MENTAL HOSPITALS OF THE DOMINION (REPORT ON) FOR 1932.

Appendix to the Journals of the House of Representatives, 1933 Session I, H-07

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1933. NEW ZEALAND.

MENTAL HOSPITALS OF THE DOMINION (REPORT ON) FOR 1932.

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

The Director-General to the Hon. J. A. Young, Minister in Charge of the Department of Mental Hospitals. Bm,— Wellington, Ist July, 1933. 1 have the honour to submit the annual report upon the work of the Department of Mental Hospitals for the year ending 31st December, 1932. At the close of the year there were 7,194 persons on the registers of the Department, including 44 at Ashburn Hall private licensed institution, and 167 who were on probation in the care of friends Or relatives. Of the 6,683 persons actually in residence in Government institutions at the end of the year, 6,417 were detained under reception orders, while 266 had been admitted at their own request as voluntary boarders. During the year 1,396 patients were committed to the various hospitals and 325 voluntary boarders applied for care and treatment, the total admissions showing a slight decrease (10) compared with last year. We were able to discharge 759 patients and boarder-, or 54-3 per cent, calculated upon the admissions, but of that number only 599, or 42-9 per cent., could be regarded as having " recovered." This recovery-rate is much in accord with that reported from other countries whose figures are available for comparison. Our discharge-rate is high, and this year our death-rate is the lowest recorded for twenty-four years; between these and the total admissions there is always a balance, more or less permanently, added in our populat ion. In my last report 1 showed that the average annual permanent accretion to our population was 239 ; this average is raised to "212 by the inclusion of t he figures for the current year. Discharge and Probation. It will be noted that during the year we discharged 7:V.) persons, or 54'3 pel' cent, calculated upon the number admitted. In addition, at the end of the year 467 of those on our registers were living outside the institutions on probation in the. care of their friends. These figures show clearly that no effort is being spared to restore the patients In their friends if such a course is at all reasonably possible. The discharge or release on probation of patients is one of the heaviest responsibilities which fall to the lot of a medical superintendent, and I am glad to record by the figures quoted above the manner in which this duty is being carried out. On the one hand there is the urge to premature discharge or release mi probation because of the shortage of accommodation supported by the not unnatural importunity of anxious relatives, and on the other hand there lies the duty of protecting l lie safety of the community and the real interests of the patient concerned, and in these circumstances it is rather amazing that untoward incidents have been so few and far between in the whole history (if the Depart nienl , These reflections have been partly prompted by one tragic occurrence during the year when a female patient on probation caused the death of her child, the hospital authorities being completely exonerated at the subsequent Coroner's inquest. Whilst such occurrences cause a painful public emotion they must be regarded in relationship to the whole question of modern menial hospital policy, and not be allowed to stampede us into using remedies which would be worse than the ills they might purport to cine. Discharge, probation, and parole are all attended, with some degree of risk, but the advantages of granting as much freedom as possible to patients are so manifest to those of us who have experienced

