. Copper piping has been substituted for iron piping for hot water in many parts of the building. A veranda has been added to the Senior Medical Officer's house. A steady programme of painting has been carried on throughout the institution, and the Nurses' Home has been painted throughout. I think the time has come when the Department should consider the advisability of disposing of the property of 90 acres, known as " The Reef," which lies adjacent to the Zoological Gardens. Its grazing-properties are poor, and owing to the tramways being now established in the Great North Road the driving of the stock to and from " The Reef " has become a difficult and to a certain extent a dangerous undertaking, The accommodation of the Summer Camp at Kingseat was increased, and now houses thirty patients. These patients are employed in preparing building-sites and roadmaking for the new hospital. They are happy in their surroundings, appreciate the freedom they obtain, and express a reluctance to leave Kingseat to return to Auckland. The usual round of entertainments was provided —bands, concerts, dances, and visits to the local picture-theatre. Competitions in bowls and tennis took place. The annual picnic, as usual, was greatly enjoyed. Regular visits were paid by the Official Visitors. I take this opportunity to record thanks to my whole staff for their loyal co-operation during the year.

TOKANUI MENTAL HOSPITAL. Dr. Prins reports I have the honour to submit my report for the year ending 31st December, 1930. The total number of oases under care has been 613, with a weekly average of 530. The admissions were 64 (males 34, females 30) of these, -32 males and 30 females were admitted for the first time. The transfers were 106 (males 4, females 102). The general health of the Hospital has been exceptionally good. ■ The deaths have been 21 (males 8, females 13), senile decay being the principal cause. The discharges numbered 29 (males 16, females 13) ; of these, 10 males and 9 females were recoveries.

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There were 26 voluntary boarders (15 males and 11 females) under treatment during the year, 7 males and 4 females being new admissions. The discharges were 6 males and 1 female. The cases admitted under section Bof the Act were 24. The number on probation with their people is 13 males and 11 females. The parole system continues to work very well, and the number of male patients allowed this privilege in varying degrees is now 220. The three new villas were opened in February last, 100 female patients being received from Porirua. The recreation of the patients has comprised pictures, dances, and concerts ; while parties have been to the races, show, &c. ; and in the summer bathing parties of men and women. The pictures will cease shortly, owing to there being no supply of silent films, and will be very much missed by every one. During the year a new washing-machine has been installed in the laundry, a new steamer in the kitchen, and the Hospital is being rewired. Lectures have been given to the senior and junior staff. Four attendants and one nurse obtained the senior nursing certificate. Mr. Battson, Official Visitor, has visited the Hospital regularly. In conclusion, I have to express my thanks to all members of the staff for their help and co-operation in the work of the Hospital.

PORIRUA MENTAL HOSPITAL. Dr. Williams reports : — I have the honour to present my report for the year 1930. The total number of people under care during the year was 1,976, of whom 1,809 were committed patients and 167 voluntary boarders. Of committed patients, the number on the register on the Ist January was 1,535 (823 males and 712 females) ; on the 31st December there were 1,458 (855 males and 603 females). The number of admissions for the twelve months was 274 (157 males and 117 females) ; the number discharged was 127 (62 males and 65 females), of whom 107 were " recovered." The number transferred was 113, and the number of deaths was 111. During the year 167 voluntary boarders were under our care ; of these, 93 entered the Hospital for the first time, while 24 were readmissions. We were able to discharge 59 as recovered or greatly improved, 8 required committal, and 6 died, leaving 94 in residence at the end of the year. Thirty-three persons (12 males and 21 females) were admitted under section 8 of the 1928 Amendment Act; all were subsequently committed. It is evident that knowledge concerning this much less harsh form of admission is becoming more widespread —our own figures, for example, are twice those of last year. Overcrowding is still of serious dimensions, more particularly on the male side. Conditions on. the female side were considerably relieved by the transfer to Tokanui early in February of 100 patients ; unfortunately, however, the number of women patients is still uncomfortably close to the prescribed limit. It is very evident, too, that as soon as circumstances permit it will be necessary to provide special accommodation for senile cases requiring only custodial care, and for the mentally deficient. This applies more particularly to the male population, and if such provision were made not only would undue congestion be relieved, but also would be possible a more rational system of classification, with its consequent advantages from the treatment point of view. The general health of patients during the year has been satisfactory. There have been no epidemics, nor any serious or avoidable accidents. A satisfactory amount of work in the way of renovations, additions, &c., has been accomplished during the year, and much of this has tended to the still further comfort of patients. Steam-kettles have been installed in various wards ; hot water has been laid on to the wash-hand-basins where required ; extra bathroom and lavatory accommodation has been added in some parts and enlarged in others. A new servery has been added in A and C Wards, and a host of minor defects have received attention. Outside, too, much has been done. Renovations have been made to the main building, Rauta, the farm buildings, and elsewhere. The five villas, the whole of Rauta, and many other wards have been completely repainted. Repairs have been made to the main drive, and the new access road has been entirely reconstructed. Authority has been given for the repainting of the main building, and this very necessary work will be commenced as soon as weather conditions have settled. Some thousands of trees have been planted on various parts of the estate, for shelter-belts and for beautifying purposes. On the therapeutic side have been added radiant-heat baths, electric sterilizers and drums, and a new surgery is being built in A Ward. The psychiatric clinic at Wellington Hospital continues to function usefully, though, to be sure, we are now finding the two days weekly allotted there barely sufficient to cope satisfactorily with the large numbers attending for treatment. The number of consultations during the year was 819 ; of these 287 were first visits. All classes of nervous and mental disorder were represented, though the bulk consisted of minor neuroses and psychoneuroses. It was noted, too, how large a part conditions of economic stress played in the etiology of the disorders encountered, more particularly those of an anxiety and of paranoidal nature. As heretofore, patients were referred from many sources, and from all parts of the Wellington District.

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Concerning amusements and recreations, "the usual weekly cinema entertainments have been given, as well as dances at regular intervals ; concerts, also, by various amateur and professional artists interested in the hospital —and these are many. Indeed, the patients here are fortunate in the amount of interest that is displayed in their welfare by the people of the Wellington District, as there are very numerous associations, societies, and private individuals who have contributed in truly practical manner in the cause. I must particularly mention the work of Mr. L. 0. Hooker, of Hawera, who at his own expense organized an extremely comprehensive campaign for the installation of radio throughout the hospital. As a result of his efforts the people of the Wellington District have generously subscribed to the present over £1,300, and modern and most complete radio equipment has already been installed in Rauta, Tiro-Moana, Vailima, H Cottage, and the Nurses' Home, while further installation is to be made shortly in the male villas and the lower building. The Rev. Harding, too, in addition to the good work he customarily does here, presented, in conjunction with Mrs. Knight, a very fine Atwater-Kent radio-gramophone combination for the main building. Many thanks are due, too, to the Welfare Branch of the Women's National Reserve, the Wellington Commercial Travellers and Warehousemen's Association, the Victoria University College Social Service Club, the R.S.A., the Red Cross Society, the Salvation Army, Messrs. Nimmo and Sons, and to the many others who have given so generously in the way of services and of donations. My thanks are due also to Mrs. Fraser and Mrs. McVicar, and Messrs. Bothamley and Brady, Official Visitors, for the good work they have done during the year. To the ministers of religion who have visited lam also grateful, for all have been most kind and helpful. I am greatly indebted to my colleagues and to the staff generally for their loyal support throughout the year.

NELSON MENTAL HOSPITAL. Dr. Jeffreys reports : —• I have the honour to submit my report for the year ended 31st December, 1930. At the beginning of the year there were 412 patients on the register (284 males, 128 females), and on the 31st December there were 434. The total number under care during the year was 478 (340 males, 138 females), while the weekly average number resident was 419. There were 66 admissions, and of these 64 (54 males, 10 females) were admitted for the first time. Twenty-three voluntary boarders were under treatment during the year, and of these 4 were committed as ordinary patients, 6 were discharged, and 1 died, leaving 12 remaining at the end of the year. The general health of the patients has been satisfact.ory, but the death-rate was fairly high. Thirty-five patients (27 males and 8 females) died. Of these, 12 were between sixty and eighty years of age. There were several outbreaks of influenza during the year, and the chief sufferers were mental defectives of poor physique and little resisting-power, 13 of whom died from pneumonia concurrent with or following on influenza. At the beginning of November the three new villas at Stoke were occupied by transfer of patients from the main institution at Nelson, which is now practically a home for mental defectives as distinct from the insane. The male side at Nelson is occupied almost solely by mental-defective boys and youths, but it was necessary to leave a few of the old women workers at Nelson to help in the laundry. When the new laundry is built at Stoke these patients will be transferred there. Braemar Lodge is still the receiving and convalescent home. Two of the new villas at Stoke are occupied by parole patients, who gre£Ctly appreciate their new surroundings, but particularly the fact that they are no longer behind locked doors and enjoy so much freedom. The third villa is occupied by female patients of the so-called " refractory " class, and the comparative freedom from irksome restraint has had a remarkably beneficial effect on these patients. Instead of having to spend their day in an enclosure, they now go for long walks, which they thoroughly appreciate. The doors are more often left open than not, and it is difficult to realize that this is a " refractory " ward. Since the beginning of December we have been baking our own bread, and the results are most satisfactory ; but the most urgent need of this institution is a new laundry, and it is to be hoped that before the end of the year a new one will be built at Stoke. The new villas were built for male patients, and, as the occupation of two of them by women is only a temporary arrangement made necessary to relieve congestion, I trust that it will be possible in the near future to build new villas for female patients on the excellent sites we have on what is known as York's Farm. Improvement in the accommodation of the nursing staff at Nelson has not yet been dealt with, and will have to be considered before long. In spite of the financial stringency, the Nelson people have been most generous in their donations towards the patients' recreation fund. We have now at Stoke an excellent wireless set, donated by a lady of the district. The Minister's Association has conducted religious services at Nelson, and it is hoped that similar arrangements will shortly be made for Stoke. To Dr. Brookes and other officers and staff I tender my thanks for their loyal co-operation throughout the year.