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former methods thai any curtailment of the present policy is unthinkable. Our medical officers do not claim, nor should they l>c expected, to have any superhuman prevision in regard to the way in which a discharged patient or probationer may reaci on regaining his liberty; all that we can do is to exercise a reasonable discretion in the light of one's experience and having regard to the niceties of each case. The Causation of Mental Disorder. The heavy burden imposed on the community by the steadily increasing Dumber of patients maintained in mental hospitals and kindred institutions has become a matter of deep public concern not only in New Zealand, but in most other countries where the present financial stringency has necessitated a Strict scrutiny of public expenditure, and in Crcat Britain a scientific Committee has been set up to go into the matters of causation and possible relief. In Table XII! are set forth the various causes which were assigned at the time of admission as being responsible for the mental breakdown, but experience prevents the acceptance of any single factor and bears out Mercier's dictum that heredity and >ticss an- in inverse ratio. When we regard the list of stresses in the table we cannot but admit that most of them are applicable to the majority of people : we must all pass through the critical periods of life, few of us escape during the whole of our lives from physical ill health or infections, whilst "mental stress," including excitements, disappointments, hates, loves, fears, and the whole gamul of emotions, is a common-place of human existence. What. then, is the conditioning factor which causes these experiences, incidental as they are to the majority to become in others the excitants of mental disease in all its varying phases and manifestations ( Can we doubt that the fault lies in an imperfect development of the higher functions of the central nervous system and that this imperfection is due either to an inherent lack of potentiality for complete development, or to a cessation of development, or to an ill-balanced development brought about by causes operating in the early period of life — intra or extra uterine —before the physical basis of mental function has become fully organized. That a sound inheritance is the best insurance against mental disorder is well exemplified by the selective manner in which certain direct toxins operate. As is well known, alcohol and syphilis can cause profound disintegration of the nervous system with resultant insanity, but many excessive drinkers never become insane, and only 2 per cent, approximately of those who contract syphilis become the victims of general paralysis of the insane. The healthy stable brain is capable of resisting tremendous stresses, as is proved by the. statistics dealing with the after-history of cases of serious head injuries sustained during the war. In the largest military hospital set apart in England for the reception of mental cases, out of over 5,000 admissions, only 2 per cent, had head injuries, and it was estimated that the proportion of cases of head injury that subsequently became insane was only about 0-375 per cent. Contrary to popular belief, serious massed stresses do not produce insanity ; in fact, the evidence is all in the other direction. During the war period the proportion of adult female patients admitted was consistently lower than in normal years, although these, the wives and parents of the men on service, were being subjected to a prolonged and unusual mental stress. So also with the Napier and Hastings earthquake. In Napier a few hours after the catastrophe one saw numerous cases which were indistinguishable from the shell-shock of the trenches, but, so far as severe mental disorder is concerned, there were twenty-two fewer cases admitted from the Hawke's Bay area in the year following the earthquake than in the previous twelve months, and in no individual case could the disaster be ascribed as the cause. One would be tempted to expect that the distress arising from the prevailing economic difficulties would be reflected in an increase in our admissions. Actually the total admissions, including voluntary boarders, are ten less than in the previous year, and one can only surmise that the spirit of altruism, which is always at its height at periods of national danger and anxiety, is working as ii did during the war years. The great occasion is one of real stresses which leave no room for petty vanities and morbid imaginings and introspections: there is a call to ait ion. an exaltation of the community spirit and a self-discipline which tends to sanity. Thk Standard of Nursing in Mental Hospitals. The work carried out by the nursing staffs of our institutions is by its very nature precluded from any great share of public recognition, and it is therefore due that I should record from time to time my appreciation of the way in which our nurses and attendants carry out their duties. The care of the mentally afflicted calls for personal qualifications of a very high order, and. in addition to the possession of such primary essentials as suitability of temperament and self-control, our trainees are required to undertake a serious course of study extending over three fears and to qualify by examination before promotion to a responsible position. These examinations, which are on the standard required by the Royal Medico-Psychological Association of Great Britain, \\ ere instituted in 1907, since when over one thousand nurses and attendants have qualified fof registration. In this, as in any other social service, the work is rendered more congenial and easier in proportion to the intellectual as well as the humanitarian interest which is brought to bear on it. and we have endeavoured during recent years to maintain the training on a high level, particularly by the use of general trained nurses as tutor sisters, who supplement, by practical demonstrations and coaching, the lectures given by the medical stall'. One result of this system which appears likely to be of great benefit to the Department is that several of our nurses on completion of their training with us have applied for leave in order to enter