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HOKITIKA MENTAL HOSPITAL. Dr. Hayes reports : — I have the honour to submit my report for the year 1930. At the beginning of the year there were 251 patients on the register (175 males, 76 females), and at the end of the year 285 patients (176 males, 109 females). The total number under care was 307 (190 males, 117 females), the average weekly being 246 (171 males, 75 females). Admissions numbered 56 (15 males, 41 females), of which 33 females were transfers and 2 males were readmissions. Of those admitted for the first time, 13 were male and 8 female. Discharges were 9 recovered (6 male, 3 female), plus 2 males discharged not improved. Two females were transferred. There were 2 female voluntary boarders resident on the Ist January, and 2 males and 1 female were admitted during the course of the year. Two female and 1 male voluntary boarders were discharged. None was committed. The health of the patients was good, deaths numbering 9(6 male, 3 female). The principal causes of death was senile decay and cardiovascular degeneration. There was one case of typhoid, which recovered. During the year 7| acres of virgin ground have been cleared, drained, ploughed, and left fallow. This is less than last year, due to the working-parties being employed in roadmaking for the new villa and farm buildings, and also assisting in the construction of the latter. In connection with Huia, the new villa, it was necessary to pipe 9| chains of open drain. This was done by pipes made by the working-parties in wet weather, when they could not be employed outside, and proved to be quite economical, as the cost was practically that of the cement only. The vegetable-garden was enlarged by taking in 1J acres from the farm to meet the growing population. The addition to the greenhouse was completed in July, and our yield of tomatoes should be double that of last year. The installation of pumping machinery to the well and water-tower was practically completed at the end of the year. The farm buildings were well advanced, and the installation of laundry machinery commenced. The fowlhouses have been removed to a site adjacent to the new farm buildings. No tree-planting was done in the afforested area this year, but a nursery was started next to Egmont, in which red-cedars have been planted, and should be ready for blanking up next year. These cedars were kindly supplied by the Conservator of Forests. This nursery is also being used to raise shrubs and flowers for the gardens. The new villa was completed in November, and the old block of ten single rooms was demolished. A tennis-court was constructed by hospital labour, and is now in use. The ground at the back of Aorangi was planted with native bush, and it is proposed to follow this plan next year behind the new villa. The usual recreation has been given to the patients, but in addition extra entertainment has been afforded them, due to the kindness of the Municipal Band and Mr. Lawn's orchestra playing at their dances. Thanks are also due to the Eev. Mr. Knowles Smith, the St. Paul's Dramatic Club, and the Maori Methodist Mission. For Christmas entertainment I wish to thank the combined choirs, and.also Mr. George Davidson. Owing to bad weather, the patients' picnic had to be held in two instalments, the picnic being in the grounds, followed later by a drive in the country. The Official Visitors have paid regular visits, and thanks are due to Miss Reynolds and Messrs. Clifton and Coulson in this respect. The Hospital lost in the death of the Hon. H. L. Michel an Official Visitor who was connected with it for over thirty years, and who right up to the time of his last illness paid regular visits and took the keenest interest in the welfare of the patients. In conclusion, I wish to thank the staff generally for their good work during the year.

CHRISTCHURCH MENTAL HOSPITAL. Dr. McKillop reports : — I have the honour to forward my annual report for the year ending 31st- December, 1930. On the Ist January, 1930, there were 960 patients on the register. During the year 271 patients (141 men and 130 women) were admitted. Seventy-eight patients were discharged and 42 transferred to other institutions. The total number of committed patients under care during the year was 1,231, and 1,051 remained on the 31st December, 1930. During the year 109 voluntary boarders received treatment; 47 (33 men and 14 women) were discharged, 2 died, and 5 were committed. It is very gratifying to note the increasing number who have taken advantage of the section in the Act sanctioning voluntary admission : 26 of the voluntary boarders were recurrent cases who recognized early symptoms of relapse and came in the hope that an attack might be warded off. The general health of the patients has been very good. There were 60 deaths (31 males and 29 females), half the deaths being due to senile changes.

8

H.-7.

Professor Hercus, of the Otago Medical School, continues to take a keen interest in the work of this institution, and I have to record my indebtedness to him and to the officers of his Department for their assistance. Wassermann and other tests for syphilis have been carried out by them in 1,323 cases, 56 males and 18 females giving positive reactions—s-6 per cent, of the number examined. During the year malarial therapy was given to sixteen cases of general paralysis, with satisfactory results in the majority. Tryparsamide therapy has also been carried out, and several cases that have received both courses have made considerable improvement. The Mental Hospital buildings and property have been maintained in good order by the artisan staff, and quite a number of alterations have been completed. The Reception House has been renovated, a sleeping-veranda to accommodate ten patients has been completed, and extensive alterations have been made to provide adequate dining-space. B Ward, one of the original buildings, has been demolished, and the new villa to replace it will soon be available for occupation. The farm house and buildings at Jenkins's Farm, Templeton, have been renovated, and twelve patients are now in residence there. The returns from the farm have been very satisfactory. The patients' recreation has been arranged on the usual lines, but it is hoped that it will be possible to continue the weekly picture entertainments. A new wireless installation is required. To the District Inspector (Mr. H. D. Acland) and Official Visitors (Mrs. Williams and Mr. H. H. Hanna) I tender my thanks for their regular visits and for their attention to the patients. I desire to record my thanks to Drs. Brown, Lewis, and Bellringer for the help they have afforded me in the medical and general work of the institution. I have also to thank Mr. Thomas and the office staff, the Matrons, Head Attendants, and other heads of departments for their loyal and efficient assistance, and the stafl as a whole for the satisfactory manner in which the work of the Hospital has been carried out.

SEACLIFF MENTAL HOSPITAL. Dr. Ohilds reports : — I have the honour to submit my report for the year ending 31st December, 1930. At the beginning of the year there were 1.186 patients on the register (657 males and 529 females), while at the end of the year there were 1,221 (658 males and 563 females). The admissions numbered 176 (96 males and 80 females). Forty-four were discharged (22 males and 22 females), and 1 male patient was transferred to another hospital. The deaths numbered 96 (72 males and 24 females), the number over eighty years of age being 9 (7 males and 2 females), and over seventy being 28 (23 males and 5 females). " At the beginning of the year there were 44 voluntary boarders (26 males and 18 females). During the year there were 32 admissions (13 males and 19 females). Twenty-five were discharged (12 males and 13 females). There were 3 deaths, and 2 females were committed. The average weekly number of patients resident during the year was 1,159 (635 males and 524 females). The number of patients placed on probation numbered 90 (44 males and 46 females). The health of the patients has been, on the whole, good ; but during the extremely cold weather from mid-August to mid-October there was an outbreak of influenza, many cases being followed by pneumonia, and this .took a toll of the patients, especially the elderly male patients, and accounts for the fairly high death-rate. The health of the stafl has been uniformly good, but I regret to report the death of Charge Nurse J. McGregor, An extensive building programme has been in progress throughout the year. The new kitchen and laundry block is now occupied and in full running-order, while the demolition of the old kitchen block has been commenced. The new pipe-line supplying water from Double Hill is now completed, and supplies the institution with a plentiful supply of good water, the Neuropathic Unit also being connected up. The new villa at Waitati is almost ready for occupation, and this will afford welcome relief to the main building, as the overcrowding is at present rather a problem. The new villa will house the better type of chronic patient; it is well furnished, and is well suited for this purpose. A new day-room of pleasing structure has been added to F. 4, and, being well furnished, is an asset to the institution. A new recreation-park and shelter-shed have been opened on the female side, and this additional space has been much appreciated. The plumbers' yard has been roofed in and new machinery installed in this building. A considerable part of the lavatory accommodation of the main building and D Ward has been overhauled and brought up to date, and this has effected a considerable improvement. The Female Cottage has been renovated, the ceilings in F. 2 and F. 3 Wards renewed, and the snow gratings over the flat roofs of the Concert Hall, Male A, B, and C Wards have also been renewed. Renovations and repairs have, been carried out at Cherry Farm Homestead, while the farm has been supplied with water from the Waikouaiti Borough Council's mains. The Fishing-station cottage at Karitane has also been repaired and renovated, and electric light installed. F. 3 Diningroom has had a new wooden floor put in, and this has been an improvement, making the room much warmer. A new bridge has been built at Orokonui Home, Waitati, and the cowyard at Simla Byres concreted. In addition to this, a considerable amount of minor work has been carried out. The work on the farm has proceeded steadily, and the farm itself is looking well. The usual routine of top-dressing, fencing, draining, and roadmaking has been carried out, while attention has been given to improvement of the dairy herd and to the breeding of stock. The gardens, as usual, have been well looked after, and show the attention received.

2 -tL. 7

9

H.—7.

The clinic at Dunedin Hospital has been attended weekly, while a monthly clinic has been held at the Southland Hospital; the latter is a new departure, and has been well worth while. Amusements and recreations have, as usual, formed a part of the hospital life. Pictures weekly, weekly dances in the winter, and occasional concerts being held ; while cricket, football, bowls, tennis, and croquet have been patronized. Selected parties have also attended the Summer and Winter Shows and the Waikouaiti races, while outdoor picnics have been indulged in when the weather was favourable. I would thank the nursing staff generally, and the Matrons and Head Attendants especially, for the way they have performed their duties during the year. Thanks are also due to other branches of the staff, especially the heads of the various branches. Mr. Cumming, the " Patients' Friend," has been absent through illness during part of the year, his place being taken by Mr. Syder. Mr. Cumming has been missed, but is now, every one is pleased to know, well on the way to recovery. My thanks are due to the clergy of the different denominations for their regular visits, and to the Red Cross for donations of tobacco throughout the year and for Christmas gifts to returned-soldier patients. The medical officers have ably assisted me during the year, and their work has been of a consistently high standard.

STATISTICAL. The patients on the register at the end of the year numbered 6,383 (m. 3,572, f. 2,811), or 290 (m. 173, f. 117) more than at the beginning ; and the daily average under treatment during the year was 5,932 (m. 3,342, f. 2,590), or 222 (m. 127, f. 95) more than in the previous year ; while the total under care was 7,363. Patients belonging to the Native race numbered 89 (m. 46, f. 43) at the end of the year. The admissions numbered 1,095 (m. 621, f. 474), or 139 more (m. 72, f. 67) than in the previous year. Of these, 162 had been previously under care, making the proportion of readmissions 14-79 per cent., and 933 patients were admitted for the first time. The ratio to population of all admissions (exclusive of Maoris) was 7-57 (m. 8-45, f. 6-66) to 10,000, and of first admissions 6-44 (m. 7-33, f. 5-51), so that 1,320 persons in the general population contributed one patient, and 1,552 contributed a patient admitted for the first time. The discharges (excluding transfers) numbered 382, or 3 less than in 1929. 116 (or 20 more) harmless unrecovered persons were returned to the care of friends; and 266 (m. 138, f. 128) recovered —23 less than last year —representing a percentage of 24-29 (m. 22-22, f. 27-00) on the total admitted. With voluntary boarders added the percentage rises to 33-69. Altogether, 41-93 per cent, of the inmates admitted were able to leave institutional care. Of a total of 7,363 patients under care, 423 (m. 251, f. 172) died, or 7-15 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, 23-40; disease of the brain and nervous system group, 22-46; heart-disease, 22-46; tuberculosis, 4-73. 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 .. .. .. .. .. 9-82 7-17 8-68 Congenital .. .. .. .. .. 21-58 19-83 20-82 Predisposed by previous attack .. .. 10-31 14-14 11-96 Critical periods .. .. .. .. 15-94 29-11 21-64 Child-bearing (puerperal, non-septic, and lactation) .. 1-48 0-64 Mental stress .. .. .. .. 15-46 12-03 13-97 Toxic, including M. f. Syphilis .. .. .. 4-83 1-05^| Alcohol .. .. .. 7-25 2-11 >■ 12-08 4-43 8-77 Drug habit .. .. .. 0-63 j Traumatic .. .. .. .. . . 0-64 .. 0-37 Disorder of nervous system, including— m. f. Epilepsy .. '.. .. 5-31 2-74 8-70 4-64 6-94 Other bodily affections .. .. . . 3-86 4-43 4-11 No definite cause assigned .. .. .. 1-61 2-74 2-10 100-00 100-00 100-00

10

H.—7.