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public hospitals. On completion of their general training these muses have returned to mir service where their double qualification renders them particularly well qualified to hold the higher nursing positions in the Department. In addition to our own muses who return to us in this way we have recently engaged a number of other general trained nurses who are anxious to acquire a knowledge of mental nursing, and to whom we make a concession of one year in the period of instruction. In all we have forty-eight general trained nurses on our staffs, and the liaison thus established between the mental hospital and the general hospital cannot fail to have a result beneficial to both. This vear we have instituted a medallion for proficiency in mental nursing which those who pass the final examination are entitled to wear, and so far 288 nurses and attendants have availed themselves of this privilege. The Psychological Clinics. Since the passing of the Mental Defectives Amendment Act in 1928 two psychological clinics have been established by the Department—one at the Head Office in Wellington, conducted by Dr. John Russell, and the other in Auckland, under Dr. Kathleen Todd. During the vear 571 new eases have I n seen at the clinics, and the following table shows the sources from which they were referred : — Wellington. Auckland. Department of Education .. •• •• •■ ..35 98 Department of Education (Child Welfare Branch) .. .. 132 37 Department of Health (School Hygiene Division) .. ..42 28 Magistrates'and Children's Courts .. .. .■ ..19 Taients. guardians, medical practitioners, societies, and orphanages. . 128 11 356 215 Total 571 The number of new cases, although impressive, does not by any means indicate the extent or nature of the work being carried on by the clinics. From the outset we have endeavoured to avoid the tendency observed in other countries for these clinics to become mere machines for the collection and tabulation of symptoms, and our aim has been that they should ileal in an eminently practical way with each case presented. To carry out this ideal our investigations have been concerned not merely with the mentality of our patients, but have embraced also all those physical, economic, and socialogical conditions wliich make up his environment and which have to be intelligently, as well as sympathetically, appreciated before readjustment is possible. The clinics have now been established over three years, and Dr. Russell in the following report gives his views as to the directions in which this aspect of the work is likely to be of most value:— " There is little difficulty in deciding the treatment and necessary training or care of children of feeble-minded or lower grade mentality once a definite diagnosis is made. The ability of the parents to CO-operate in the training of each child is a major factor in deciding whether a child will be most benefited by remaining with the parents or being placed in a suitable home. The educability of the individual child determines whether the child is suitable for special training in a special school or class or at Templeton Farm. "The most difficult problem very often is the child who is on the border-line (80-90 per cent, normal intelligence), coming as he does between the normal and the definitely mentally deficient, The difficulty generally arises because too much is expected <>f such a child, who may manage to pass his standards until reaching the Fourth or Fifth, and then fails. Such children are sometimes placed in a special manual class at the technical school, which in many cases proves to be most successful. In others, however, inability to grasp any form of higher education leads to a complete loss of interest, and the child, seeking an outlet in other directions, may begin to play truant, indulge in petty thieving, or indulge in other actions of an anti-social nature. If properly handled and the way opened out fer employment in a channel suitable to the child's mentality, complete readjustment takes place and happiness is regained. . "When the clinics were first started most of the children examined were mentally deficient or border-line cases. As time has gone on it has been found that a gradually-increasing number of normal children have been brought for advice because of behaviour problems. It has also been found that an increasing number of children have been referred by medical practitioners and brought by the parents themselves, as apart from cases referred by various social-service organizatio "As regards normal children who have been referred or brought for advice because of varying abnormalities in their behaviour, it has been found that they very largely fall into one or other of the following , groups : — ■ (!) Children with positive behaviour characteristics—i.e., the aggressive type expressing themselves in various forms of abnormal behaviour, such as stealing, lying, temper tantrums, fighting, cruelty, and sex difficulties at home or at school. " (2) Children with negative behaviour characteristics—i.e., the timid, self-effacing type, expressing themselves by abnormal timidity, seclusiveness, selfishness, emotional disturbances, fears, excessive crying, insomnia, and night terrors. '• (3) Children with habit disorders : Very often children brought because of these habit disorders are found to belong to one or other of the above classes— e.g., stammering and ding (often found in association) or stammering and fears; Enuresis (bed-wetting), associated with stealing or lying, and very often with fears and timidity ; eating and sleeping difficulties and habit spasms. •■'(4) Abnormal behaviour in conjunction with physical diseases: Choreas, postencephalitic states, polio-encephalitis, malnutrition, fatigue, &c.