Voluntary Boarders.

It will be noted that there were 312 voluntary admissions in the year under review, that 209 were discharged, and that 24 boarders, representing 7-7 per cent, of the admissions, 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 voluntary boarders), while the proportion of deaths on average number resident was 4*9 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 average daily number of voluntary boarders in 1930 was 283 (m. 150, f. 133).

MENTAL NURSES. In December the usual examination was held for the registration of mental nurses, when the following passed : — Auckland : First Grade —Elizabeth Eva Marks. Second Grade—Rita Edna Basham, IvyMary Coleman, Reginald John Grainger, Lucy King, Edgar Mawson Leuty, Margaret May Massey, James Mathews, Hugh Mulligan, Jean McKillen, Marshall Robinson, Patrick McNeill Robinson, George James Rose, Mary Kathleen Patricia Wall, John Watson. Tokanui: Second Grade —-George Clarence Hudson, Adam Tait Knox, Frederick Erastus Lehndorf, Leonard Rycroft, Kathleen Marama Storey. Porirua : First Grade —Winifred Cicely Flynn. Second Grade —Winifred Bessie Dickson, Leslie John Ell, Lily Lawson, Sophia Mary Logan, Isabel Dorothy Mair, Bridget Ellen McShane, Walter Roberts, Lionel Alfred Sharman, William Soutar, James Woods. Christchurch: First Grade —Kathleen Myrtle Coghlan, Allan Joseph Marshall. Second Grade —Flora Margaret Akins, Samuel George Bossons, Juanita Northcote Clarke, Samuel Craig Ferguson, John Herbert Wood Freear, Rose May Freeman, Edith Gwendoline Gough, Charles Alexander Kerr Guy, Herbert Tamblyn Hirst, Amy Louisa Kathleen Hitchins, James Lightfoot, Edna Lucy Pollock, Thomas Simpson, George Way Townshend. Nelson : Second Grade —George Ashworth, Elizabeth Maud Bailey, Thomas Malcolm Crombie, Mary Josephine Crowe, Dorothy Dibble, Constance Maud Minehan, Ida Heaton Moore, Mary Louisa Shield. Seaclifl : Second Grade —Mavis Rose Bennett, Agnes Annie Caskie, Patrick Early, Eva Joyce, Janet Gertrude Logie, Alice Christian Lothian, Edna Laidlaw Mathison, William Rogers, Ellen Scally, Maud Mabel Souquet, Ethel Szivak, Constance Marion Turner. Hokitika: Second Grade —Mary Margaret Caliari, Margaret Anne Groufsky, Matthew Moynihan, Albert Edward Stevens, Doris Clara Williams. Highest marks in written paper : Allan Joseph Marshall, Christchurch, 79. Highest total marks for written, oral, and practical : Winifred Cicely Flynn, Porirua, 252. (Average, 84.)

11

nw Wot ĪW, Tntal Transferred Bemainlng Year ' Admission Emission AdmMons to Ee g' ster Die(i - Discharged. on Admission. Admission, j Admissions. of Patients . 31st December. I : I _j ; 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 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 1928 .. ..120 94 214 37 39 76 157 133 290 8 10 18 10 8 18 102 97 199 117 141 258 1929 .. .. 102 63 165 50 43 93 152 106 258 11 3 14 9 9 18 119 110 229 130 125 255 1930 .. .. 152 84 236 41 35 76 193 119 312 15 9 24 8 6 14 130 79 209 170 150 320

H.—7.

APPENDIX.

Table I. —Showing the Admissions, Readmissions, Discharges, and Deaths in Mental Hospitals during the Year 1930.

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 1930.

12

M. F. T. M. F. T. In mental hospitals, 1st January, 1930 .. .. .. ' .. 3,399 2,694 6,093 Admitted for the first time .. .. . • .. 539 394 933 \ ggi 474 j nng Readmitted .. .. .. • • • ■ • • 82 80 162 / Total under care during the year .. .. .. 4,020 3,168 7,188 Discharged and died — Recovered .. .. .. .. .. .. 138 128 266 Relieved .. .. . . .. .. .. 28 34 62 Not improved .. .. .. .. .. 31 23 54 Died .. .. . . .. .. .. 251 172 423 (Not including transfers —Males 25, females 150.) 448 357 805 Remaining in mental hospitals, 31st December, 1930 .. .. 3,572 2,811 6,383 Increase over 31st December, 1929 .. .. .. .. 173 117 290 Average number resident during the year .. .. .. .. 3,342 2,590 5,932

Jn Mental Ho* Admissions in 1930. I Total Number Mental Hospitals, I pitals on — - Pucinnt-c 1st January, 1930. Admitted for the Not First Transfers under Carp First Time. | Admission. lransiers. under care. M. F. T. M. P. T. M. F. T. M. F. T. M. F. T. Auckland. .. .. 692 569 1,261 101 90 191 28 17 45 7 4 11 828 680 1,508 Christohuroh .. .. 468 492 960 119 105 224 18 21 39 4 4 8 609 622 1,231 Duiiedin (Seacliff) .. 657 529 1,186 86 63 149 6 13 19 4 4 8 753 609 1,362 Hokitika .. .. 175 76 251 13 8 21 2 0 2 0 33 33 190 117 307 Nelson .. . . 284 128 412 54 10 64 1 0 1 1 0 1 340 138 478 Porirua .. .. 823 712 1,535 128 88 216 25 27 52 4 2 6 980 829 1,809 Tokanui . . .. 285 158 443 32 30 62 2 0 2 4 102 106 323 290 613 Ashburn Hall (private 15 30 45 6 0 6 0 2 2 1 1 2 22 33 55 mental hospital) : — Totals .. 3,399 2,694 6,093 539 394 933 82 80 162 25 150 175 4,045 3,318 7,363 Patients discharged, transferred, and died. ' In Menta j Hos . . , : - pitals on Mental Hospitals. I Total discharged, 31st December, Recovered j n?t recovfred. Transferred. | Died. 1930 ' I 1 M. F. T. M. F. T. M. F. T. M. F. T. M. F. T. M. F. T. Auckland .. .. : 20 20 40 21 26 47 6 1 7 50 38 88 97 85 182 731 595 1,326 Christehurch .. 32 23 55 13 10 23 4 38 42 31 29 60 80 100 180 529 522 1,051 Dunedin (Seacliff:) 13 12 25 9 10 19 1 0 1 72 24 96 95 46 141 658 563 1,221 Hokitika .. .. 6 3 9 2 0 2 0 2 2 6 3 9 14 8 22 176 109 285 Nelson .. . . 6 2 8 .. 0 1 1 27 8 35 33 11 44 307 127 434 Porirua .. .. 50 57 107 12 8 20 8 105.113 55 56 111 125 226 351 855 603 1,458 Tokanui .. 10 9 19 1 3 4 5 ] 6 8 13 21 24 26 50 299 264 563 Ashburn Hall (private 1 2 3 1 0 1 1 2 3 2 1 3 5 5 10 17 28 45 mental hospital) —■ Totals .. 138 128 266 59 57 116 25 150 175 251172 423 473 507 980 3,572 2,8116,383 Average Number Percentage I Percentage of Mental HnRnitals rpsidmt dnrine of Becoveries on Deaths on Average Mental Hospitals. resident during Admissions Number resident during the Tear. during the Tear. M. F. T. M. F. T. M. F. T. Auckland .. .. .. .. .. 683 540 1,223 15-50 18-70 16-99 7-32 7-04 7-19 Christchurch . . .. .. . . .. 468 492 960 23-36 18-25 20-91 6-62 5-89 6-25 Dunedin (Seacliff) .. .. .. .. 635 524 1,159 14-13 15-78 14-88 11-33 4-60 8-28 Hokitika .. .. .. . . .. 171 75 246 40-00 37-50 39-13 3-50 4-00 3-66 Nelson .. . . .. .. . . .. 293 126 419 10-90 20-00 12-30 9-22 6-35 8-35 Porirua .. .. .. .. .. 790 558 1,348" 32-67 49-56 39-92 6-97 10-03 8-23 Tokanui .. .. .. .. .. 285 245 530 29-41 30-00 29-68 2-80 5-30 3-90 Ashburn Hall (private mental hospital) .. .. 17 30 47 16-66 100-00 37-50 11-77 3-33 6-38 Totals .. .. .. |3, 342 2,590 5,932 22-22 27-00 24-29 7-51 6-64 7-15

H.—7.

Table IV.—Duration of Disorder on Admission.

Table III.— Ages of Admissions.