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"In these children it is generally the aggressive form of behaviour with restlessness and distractibilit v. "In the investigation of cases in any of the above groups it lias been found that the following factors have been present eil her singly en , in combinal ion, and may therefore be said to be causative : — " («) Environmental, which may be in the (i) emotional, or (ii) material spheres, and operating either at home or school, or both : there may be the home with too much license, or the repressive type of home which stultifies the child's development. " In some quarters at the present time there is a tendency to encourage the lirst type of environment too much license—thus placing too much responsibility on the immature mind and leading to anti-social behaviour. A mean between these is desirable for the normal and harmonious development of the child. "It is often Found that one parent gives one form of training whilst the other is diametrically opposed. In this way conflicts are set up both in the home and in the child's mind. " Absence of one parent or the presence of an unsympathetic step mother or father may lead to difficulties, or the lack of any contented and sympathetic background leads to a feeling of lack of support. ■■ Poverty and unemployment have their effects, particularly on older children, but although these occur they appear to be less detrimental than disharmony and conflict in the home. When in emotionally happy surroundings even though materially poor, a child can grow up an emotionally well-adjusted child. " Changes in the environment — from home to orphanage, or the reverse necessitate an adjustment in the child which may be found difficult. In a large number of cases the environmental factor has been of much importance ami by a rearrangement it has been possible to alter t he behaviour in t he desired direction. " (b) Temperamental difficulties or the mental make up : Children are born with varying characteristics, physical, mental, and emotional, and in consequence require differing individual attention a placid child may develop normally, whereas the sensitive sister or brothei- may develop nervous symptoms when brought up in the same at mosphere. " (c) Specific diseases and physical condition : Malnutrition, fatigue, chorea, meningitis, encephalitis. &c. " In the management of each case no aspect of the child nor its environment can be neglected. Before any decision can be made an adequate investigation must be made in three directions : " (1) Environmental : This investigation is carried out by an experienced social worker, which department of the work is of the utmost importance. Without an investigation into the child's environmental background both home and school a clinic can be, of little value either in diagnosis or future guidance. "(2) and (.')) Physcial and mental characteristics, the latter including an estimation ol the child's intellectual capacity and temperamental make-up. "The psychiatrist must have binocular vision and must be able to study and assess the factors of both physical and mental origin. He must be able to appreciate the possible bearing, which factors of eit her of t he above, may have on t he problems at issue. " The work of the clinic is so intermingled with the work of allied Departments (Education and Health), and existing social organizations that their co-operation is of the greatest assistance in int reducing children to the climes, and in the later adjustment of the child. ■ '■ Advice has been asked for in many cases of juvenile delinquency which have either reached the Children's Courts, or have been treated as' preventive cases.' [n the case of the latter these children have been brought under examination by the officers of the Child Welfare Department, whose sympathetic handling of the cases has always been of Ihe greatest assistance. The willing co-operat ion of this Department has also been of much assistance in the future guidance of cases in the provision and supervision of suitable foster homes in certain eases and numerous other ways. "In all this work a narrow view must be avoided. The officers working on a particular case must view it from the widest possible angle, must consider each possible factor I hat mav be playing a part, and then do their best to modify any undesirable situation by every means possible. ■' It is impossible at this early stage to make any definite statement as to how much clinics for child guidance may do in the sphere of prevention. Experience over a period of years of cases definitely psychotic or psycho-neurotic leads one to suspect in some cases the early stages of such conditions, more especially those which have come to be recognized a- only likely to occur in certain types of individual. The recognition of these types of normal individuals must be of value, and if an appropriate adjustment can be made in the most suitable environment it is at least hopeful that the course of such abnormal conditions may be made at least less severe if not arrested. Even at this stage the officers who have been engaged in this work are hopeful from their experience that the preventive work done may yet prove of value." Alterations, Improvements, and Additions. Our capita] expenditure on new buildings ami additions and improvements during the vear was £28,755, and the following summary shows the principal items making up the total, as well a> new buildings in progress but not completed by the 31st March :— Auckland (£677). Alterations to electrical system to allow of charge being made on a more economical basis.