13

n j I I Ashburn Hall Ages, Auckland. Christchurch Hokitika. Nelson. j Porirua. Tokanui. (Private Mental Total. | (toeaclm). I Hospital). % I M. F. T. M. F. T. M. F. T. M. F. T. j M. F. T. M. F. T. M. F. T. M. F. T. M. F. T. Under 5 years .. .. .. .. 224 .. .. 5 0 5 123 .. .. 84 12 From 5 tpj 10 years .. .. .. 112 9 10 19 202 .. 404 314 101 .. 20 12 32 10,;; 15 „ .. .. .. 22 16 38 3 0 3 0 X 1 ! 11 0 11 4 2 6 .. .. 40 19 59 „ 15 20 „ .. .. 9 6 15 14 17 31 14 3 17 1 0 1 ; 16 1 17 10 10 20 6 3 9 .. 70 40 110 . „ 20 30 „ .. .. .. 20 10 30 20 13 33 17 13 30 2 0 2 4 1 5 20 16 36 4 4 8 1 0 1 88 57 145 30 „ 40 „ .. .. .. 31 19 50 21 23 44 15 16 31 4 3 7 4 2 6 31 23 54 7 8 15 .. 113 94 207 „ 40 „ 50 „ .. .. .. 19 31 50 17 18 35 15 12 27 3 1 4 5 3 8 30 21 51 5 6 11 1 1 2 95 93 188 „ 50 „ 60 „ .. .. 22 14 36 8 15 23 7 18 25 5 0 5 0 1 1 25 17 42 6 6 12 2 1 3 75 72 147 „ 60 „ 70 „ . . .. 11 8 19 12 6 18 7 6 13 .. 2 0 2 16 15 31 1 2 3 .. 49 37 86 „ 70 „ 80 „ .. .. 11 7 18 11 6 17 6 6 12 0 1 1 1 1 2 6 7 13 2 1 3 1 0 1 38 29 67 „ 80 „ 90 „ .. .. 5 6 11 1 0 1 3 2 5 0 2 2! 3 1 4 5 1 6 2 0 2 1 0 1 20 12 32 „ 90 „ 100 „ .. .. .. .. .. .. .. 10 1 .. .. 10 1 Unknown .. .. .. .. 0 5 5 .. 303 .. ! .. 101 .. .. 459 Transfers .. .. .. .. 7 4 11 4 4 8 4 4 8 0 33 33 1 0 1 4 2 6 4 102 106 1 1 2 25 150 175 Totals .. .. 136 111 247 141 130 271 96 80 176 15 41 56 56 10 66 157 117 274 38 132 170 j 7 3 10 646 624 1,270

1 ■ -l' if ! ■ {••; '' I ' ' i , j J *•" J: .J Dnnpflin Ashburn Hall Auckland. Christchurcli. Hokitika. Nelson. Porirua. Tokanui. (Private Mental i Total. (beacutt). Hospital). 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. First class (first attack and within 3 months 45 36 81 36 21 57 35 61 96 6 5 11 8 1 9 1 86 59 145- 21 22 43 4 0 4 241 205 446 on admission) Second class (first attack above 3 months and 15 14 29 10 12 22 9 2 11 1 1 2 2 0 2 12 6 18 4 1 5 1 0 1 54 36 90 within 12 months on admission) Third class (not first attack, and within 12 25 22 47 17 22 39 9 13 22 2 0 2 3 2 5 22 29 51 7 6 13 0 2 2 85 96 181 months on admission) Fourth class (first attack or not, but of more 33 26 59 74 71 145 39 0 39 6 2 8 42 7 49 33 21 54 2 1 3 1 0 1 230 128 358 than 12 months on admission) Unknown .. .. .. 11 9 20 .. .. .. .. .. .. .. 11 9 20 Transfers .. .. .. .. 7 4 11 4 4 8 4 4 8 0 33 33 1 0 1 4 2 6 4 102 106 1 1 2 25 150 175 Totals .. .. .. 136 111247 141130 271 96 80 176 15 41 56 56 10 66 157 117 274 | 38 132 170 7 3 10 646 624 1,270

H.—7.

Table V.— Ages of Patients discharged "Recovered" and "Not Recovered" during the Year 1930.

Table VI.— Ages of Patients who died.

14

Auckland. Christchurch. Dunedin (Seacliff). Hokitika. Nelson. Porirua. Tokanui. (PrivafaTflOL). Total. fie- Not re- Be- Not re- fie- Not re- fie- Not re- Be- Not re- fie- ! Not re- fie- Not re- Be- Not re- -Recovered Not covered, covered. covered, covered. . covered. . covered. covered. 1 covered, covered. covered. covered. covered. covered, covered, covered, covered. 1 recovered. - '! I | | 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. M. F. T. M. F. T. M. F. T. M. F. T. M. F. T.j M. F. T. M. F. T. M. F. T. M. F. T. Under 5 years .. .. .. .. ..;.... .... .. .. ■ ■ . ■ .. I j From 5 to 10 years .. .. .. .. .. .. .. .. .. .. .. •• .. .. .. „ 10 15 .. .. .... .... .. .. .. .. . • • • • • ... .. | . ... , 15 20 .. .. 2 1 3 3 0 3 2 0 2 1 1 2' .. 202 .. .. .. .. 13 40 1 1213 .. j .. .. 7 5 12 6 2 8 20 30 . 5 2 71 4 58 3 11 1 0 Ij 4 5 9 .. 1 2 3 .. 1 0 1 .. 11 9 20 5 0 5 3 3 6 .. .. .. 33 24 57 7 4 11 " 30 " 40 „ .. 2 3 5 4 4 810 9 19 7 3 10 2 3 5 2 4 6 2 1 3! 1 0 1 2 0 2 .. 15 13 28 1 0 1 2 2 4 .. 0 1 1 .. 35 32 6715 11 26 40 " 50 „ .. 4 11 15 7 6 13 5 6 11 0 3 33 1 42 2 41. 0 1 .. 3 2 5 .. 9 15 24 1 4 5, 3 2 5 1 3 4] 0 1 1 1 0 1, 28 38 66 12 18 30 " 50 ' 60 .... 5 0 5 4 6 10 3 3 6 3 2 5 2 2 4 .. 2 0 2 1 0 1 .. .. 11 10 21 2 2 4 0 1 1' .. ; 1 0 1 .. 24 16 4010 10 20 60 70 „ .. 2 0 2 2 4 6 3 2 5 .. ! 2 1 3 0 3 3 .. .. .. 3 5 8 2 1 3.. .. .. .. 10 8 18 4 8 12 70 „ 80 .... 0 1 1 0 1 1 1 0 1 1 1 2 1 0 1.. .. .. .. 0 2 2 .. .. .. .. .. 1 3 4 2 2 4 „ 80 „ 90 „ -. 0 11.. . - .. •• • • ■• • • • • •• 101.. .. .. .. .. 112 „ 90 „ 100 „ .. .. .. • • • • ■ ■ .... Unknown .. ..022 .. .. .. .. 213 .. .. .. .. .. .. .. .. .. ■■ 022213 Transfers .. .. .. 617 .. 4 38 42 .. 101 .. 022 .. 011 .. 8 105 113 .. 5 1 6 .. 1 2 3 .. 25 150 175 Totals .. 20 20 40 27 27 54 32 23 5517 48 65il3 12 25 10 10 20 6 3 9 2 2 4 6 2 8 0 1 150 57 107,20 113 133 10 9 19 6 4 10 1 2 3 2 2 4 138 128 266 84 207 291

Ages. Auckland. Christchurch. Danedin (Seacliff). HoMtika, Nelson. Porirua. Tokanui. ( ĪM vut eK) Total. t __ _ , . _ j — r . f 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 .. .. .. ..... . . .. .. . . Oil .. .. Oil J?rom 5 to 10 years .. .. .. •• 112 .. .. 202 .. .. .. 314 „ 10 „ 15 „ .. .. .. •• Oil .. .. 202 Oil 10 1 .. 325 „ 15 „ 20 „ .. .. .. .. Oil 1 0 1 .. 3 0 3 0 4 4 .. .. 4 5 9 „ 20 „ 30 „ .. .. .. 2 0 2 1 1 2 1 3 4 .. 4 0 4 Oil 101 .. 9 5 14 „ 30 „ 40 .. .. .. 3 6 9 2 2 4 4 0 4 .. 3 0 3 2 9 11 .. .. 14 17 31 „ 40 „ 50 „ .. .. .. 5 9 14 3 3 6 11 6 17 .. 3 3 6 10 4 14 0 2 2 .. 32 27 59 „ 50 „ 60 „ .. .. .. 11 8 19 6 8 14 15 3 18 3 0 3 1 2 3 9 7 16 1 2 3 .. 46 30 76 „ 60 „ 70 „ .. .. .. 8 8 16 7 2 9 9 5 14 1 0 1 4 3 7 16 10 26 2 2 4 1 0 1 48 30 78 „ 70 .. SO „ .. .. 12 3 15 7 9 16 23 5 28 1 1 2 5 0 5 14 14 28 Oil 1 1 2 63 34 97 „ SO „ 90 „ .. .. .. 6 4 10 4 0 4 7 2 9 1 2 3 .. 3 5 8 3 4 7 .. 24 17 41 „ 90 „ 100 „ ■ • Oil .. .. .. 101 0 2 2 .. 1 3 4 Unknown .. .. .. .. 303 .. 1 0 1 ... .. •• •• .. 404 Totals .. .. .. 50 38 88 31 29 60 72 24 96 6 3 9 27 8 35 55 56 111 8 13 21 2 1 3 251 172 423

H.—'7.

Table VII.—Condition as to Marriage.

15

j Admissions. Discharges. Deaths. Auckland— m. f. t. m. p. t. m. p. t. Single .. . . .. .. .. .. 67 40 107 20 17 37 19 17 36 Married .. .. . . .. 51 45 96 19 19 38 22 12 34 Widowed .. . . .. .. 10 20 30 0 7 7 8 9 17 Unknown .. .. .. .. .. 123 235 101 Transfers .. .. .. .. .. 7411 617 Totals .. .. .. .. 136 111 247 47 47 94 50 38 88 C HKISTCHTTROTT — Single .. .. . . .. .. . . 90 71 161 27 12 39 20 12 32 Married . . .. . . .. .. 42 43 85 17 18 35 9 12 21 Widowed .. .. .. .. .. 5 12 17 1 3 4 2 5 7 Unknown Transfers .. .. .. .. .. 448 4 38 42 Totals .. .. .. .. .. 141 130 271 49 71 120 31 29 60 Dotedin (Seacliit) — Single .. .. .. .. .. .. 65 27 92 14 10 24 41 9 50 Married .. .. .. .. .. 21 39 60 6 8 14 18 6 24 Widowed .. .. .. .. .. 6 10 16 2 4 6 13 9 22 Unknown Transfers .. .. .. .. .. 448 101 Totals .. .. .. .. .. 96 80 176 23 22 45 72 24 96 Hokitika— Single.. .. .. .. .. .. 11 4 15 6 1 7 3 0 3 Married .. .. .. .. .. 426 224 314 Widowed .. .. .. .. .. 022 .. 022 Unknown Transfers .. .. .. .. .. 0 33 33 0 2 2 !! Totals .. .. .. .. .. 15 41 56 8 5 13 6 3 9 Nelson— Single .. .. .. . . . . .. 46 6 52 4 0 4 19 4 23 Married .. .. .. .. .. 93 12 224 64 10 Widowed .. .. .. .. .. 011 .. 202 Unknown Transfers .. .. .. .. 101 0 11 Totals . . .. . . . . .. 56 10 66 6 3 9 27 8 35 PORIRTTA— Single .. .. .. .. .. .. 86 55 141 41 25 66 27 19 46 Married .. .. .. .. .. 53 44 97 21 34 55 19 21 40 Widowed .. .. .. .. .. 14 16 30 0 6 6 9 16 25 Unknown Transfers .. .. .. .. .. 4 2 6 8 105 113 " Totals .. .. .. .. .. 157 117 274 70 170 240 55 56 111 Tokanui— Single .. .. .. .. .. .. 20 6 26 8 6 14 6 3 9 Married .. .. .. .. .. 12 22 34 3 4 7 2 8 10 Widowed .. .. .. .. .. 224 0 22 022 Unknown Transfers .. .. .. .. .. 4 102 106 5 1 6 '.! Totals .. .. .. .. .. 38 132 170 16 13 29 8 13 21 Ashbubn Hall— Single .. .. .. .. .. .. 426 224 101 Married .. .. .. .. ,, 202 .. 112 Widowed Unknown Transfers .. .. .. .. .. 112 123 Totals .. .. .. .. .. 73 10 347 21 3 Totals— Single.. .. .. .. .. .. 389 211 600 122 73 195 136 64 200 Married .. .. .. ,. .. 194 198 392 70 87 157 80 65 145 Widowed .. .. .. .. .. 37 63 100 3 22 25 34 43 77 Unknown .. .. .. .. .. 1 2 3 2 3 5 1 0 1 Transfers .. .. .. .. .. 25 150 175 25 150 175 Totals .. .. .. .. .. 646 624 1,270 222 335 557 251 172 423

H.—7.

Table IX.—Ages of Patients on 31st December, 1930.

Table VIII.— Native Countries.

16

Countries. j Auckland. Christchurch I Hokitika. j Nelson. Porirua. Tokanui. (Private M.H.). Total. ' L_ j j I ' s M F T ■ M. E. T. M. F. T. M. F. T. i M. F. T. M. F. T. M. F. T. M. ī. T. M. F. T. Ens-land and Wales .. 118 86 204 ! 71 74 145 ' 77 50 127 ! 39 12 51 24 10 34 170 86 256 59 32 91 4 4 8 562 354 916 Scotland . 28 15 43 24 ' 17 41 56 43 99 6 2 8 14 5 19 40 29 69 22 7 29 3 0 3 193 118 311 Ire i am i 1 47 38 85 ! 20 24 44 38 40 78 1 16 8 24 : 10 2 12 47 44 91 16 19 35 1 0 1 195 175 370 New Zealand ' 378 371 749 1394 376 770 ; 445 394 839 i 82 72 154 243 96 339 492 389 881,160 186 346 9 22 31 2,203 1,906 4,109 Australian States 41 28 69 | 11 16 27 17 23 40 11 5 16 4 5 9 30 22 52 1 11 11 22 0 2 2 125 112 237 France .. .. •• ..0111 •• •• 101011:303 .. 426 Germany 61 7 ! 1 12 30 3,101 101 415:314 .. 19 4 23 Austria' .. . . • • .. 32 5 37 : 0 2 2 1 0 1 .. 2 0 2 .. 5 0 5 .. 40 7 47 Norway 3 0 3 0 1 1 .. 1 0 1 . . 3 1 4 2 0 2 .. 9 2 11 Sweden 51 61202 30 3 2 0 2 101 415 01 ] .. 17 3 20 Denmark 2 0 2 j 2 0 2 i 1 1 2 3 0 3 1 0 1 7 2, 9 2 0 2 .. 18 3 21 Italy 23 5! .. 1 0 1 2 02 .. 527202 .. 12 5 17 China ■ • • • • • 10 110 1 • • 4 15 .. .. 6 17 Maoris " S 18 23 41 1 1 2 .. 1 0 1 .. 22 15 37 4 4 8 .. 46 43 89 Other countries .. .. .. 26 10 36 3 10 13 7 5 12 7 0 7 .. 20 4 24 10 3 13 .. 73 32 105 Unknown 25 13 38 .. 8 7 15 4 10 14 j 6 9 15 7 5 12 .. .. 50 44 94 Totals .. .. 731 595 1,326 i 529 522 1,051 658 563 1,221 176 109 285 307 127 434 855 603 1,458 j 299 264 563 17 28 45 3,572 2,8116,383

Ages. Auckland. Cliristchurch. (SeacHff). Hokitika. Nelson. Porirua. Tokanui. j Total. I . 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. 1 to 5 years .. .. 325224 .. 1 0 1325 .. .. 96 15 5 10" .. .. 2 3 5 16 10 26 4 3 7 .. 24 0 24 2 6 8 2 2 4 .. 50 24 74 10 " 15 1 6 7 41 28 69 4 2 6 0 3 3 45 2 47 6 14 20 1 1 2 .. 98 56 154 " 15 " 20 " .. 24 14 38 33 26 59 26 15 41 2 2 4 63 7 70 25 23 48 9 8 17 .. 182 95 277 " 90 " 30 " 66 67 133 73 45 118 108 35 143 11 11 22 36 15 51 98 58 156 25 22 47 0 1 I 417 254 671 t: 30 " 40 " 146 104 250 95 68 163 116 89 205 17 14 31 28 19 47 157 108 265 35 46 81 3 1 4 597 449 1,046 " 40 " 50 " 162 134 296 107 109 216 139 128 267 52 23 75 37 18 55 209 141 350 70 70 140 2 8 10 778 631 1,409 " 50 " 60 " .. 157 130 287 76 119 195 122 140 262 43 33 76 24 19 43 184 118 302 83 57 140 2 5 7 691 621 1,312 60 " 70 " 89 70 159 43 81 124 82 104 186 37 13 50 - 30 28 58 106 79 185 46 38 84 6 7 13 439 420 859 " 70 " 80 " . 53 42 95 37 25 62 39 36 75 7 3 10 13 12 25 48 40 88 17 15 32 3 5 8 217 178 395 I', 80 90 " .. .. .. 12 11 23 5 8 13 8 8 16 3 2 5 5 5 10 16 14 3.0 5 0 5 I 1 2 55 49 104 Upwards of 90 .. ..10 101110 1011 .. 101 .. •• 3 1 5 Unknown.. ' 18 14 32 .. 7 1 8 4 4 8 1 2 3 .. 6 5 11 .. 36 26 62 Totals .. .. 731 595 1,326 529 522 1,051 658 563 1,221 176 109 285 307 127 434 855 603 1,458 299 264 563 17 28 45 3,572 2,811 6,383

3—H. 7.

H.—7.

Table XI.—Length of Residence of Patients discharged "Recovered" during 1930.

Table X.—Length of Residence of Patients who died during 1930.

17

Length of Residence. Auckland. Christchurch. (feaclfff?. Hokitika. Nelson. Porirua. Tokanui. (p^ate^H ) Total - TT A 1 4.U M ' F ' T ' M " T " M " F ' T " M ' F " T " M " T - M. jr. T. M. P. T. M F T MET Under 1 month 7 4 11 0 2 2 5 6 11 .. 4 0 4 4 4 8 1 3 4 91 1( ' l\ From 1 to 3 months 9 2 11 3 2 5 6 1 7 .. 2 1 3 10 8 18 Oil !! to 16 45 " I" Q " • ° a ? ! 2 1 3 3 1 4 1 0 1 .. 6 4 10 .. 1 0 1 13 8 21 " ® ® 6 1 7 .. 2 1 3 1 1 2 .. 5 0 5 id. q 17 „ 9 „ 12 ,, .. .. .. 123 112 213 .. 011 257 112 7 11 18 " 2 " 3 yearS 1 3 4 2 \ t 11k 101 • • 9 4 13 1 1 2 .. 22 11 33 " i " i " •• •• 134 235 325 .. 101 248 202 y io w » »" « » 5 3 8 2 1 3 5 1 6 .. 3 0 3 4 5 9 . " 9 0 29 " " Ill tin ? i 3 101 4 1 5 2 6 8 0 1 1 !! 16 14 30 " ,n " Jo " 2 2 4 2 5 7 4 0 4 .. 6 0 6 0 6 6 1 0 1 .. 15 13 28 " J® " 12 " •• •• " 2 0 2 2 0 2 1 0 1 .. 1 0 1 ft n R n" ,t" 15 " " " " 224 527 538 101 011 336 011 16 12 28 Oyer 15 years 5 10 15 4 8 12 29 5 34 0 2 2 7 3 10 6 6 11 1 5 6 1 'i 2 « 3Q Q9 Died while absent on trial .. .. 527 .. 101 .. 011 123 101 8 5 13 Totals 50 38 88 31 29 60 j 72 24 96 6 3 9 27 iT~35 55 56 111 8 13 21 2 1 3 251 172 423 : ' '

Length of Residence. Auckland. Christehurch. ( f e Tclfff?. Hokitika. Nelson. Porlrua. Tokanui. ,^hb urn Hall | Tota) TT j I M " F - T - M " F ' T ' M ' *• T - M - F. T. M. V. T. M. V. T. M. F. T. M. F T M 3? T« Under 1 month .. .. .. .. 1 0 1 2 2 4 o From 1 to 3 months 2 3 5 8 6 14 3 *3 6 5 0 6 1 0 1 6 *2 8 1 'i 2 1 'Ô 1 27 15 49 ' 3 6 " I I ! ? »8 " I i I 022 •• 6 9 15 4 2 6 0 J 1 26 28 tl " 9 " i® " - I f o o •' 11 7 18 4 2 6 Oil 21 21 42 ,, y ,, iz ,, .. .. .. o 4 10 1 1 2 1 2 3 .. .. 2 8 10 1 2 3 n n oe » I" I y ears 5 4 9 11 5 16 2 0 2 .. 2 0 2 13 11 24 0 2 2 " 33 22 55 "3-5 •• n 9 9 , o 1 0 1 7 8 15 •• 10 8 18 " g" 7 " " , "A , 0 2 2 1 1 2 .. 3 7 10 .. .. 4 10 14 " 7 " J " " '■ '• 10 1 .. .. .. 112 .. .. 2 13 "l0 "l2 " •' '• •• '• 112.. .. 112 ;;is;; is ;; :: :: :: :: :: :: •• ® 2 ? •• o - 2 2 Over 15 years ........ .. .. .. '' '' * • 011 Totals 20 20 40 32 23 55 13 12~25 6 3 9 «TTl 50 57 107 10 9 19 1 2 3 138 128 266

U,—7.

Table XII. —Causes of Death, 1930.