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Kingseat (£10,278). \ illas No. 3 and No. I. each for fifty patients, under construction. Necessary roading and sewerage connections. Tokanui (£2,917). Rearrangement of water reticulation and provision of new reservoir. Porirua (£200). Minor improvements. Nelson and Stoke (£2,(i2">). Addit ions to lavatories (Nelson). Provision of fire service (portion), and purchase of land for water-supply (Stoke). Hokitika (£3,107). No. 2 villa for fifty women completed and occupied. Christchwrch (£7,343). No. I villa, Templeton, for forty-eighi girls completed. Alterations to reception house (Christchurch). Seacliff (£1,608). Equipment for hospital ward. Additions to water storage and reticulation (Waitatd). Financial Statement. The details of expenditure and credit are shown in Tables Will and XVIIIa, and the outstanding features arc an increase of over £3,000 in the total amount received lor maintenance, and a diminution of almost £5 in flic net annual cost per patient. The fact that we have collected over •: I 25.000, and that this i" an increase instead of a fall as compared with last year, is highly creditable to .Mr. A. T. Wells, our Receiver, who carries out bis difficult task with greal sympathy and delicacy and a notable absence of friction. During the year we have endeavoured to maintain a just balance between the needs of those entrusted to our care and a due regard for the public purse, and I think we may claim that the very real economies effected have not in any way inflicted hardship on the patients. The main items of our expenditure are : — Per Cent. • Per Cent. Salaries .. .. .. 57*46 Repairs .. .. .. 1-07 Rations .. .. .. Ki-ll Patients'recreation .. 2-01 Fuel, lighting, and cleaning .. 7-5 Bedding and clothing .. 6-36 93-01 Farms .. .. .. 2-20 It may safely be said that our stall's are not in excess of requirements and in normal times mighi well be increased, and. in so far as I he cither items are concerned, our expenditure is largely dependent upon price-levels. Tins fact may be illustrated by the following examples: —

While our hospital farms are regarded mainly from the therapeutic point of view as affording suitable occupation and exercise for our patients, it is satisfactory to note that, in spite of the low prices of produce, they have, with two small exceptions, all shown a favourable balance, and our credits in aid from this source totalled £7,981. Appreciation. In conclusion, I desire to record my appreciation of the support accorded to me during the pear by Dr. Russell, the Deputy Director-General, the medical superintendents, and the other officers of the service. I am also greatly indebted to Mr. Holder and the Head Office staff for their unfailing loyalty and .support a! all times. I have, &c, Theo. G. Gray.

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An annual We use An Increase of Increased Expenditure of Per Ib. £ 5,000 lb. butter weekly .. .. .. .. .. Id. 1,040 2,700 lb. cheese monthly .. .. .. .. .. Id. 585 5,200 lb. meat daily .. .. .. .. ..I Jd. 1,970 32,000 lb. sugar monthly (plus 30 tons jam annually) .. .. £d. 940

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MEDICAL SUPERINTENDENTS' REPORTS.