18

IS" ! «a -f--G ~ cS j) j g o Causes. ill! |ê I g S I ||f ~ « ■ "d S 0 s3 9 3 — <» 53 Sj 35 | iw c3 ,Q >PH «3 o C £3 *3 a>!'£ rfi'C*-" fl 5 S O *z ' O O 2CU r° o q w j Ph h H I. General Diseases. Tuberculosis — M. F. j M. f. m. f. m. f. m. f. m. f. m. f. m. f. m. f. General .. .. ■■ .. ■■ 10 -. .. •• •• •• 10 Of lungs .. .. ..25121 10 .. .. 1401 .. 6 11 Of spine .. .. ..10 .. .. .. .. .. • ■ • • 10 Of larynx .. .. ..10 .. .. .. .. .. .. •• 10 Cancer .. .. ..123121 .. 101101 .. 86 Dysentery, bacillary .. ..20 .. .. .. .. .. -• •• 20 Purpura rheumatica .. .. .. 10 .. .. .. .. .. 10 Toxaemia .. .. .. .. ■■ .. t .. .. 01 .. •• 01 Graves's disease .. ..0101 .. .. .. .. .. •• 02 Pernicious anaemia .. .. .. .. .. 10 .. •• •• •• 10 Diabetes .. .. .. .. .. 01 .. .. .. •• 01 Erysipelas .. .. .. .. •• .. 10».. .. •• •• 10 II. Diseases of the Nervous System. Mania, exhaustion from ..1 2 .. 02 .. .. 20 .. .. 34 Melancholia, exhaustion from ..02 1 001 .. .. 01 .. 14 Stupor, exhaustion from ..1001 .. .. .. .. 10 .. 21 General paralysis of insane ..50 32 31 .. 0 1 11 1 0 1 .. 22 6 Tabo-paresis .. 2 0 ! .. .. .. .. •• •• •• 20 Organic brain-disease .. .. .. .. 10 .. .. •• •• 10 Epilepsy .. •• •• 1 2 | 1 4 61 .. 40 1 10 10 .. 14 17 Cerebral haemorrhage .. .. .. 1053 .. 1022 10 .. 10 5 Cerebral abscess .. .. 0 1 i .. .. .. •• •• 01 Chorba .. .. ..10 .. .. .. .. • • • • • • in Myoclonus .. .. ..10 .. .. .. .. • • • ■ • • 10 III. Diseases of the Respiratory System. Pneumonia .. .. •• 10 14 1 .. 11 24401 .. 30 8 Pleurisy .. .. •• .. •- •• 01 .. •• 9 i Bronchitis .. .. ■■ 10 .. 20 .. 1131 .. n l Gangrene of lungs .. ..01 Pulmonary haemorrhage .. .. .. 01 .. .. •• •• •• 01 IV. Diseases of the Circulatory System. Heart-disease .. .. 8 11 5 6 10 8 2 0 5 1 18 19 0 2 .. 48 47 Arterio-sclerosis .. ..220220 .. .. •• •• •• 44 V. Diseases of the Digestive System. Peritonitis .. .. •• 10 .. .. .. . ■ •• o ? Intestinal obstruction .. .. 2001 .. .. ■■ if Pyloric obstruction .. .. .. .. .. •• •• 10 .. I 0 Gastritis .. .. .. .. •• •• •• 01 VI. Diseases of the Genitourinary System. Nephritis 13 .. 1020 .. 10 .. .. 53 VII. Diseases of the Bones. Osteomyelitis .. .. .. 01 VIII. Old Age. Senile decay .. .. .. 14 4 10 10 23 . 3 0 3 3 0 8 9 3 6 2 1 63 36 IX. External Causes. Shock from burns .. .. .. .. •• •• •• 01 .. .. 0 1 Suicide 2 0 .. 2 0 Asphyxia .. * .. .. ■■ •• •• •• •• 01 • • " * Fracture of skull .. .. •• •• •• 10 .. .. 10 X. Died while on Trial .. 52 .. 10 .. 0112 10 .. 85 Totals .. .. 50 38 31 29 72 24 6 3 27 8 55 56 8 13 2 1 251 172

4—H. 7.

H.—7.

Table XIII.—Principal Assigned Causes of Insanity, 1930.

19

Ohriqf,- T)nnflfli'n I I Astlburn Causes. Auckland, church. (Seacliff). Hokitika -' Nelson. Porirua. j Tokanni. Hall Total. (P .M!. H.). M. F. M. F. M. F. M. F. M. F. M. F. M. F. M. F. M. F. Heredity .. .. 9 10 22 18 3 2 .. 19 1 4 3 3 0 1 0 61 34 Congenital .. .. .. 13 15 49 52 30 11 3 1 16 1 21 13 1 1 1 0 134 94 Previous attack .. .. 17 13 6 11 10 13 1 0 .. 30 27 0 1 0 2 64 67 Puberty or adolescence 2 1 10 4 .. 1 1 .. 6 9 3 2 .. 22 17 Climacteric .. .. 011 0 14 0 12 0 1 .. 08 02 .. 0 48 Senility .. .. .. 16 18 18 15 11 12 0 3 6 2 18 17 4 1 1 0 74 68 Involution .. .. ..25 .. .. 10 .. .. .. .. 35 Puerperal .. .. ..010101 .. .. 0102 .. 06 Pregnancy .. .. .. .. .. .. .. .. .. o 1 .. 0 1 Mental stress.. .. .. 34 17 7 2 3 5 3 1 3 1 38 19 7 12 1 0 96 57 Alcohol .. .. .. 4 2 11 4 9 1 5 0 6 1 8 2 1 0 1 0 45 10 Syphilis .. .. .. 10 18011 .. 018230 .. 30 5 Cerebral hemorrhage .. .. .. .. .. .. .. 01 .. 1011 Arterio-selerosis .. ..73 1020 .. .. .. .. .. 10 3 Organic brain-disease .. ..021022 ,. .. .. .. .. 34 Post-operative .. .. .. .. 10 .. .. .. .. .. 10 Traumatic .. .. -.30 .. .. .. 10 .. .. .. 40 Epilepsy .. .. .. 10 3 4 2 7 3 1 0 .. 10 5 1 0 .. 33 13 Encephalitis .. .. ..10 .. 21 .. .. 30 .. .. 61 Influenza .. .. .. .. .. 10 .. .. .. .. .. 10 Phthisis .. .. ..01 .. .. .. .. .. .. .. 01 III health .. .. ..02 02 40 .. .. 3411 7 .. 18 15 Toxic .. .. .. .. .. .. 01 .. 02 .. .. 03 Exophthalmic goitre .. .. .. .. 02 .. .. .. .. .. 02 Heart-disease .. .. .. .. .. .. .. .. 01 .. 01 Diabetes .. .. .. .. .. .. .... 10 .. 10 Insomnia .. .. .. .. .. .. .. 01 .. .. .. 01 Privation .. .. .. .. .. .. ! 31 .. 31 Drug habit .. .. 0 10 1 .. I 01 .. .. 03 Myelitis .. . . .. ! .. .. 10 .. . . . 10 Unknown .. .. . . 11.. 6 10 .. 32 .. .. .. 10 13 Transfers .. .. .. 7 4 I 4 4 4 4 0 33 1 0 4 2 4 102 1 1 25 150 Totals .. .. 136 111 141 130 96 80 15 41 56 10 157 117 38 132 7 3 646 624

11.—...

Table XIV.—Former Occupations of Patients.

20

K . w § ā . w a .1 - .3 i Occupations. 2 - 0 Occupations. 2 oq 3 ~ • W rrt 3 — W l 2 '-3 ā A S § | | | ā fl g g S ■8 -S S a 8 -g a | £ i -S S' 3 s I I S *a I 5 g « I £ g 1 g Males. Bakers .. .. 1 1.... I 12..i 6 Merchants .. .. l 1 1.... 3 Barman .. 1 .... j .... 1 Milkman .. .. 1 i j Billiard-saloon keeper .. .. 1 .. 1 Miners .. , 2 .1 1 1 5 Blacksmiths .. 2 .. .. 2 Missionary .. .. .. 1 1 Boilermaker .. .. 1 1 Motor-drivers 3 .. .. 3 Bootmakers .. .. 2 1 1 !....! 4 Motor mechanics .. 3 2 1 6 Bricklayer .. .. .. 1 .. 1 i Moulder .. 1 .. 1 Bushman .. 1 . ! Musician .. .. .. 1 1 Butcher .. 1 .. .. 1 Optician .. 1 .. .. 1 Carpenters .. .. 3 1 .2 .. 1 5 .... 12 Orchardists .. .. 1 1 2 Car-trimmer .. l) .. 1 Painters .. .. 121.. 211.. 8 Chemist . . .. 1 .... 1 Pensioners .. .. 6 2 2.. 1 3.... 14 Cooks .. .. 2.. 2 .... 2 .... 6 Piano-tuners .. 2 2 Clerks .. .. 3 3 6 2 .. 14 Plasterer .. 1 ] Confectioners .. 1.. 1 2 Plumbers .. .. 3 3 Dairy assistant 1 1 Printer .. 1 .. .. 1 Dealer .. .. 1 1 Prisoners .. 2 1 ... .. 3 Dentist .. 1 .. 1 Rabbiter .. 1 1 Draper .. 1 .. .. 1 Railway employees . , .. 1 1 .. .. 1 .. .. 3 Driver .. 1 1 Salesmen .. 1 2 1.... 1.... 5 Electrician .. 1 .. .. 1 School-teachers .. 2 1 1 4 Engineer .. I 1 Seamen .. .. 1.. 2.... 3 1.. 7 Engine-drivers .. 2 2 .. .. 4 Seedsman .. .. 1 1 Factory hands .. 1 .. 1 .... 2 Sheet-metal workers 2 2 Farmers .. .. 12 9 8 2 2 17 5 4 59 Shepherds .. 4 4 Farmhands .. 6 .. .. 9 4 .. 19 Soldiers .. 1 ] 2 Fellmonger .. .. . . J 1 Solicitors .. 1.... 1.... 2 Fishmongers .. 2 .... 2 Steward .. 1 ] Fitters .. 1 .. .. 2 .... 3 Storekeeper .. .. 1 1 Fruiterers .. 2 .... 2 Storeman .. .. .. 1 1 Gardeners .. .. 2 2 2 .... 6 Students .. 1.. 1.... 2 Grocers .. 2 .. 2 Surveyor .. 1 .. .. 1 Hairdressers .. .. 2 1 .. 3 Telegraphist .. .. .. 1 1 Hawkers .. 1 .. 1 2 Tram-conductor 1 1 Hotelkeepers 2.. 1 .. .. 3 Travellers .. .. .. 2 ] 3 Insurance agent . . 1 I Watchm aker .. 1 1 Jeweller .. 1 1 Wheelwright .. 1 1 Jockey .. 1 . . 1 No occupation .. 23 55 20 2 39 21 4 1 165 Journalists .. .'. I 1 .. .. 2 Transfers .. .. 7, 4 4 .. 1 4 4 1 25 Labourers .. .. 40 43 26 6 5 49 81 .. j 177 1 Machinists .. .. 2 j .. j 2 Totals ... 136 141 96 15 56157 38 7 646 Mechanics .. .... 2 .... 1 .... I 3 i Females Boardinghouse-keeper.. 1 I Prisoners .. .. 2, 2 Clerks .. .. 1 1 1 3' School-teachers .. 1 .. 1 .. .. 2 1 .. 5 Cook .. .. I .. 1 .. 1 Tailoress .. 1 1 Domestic duties .. 79 76 68 5 7 108 26 1 370 Typists .. 1 .. .. 1 .. .. 2 Factory workers .. 1 .. 2 3 Typesetter .. 1 .. 1 Hawker .. .. .. 1 1 Waitress .. .. 1 1 Hotelkeeper .. .. 1 1 No occupation .. 14 44 1 2 3 4 2 .. 70 Librarian .. .. 1 1 Transfers .. .. 4 1 4 4 33 .. 2102 1 150 Nurses .. . 13 1 1 6 ! Pensioners .. .. 3 1 .. 1 .. .. 5 Totals .. Ill 130 1 80 41 10117 132 3 624

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.

21

Discharged. It»-. Vanr 1 i Remaining, Av#»raffp "NnmhwH Percentage Percentage of Deaths "R pcnvArprf -p i. j „, T _ Died - j 31st December in resident of Recoveries on on Average Numbers Recovered. Believed. Hot Improved. | each Year. resident. Admissions. resident. M - *• T - M. F. T. M. P. T. M. F. T. M. F. T. M. F. ! T. M. F. T. M. F. T. M. F T } 87 5 •• 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 Jo!? Ifoi 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 .. ! „3-! ' 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 5-5* 188L .. 267 152! 419 95 59 154 49 32 81 5 6 11 60 19 79 827 442 1,269 796 421 1,217 35-58 38-81 36-75 7-53 4-51 6-49 " : . S ; 1 ®' I 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 68 24 92 938 514 1,452 911 497 1,408 37-39 50-32 42-45 7-46 4-82 6-53 1880 ; 246 j 133 i 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 1 165 1 372 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 .. j '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 .. j 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 1 161 391 93 53 146 31 30 61 3 1 4 70 I 30 100 1,074 687 1,761 1,046 660 1,707 40-43 32-92 1 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 j 47*69 7-05 5-11 6-29 1891 .. j 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 .. 231i 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 75S 1,930 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 i 417: 105 77 182 24 19 43 1 2 3 101 42 143 1,329 885; 2,214 1,313 849; 2,162! 4!-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 .. j 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 .. | oOO 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 4-94 6-2S 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 .. j 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 5"84 6-38 1905 ' .1 360 251 611 149 121 270 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 3,088139-75 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 9"08 4-98 7-39 1908 .. 426 318 744 180 , 146 326 9 12 21 1 .. 1 148 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 3,60li 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 .. j 466 318 784 175; 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 •• 609 359 868 207 J 62 369 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 2S4 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 •• 618 361 879 160 17 1 3 31 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

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— continued.

22

Discharged. -r, . . ... „ | ... . . . : . ■ ;. .. % ...— ■ T ,. , .Remaining, Avpnuw WnmticTK Percentage Percentage of Deaths Year. j Admitted. : Died. 31st December in ...... of Recoveries on on Average Numbers Recovered. Relieved. I Not Improved. each Year. • Admissions. resident. ' 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. 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 32-49 135-07 33-73 .10-53 9-16 9-95 1919 .. 512 371 883 190 147 337 37 44 81 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 2,099 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 4,932 2,747 2,062 4,809 34-44 40-67 37-31 7-67 8-92 8-21 1923 ..I 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 1 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 i 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 1928 .. 506 450 956 115 134 249 40 40 80 17 13 30 207 161 368 3,274 2,628 5,902 3,120 2,459 5,579 22-72 29-77 26-04 6-63 6-55 6-59 1929 .. 549 407 956 145 144 289 30 28 58 22 16 38 227 153 380 3,399 2,694 6,093 3,215 : 2,495 5,710 26-41 35-37 30-23 7-06 6-13 6-65 1930 .. j 621 474 1,095 138 128 266 28 34 64 31 23 54 251 172 423 3,572 2,811 6,383 3,342 5,932j 22-22 27-00 24-29 7-51 6-64 7-15 119,708 14,367 34,075 7,382 6,202 13,584 1,405 1,292 2,697 434 320 | 754 7,397 3,996 11,393 ! . ! 1 I Excluding transfers between institutions —1,664 males, 1,214 females.

H.—7.

Table XVI.—Showing the Admissions, Discharges, and Deaths from 1st January, 1876, to 31st December, 1930 (excluding Transfers).

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

23

M. P. T. In hospitals, 31st December, 1875 .. .. .. ... 482 254 736 Admissions .. .. .. .. .. .. 19,708 14,367 34,075 20,190 14,621 34,811 Discharged— m. f. t. Recovered .. .. 7,382 6,202 13,584 Relieved .. .. .. 1,405 1,292 2,697 Not improved ,. .. 434 320 754 Died .. .. .. .. 7,397 3,996 11,393 16,618 11,810 28,428 Remaining on 31st December, 1930 . , .. .. 3,572 2,811 6,383

Males. Females. Both Sexes. Recovered .. ., ,. . .. .. 36-08 42-41 39 02 Relieved .. .. .. .. .. 6-99 8-83 7-75 Not improved .. .. .. .. .. 2 15 2-18 2-16 Died .. .. .. .. .. .. 36-63 27-33 32-73 Remaining .. .. .. .. .. 18-15 19-25 18-34 100-00 100-00 100-00

H.—7.

Table XVIII.— Debits for the Financial Year, 1930-31.

24

—— Auckland. Christchurch. Dunedin. Hokitika. Nelson. Porirua. Tokanui. Head Office. Total. £ s. d. £ s. d. £ s. d. £ s. d. £ s. d. £ s. d. £ s. d. £ s. d. £ s. d. Salaries.. .. .. .. .. .. 43,427 18 9 46,860 6 5 57,629 9 8 14,884 1 6 21,487 2 4 55,292 3 0 24,110 10 5 8,173 3 8 271,864 15 9 Official Visitors .. .. .. .. .. 52 10 0 31 10 0 .. 10 10 0 .. 41 13 4 6 5 0 .. 142 8 4 Advertising, books, &c. .. .. .. .. 3 4 9 7 8 9 22 15 0 11 15 9 4 1 0 10 1 0 4 2 0 36 4 1 99 12 4 Bacteriological research .. .. .. .. .. 5 19 0 .. 0 10 6 0 10 6 25 13 10 . . .. 32 13 10 Bedding and clothing .. .. .. .. 5,049 7 0 4,686 19 3 6,086 11 10 625 19 10 1,262 1 10 7,847 10 6 2,150 111 .. 27,708 12 2 Buildings, including additions, &c. .. .. .. 1,151 8 0 1,346 0 10 1,257 9 1 350 0 10 394 10 8 1,115 8 8 790 4 8 .. 6,405 2 9 Dental services .. .. .. .. .. 15 1 1 31 11 7 6 11 4 14 0 0 4 13 0 68 12 6 20 4 0 580 6 2 740 19 8 Farms, maintenance of .. .. .. .. 816 5 9 2,709 4 1 1,624 13 1 295 12 10 1,145 111 1,638 0 7 1,750 17 0 .. 9,979 15 3 Fencing, draining, and reading .. .. .. 67 8 10 45 5 2 111 13 0 194 13 11 74 6 9 288 8 5 768 5 7 .. 1,550 1 8 Freight, cartage, and transport .. .. .. 131 1 9 257 9 11 502 10 0 30 11 11 180 14 8 378 17 8 233 16 5 0 11 0 1,715 13 4 Fuel, light, water, &c. .. .. .. .. 6,435 13 1 6,628 8 0 6,855 17 8 1,132 19 10 2,793 19 7 5,724 0 8 2,991 1 3 64 1 1 32,626 1 2 Funeral expenses .. .. .. .. 86 5 0 64 0 0 89 12 8 5 0 0 70 15 0 86 12 6 42 15 0 .. 445 0 2 Furniture and furnishings .. .. .. .. 840 2 3 353 3 7 617 12 10 18 12 0 64 14 0 639 8 1 209 1 10 17 10 0 2,760 4 7 Gardens and shrubberies .. .. .. .. 47 7 9 87 0 1 21 16 9 2 4 7 19 0 8 98 5 6 25 2 8 ■ .. 300 18 0 Laundry .. .. .. .. .. 411 8 6 281 13 9 1,115 2 10 928 10 6 ; 181 11 1 321 1 1 275 0 5 .. 3,514 8 2 Legal and inquiry costs .. .. .. .. 4 15 0 4 4 0 5 18 0 .. .. 10 10 0 .. .. 25 7 0 Machinery, repairs, and stores .. .. .. 116 6 3 158 5 10 314 19 0 4 1 10 30 15 10 116 12 1 153 19 5 .. 895 0 3 Medical fees .. .. .. .. .. 571 9 0 486 5 0 360 19 0 32 2 0 87 2 4 650 19 6 139 15 0 .. 2,328 11 10 Motor-vehicles, maintenance of .. .. .. 61 18 11 233 6 4 407 12 1 70 0 4 107 3 10 227 10 7 213 15 2 .. 1,321 7 3 Motor-vehicles, purchase of .. .. .. .. 282 17 8 135 1 10 132 7 0: .. .. .. .. 550 6 6 Nursing staff uniforms .. .. .. .. 223 6 2 300 2 5 327 18 7 164 8 6 83 3 1 424 8 5 124 1 0 .. 1,647 8 2 Office equipment .. .. .. .. .. 0 14 0 13 18 8 .. 21 9 5 3 2 0 0 18 7 25 13 7 9 16 10 75 13 1 Patients, expenses connected with — Gratuities .. .. .. .. .. 88 12 4 28 2 7 120 11 9 43 5 2 173 12 0 91 19 4 27 5 5 .. 573 8 7 Friends .. .. .. .. .. .. .. 100 0 0 .. .. . . .. .. 100 0 0 Recreation .. .. .. .. .. 1,891 12 10 1,445 5 2 2,530 0 5 273 3 9 434 10 4 2,722 15 0 592 0 10 .. 9,889 8 4 Transfers .. .. .. .. .. 32 14 2 83 10 1 7 12 6 0 8 6 35 2 0 85 16 8 4 19 2 .. 250 3 1 Postages, telegrams, &c. .. .. .. .. 112 6 2 106 11 3 107 3 6 20 7 6 39 8 0 152 7 4 62 0 11 209 3 7 809 8 3 Printing and stationery .. .. .. .. 247 16 3 183 10 9 153 0 8 40 7 3 59 11 2 196 9 10 86 16 4 126 12 11 1,094 5 2 Rations.. .. .. .. .. .. 15,711 4 2 13,556 1 2 17,913 12 0 4,807 9 6 5,936 2 4 19,367 8 7 6,695 9 8 .. 83,987 7 5 Rents and rates .. .. .. .. .. .. 2,057 9 9 6 17 6 .. 2 5 1 .. .. 781 17 2 2,848 9 6 Stores .. .. .. .. .. .. 562 15 10 752 7 7 960 9 1 81 19 2 251 17 8 1,261 111 443 . 6 1 .. 4,313 17 4 Surgery and dispensary — Drugs and instruments .. .. .. .. 349 1 9 335 6 6 274 12 5 12 19 10 16 4 6 661 13 3 12 1 1 .. 1,661 19 4 Wines, spirits, &c. .. .. .. .. 13 17 4 16 18 0 32 12 1 .. 7 16 0 12 0 7 .. .. 83 4 0 Telephone services .. .. .. .. 43 14 7 127 17 4 210 6 2 32 6 10 44 4 7 130 12 5 64 18 3 101 11 0 755 11 2 Transfer and removal expenses .. .. .. 2 11 6 11 14 7 4 12 6 1 7 2 476 187 039 543 31 9 10 Travelling-allowances .. .. .. .. 64 0 4 89 7 0 107 5 5 21 0 0 133 8 11 3 11 0 36 10 4 235 19 3 691 2 3 Travelling-expenses .. .. .. .. 61 9 4 52 16 3 194 3 9 16 16 6 49 16 6 97 4 7 27 6 5 j 244 11 11 744 5 3 Treatment and maintenance in general hospitals — Patients .. .. .. .. .. 83 6 6 23 16 0 54 18 0 14 3 6 21 19 6 161 13 6 32 5 0 .. 392 2 0 Staff .. .. .. .. .. .. 3 12 0 51 18 0 11 11 0 28 9 3 1 1 0 14 15 6 .. . . Ill 6 9 Contingencies .. .. .. . . .. 2 8 0 14 12 4 0 12 6 0 18 6 6 2 1 7 19 4 .. 14 12 0 47 4 9 Total expenditure .. .. .. 78,784 14 11 83,812 4 8 100,284 5 6 24,324 15 6 35,211 19 3 99,975 13 11 42,119 15 7 I 10,601 4 11 475,114 14 3 Credits .. .. .. .. .. 32,044 1111 32,726 14 11 35,044 11 1 4,398 19 0 11,216 10 1 39,246 8 7 17,502 11 1 14 14 2 172,195 0 10 Net expenditure .. .. .. .. 46,740 3 0 51,085 9 9 65,239 14 5 19,925 16 6 23,995 9 2 60,729 5 4 24,617 4 6 j 10,586 10 9 302,919 13 5

H.—7.

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

Table XVIIIa.— Credits for the Financial Year, 1930-31.

25

—- —• Auckland. Christchurch. Dunedin. Hokitika. Nelson. | Porirua. ! Head Office. Total. • V i J I ! , f s. d. £ s. d. £ s. d. £ s. d. £ s. d. £ s. d. £ s. d. £ s. d. £ s. d. Receipts for maintenance .. .. .. .. 26,871 7 3 23,968 14 9 25,572 5 10! 2,410 13 1 7,757 3 8 31,262 18 9 11,472 7 6 .. 129,315 10 10 Receipts for farms .. .. .. .. 237 17 0 3,159 3 7 1,624 13 10, 90 2 0 835 1 11 955 0 9 2,567 9 3 .. 9,469 8 4 Miscellaneous .. .. .. .. ., j 4,935 7 8 5,598 16 7 7,847 11 5 1,898 3 11 2,624 4 6 7,028 9 1 3,462 14 4 14 14 2 33,410 1 8 Totals .. .. .. ..{32,044 1111 32,726 14 11 35,044 11 1 4,398 19 0 11,216 10 1 39,246 8 7 j 17,502 11 1 14 14 2 172,195 0 10 I I I

Average I [ "d Number Bedding i Buildings I Fuel, Light, Surgery wil , Bq ,, Tw i Total Cost Other Net Coat ; Net Cost Decrease Increase Mental Hospital. : resident Salaries. and and j Farm. Water, and Provisions. and «niriti lanenm P er Mam Re " P er previous in in (inclusive of Clothing. : Repairs. ! Cleaning. Dispensary. : Patient. payments. Patient. Year. 1930-31. 1930-31. Boarders). ; j i £ 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.. .. 1,321 32 17 6 3 19 11 0 17 7 0 15 10 4 17 5 11 19 7 0 5 6 0 0 3 4 9 4 60 2 11 20 6 10 4 5 10 35 10 3 40 19 6 5 9 3 Christchurch .. 1,032 45 83 517 161 2 12 7 686 13 36 073 004 7 18 1 82 62 23 46 10 40 48 17 8 51 87 2 10 11 Dunedin (Seacliff) .. 1,207 47 15 2 5 7 3 1 0 10 1 12 3 5 12 7 14 19 7 0 4 11 0 0 6 7 9 9 84 3 10 21 3 9 8 10 11 54 9 3 54 6 6 .. 0 2 9 Hokitika . . .. 252 59 1 3 4 5 9 1 7 9 1 5 8 4 9 11 20 0 8 0 7 0 .. 10 1 4 100 19 4 9 11 4 7 17 10 83 10 2 90 14 6 7 4 4 Nelson .. .. 436 49 5 11 3 12 6 0 18 1 3 1 7 6 8 6 13 14 6 0 6 2 0 0 4 5 13 3 83 0 10 17 15 10 8 1 7 57 3 5 59 11 11 2 8 6 Porirua .. .. 1,436 38 10 1 5 9 8 0 15 6 1 7 11 3 19 9 13 11 11 0 9 4 0 0 2 5 18 2 70 2 6 21 15 5 7 13 10 40 13 3 41 10 0 0 16 9 Tokanui (includes 559 43 2 8 4 9 5 1 8 3 3 12 11 5 8 0 |12 6 9 0 2 10 .. 7 13 8 78 4 6 20 10 6 12 6 8 45 7 6 59 16 10 14 9 4 Kingseat) Head Office .. .. | 1 6 3 .. .. 002! .. .. .. 079 1 14 2 .. 001 1 14 1193 .. 04 10 Totals .. 6,243 43 11 0 4 16 2 1 0 7 1 16 7 5 4 8 13 12 2 0 6 5 0 0 3 6 18 9 | 77 6 7 20 14 3 8 0 2 48 12 2 51 11 0 2 18 10

H.—7.

Approximate Cost of Paper.—Preparation, not given; printing (600 copies), £40.

Table XXI.—Total Expenditure, out of Public Works Fund, for Buildings and Equipment at each Mental Hospital from 1st July, 1877, to 31st March, 1931.

Table XX.—Expenditure, out of Public Works Fund, on Mental Hospital Buildings, etc., during the Financial Year ended 31st March, 1931, and Liabilities at that Date.

By Authority : W. A. G. Skinner, Government Printer, Wellington.— 1931.

Price 9d. ]

26

Total Mental Hospitals. 1877-1922. 1922-23. 1923-24. 1924-25. 1925-26. 1926-27. 1927-28. 1928-29. 1929-30 1930-31 Net Expenditure, 1st July, 1877, to 31st March, 1931. £ £ £ £ £ £ £ £ £ £ £ Auckland .. .. .. .. 169,298 777 5,188 2,393 2,073 19,988 12,213 12,461 2,279 3,372 230 042 Ohristchurch (Sunayside) .. .. 193,967 2,245 1,497 6,272 j 2,901 7,229 10,164 7,777 35,291 23,993 29l'336 Dunedin (The Camp) .. .. .. 4,891 .. .. .. .. .. .. .. .. .. 4'891 Hokitika .. .. .. .. 4,711 4,789 10,216 16,013 8,034 1,745 141 401 3,064 14,761 63'878 Hornby .. .. .. .. 10,980 122 .. .. .. .. .. .. .. _ 11^102 Motuihi Island .. . .. 561 .. .. .. .. .. .. .. _ 'g0j Napier .. .. .. ■. 147 .. .. .. .. .. .. .. . _ _ 2^7 Nelson and Stoke .. .. .. 34,162 1,929 1,429 2,389 1,182 805 .. 956 127 26,494 124,300 Puhitahi .. .. .. .. .. .. .. .. .. .. .. .. .. 16J30 16J30 Seacliff .. .. .. .. 187,128 1,602 1,246 3,016 4,767 17,888 9,408 27,132 34,609 8,914 295 710 Tokanui .. .. .. ■■ 95,495 515 2,743 16,076 8,097 1,658 2,124 19,887 32,405 27,787 206'787 Waitati .. .. •. .. 16.620 848 194 .. 627 .. 853 2,170 9,557 3o'869 Wellington .. .. .. .. 29,641 .. .. .. .. .. .. .. _ 29*641 Wellington (Porirua) .. .. .. 213,130 688 2,578 18,374 38,213 16,004 16,315 27,315 9,028 3,129 344*774 Totals .. .. .. 960,731 13,852 26,541 68,438 77,835 68,635 51,118 96,782 152,096 134,140 1,650,168

Mental Hospitals. Net Expenditure for Year Liabilities ended 31st March, 1931. j on 31st March, 1931. £ £ Auckland .. .. .. .. .. .. 3,372 Ghristehurch (Sunnyside .. ,. .. .. .. 23,993 62 Hokitika.. .. .. ., .. .. .. 14,764 584 Nelson and Stoke .. .. .. .. .. .. 26,494 244 Porirua .. .. .. .. .. .. .. 3,129 73 Pubitahi .. .. .. .. .. .. 16,130 6,615 Seacliff .. .. .. .. .. .. .. 8,914 Tokanui .. .. .. .. .. .. .. 27,787 3,162 Waitati .. .. .. .. .. .. .. 9,557 656 Total .. .. .. .. .. 134,140 11,396