AUCKLAND MENTAL HOSPITAL. Dr. Buchanan reports : — I have the honour to present my annual report for the year ended ;ilst December, 1932. The total number of cases under care during the , year was 1,643, with a weekly average of 1,241. The admissions numbered 286 (164 males, 122 females). Of this Dumber iMU were admitted for the first time. Under section 8 of the Mental Defectives Amendment Act 124 patients were admitted. Ninety voluntary boarders were admitted during the year, making a total of 189 under care, and of these 95 were discharged. At the end of the year 122 patients were on probation, 58 on lull parole, and 185 on limited parole. The general health of the patients was good. Deaths totalled 96 (51 males, 45 females). The most important change effected during the year was the installation of an electric substation, through which we receive electricity in bulk, and then distribute it to the Hospital buildings according to their requirements. This lias been operating now for four months. In comparing these months with the corresponding months of last year I find that a saving of approximately £140 has been made. A new store was added to our already overtaxed accommodation, and has helped considerably to relieve the congestion. At present work is being carried out on a new hot-water circulating supply, which is to provide hot water from the Koilerhouse to the Nurses' Home, laundry, main building, Park House, and the male admission ward, .thus doing away with the use of small independent boilers. The patient population is steadily growing. The relief gained by transferring 47 male patients to Kingseat Mental Hospital at the beginning of the year was only temporary. We are over our recognized establishment again. On the female side we are overcrowded to the number of 64. The number of criminal lunatics is increasing. Many of a feeble-minded type, on completion of their prison sentence, are pul under Mental Hospital control for the safety of the public. These patients, in general, are a conceited, self-opinionated lot, who suffer under what to them is a very real sense of victimization. They consider that, having served their sentences, they have completely expiated their wrongdoings. Treatment in most of these cases is of no avail—custodial care is the sole requirement. It is hard to get them to occupy themselves usefully, and, consequently, more attendants are required in the airing courts. This cut-tails the outings of other patients. If these men do work they demand such privileges as are granted to many of our ordinary workers /.<<., parole, leave to go to entertainments, &c. In very many cases such privileges were seriously abused, and had to lie stopped. A vicious cycle is thus established. On several occasions I have found that these criminal patients have made deliberate attempts to prevent our ordinary patients from going out to work' in the usual course. They are a source of constant trouble, and I sincerely hope that a mental hospital for criminal lunatics will be established in the not too far distant future. The Psychiatric Clinic continues to function actively. Two days per week (Tuesdays and Thursdays) are devoted to this work. I now have Dr. Gordon Short associated with me in this work. He holds the Thursday session. lam indebted to him for his willing co-operation. Advice and treatment were sought by 360 persons, and the total number of consultations was 1,252. Various clubs, societies, and individuals were generous in their entertainment of the patients. Mr. Neville Carlsen was particularly active in this respect. I wish to proffer my thanks to them all. As usual, the Christmas Ball was voted the best that had ever been held. The wireless sets were overhauled, and give much appreciated service. The Official Visitors have paid regular visits, and their attentions were appreciated by both patients and staff. In conclusion, I wish to record my keen appreciation of the work of my colleagues and staff. The work is steadily increasing in amount and responsibility, and without the whole-hearted co-operation that I receive my task would be a difficult one.

KINGSEAT MENTAL HOSPITAL. I >!■. Hi niANAX reports : — I have the honour to submit this, the first annual report of the Kingseat Mental Hospital. The total number of cases under care dining the year was KM. with a weekly average of 142. The general health of the patients has been excellent, and only one death occurred. The Mental Hospital became a separate entity on the Ist April, 1932, and now consists of the farm buildings with three attached wards accommodating 58 patients, and two new villas (V. 1 and V. 2), each capable of accommodating 50 patients. These villas were occupied during January and February, 1932, by patients transferred from the Auckland and Porirua Mental Hospitals. With few exceptions, these patients quickly habituated themselves to their new surroundings. The villas are staffed with seven female nurses and a matron. All the wards at Kingseat are open, and the general atmosphere is one of freedom, with consequent contentment. All patients are employed, a few in the wards helping with domestic duties, and the remainder working either on the farm or in the development of the extensive grounds, which later will be the

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residential area. Considerable work has been done on the bitter property, including roadmaking, completion of a tennis-court, levelling of a large playing-field; tree-planting for shelter-belts, decorative purposes, and provision for future firewood supplies; preparation (if an orohard; and general oleaning, stumping, and draining. On the farm, which is approximately 550 acres in extent, there now remains only about 80 acres not yet broken in. Three acres are cultivated for vegetable-garden produce. The area set apart for building purposes approximates 100 acres. Two new villas are in course of constructicin. and should be ready for occupation in 1933. A small laundry was built in order to relieve the Auckland .Mental Hospital. It is worked by male patients under a nurse, and undertakes practically all washing for the present number of patients during good weather when the clothes can be dried outside. Tn spite of the isolated position of the Institution, and its small stall', entertainment has not been neglected. Small dances lor the patients are inaugurated from time to time, and many patients and staff have taken advantage of the tennis-court. In December a ball was held. Many of the muses from the Auckland Mental Hospital went out and whole-heartedly helped to make this first annual event a great success. Local residents were invited, and those, who came seemingly enjoyed the entertainment thoroughly. The female stall', under Acting-Matron McNoe, deserve credit for the cheerful services they have rendered. I cannot help feeling that the choice of Miss McNoe for the position of Matron was a happy one. Mr. Fowlie, in charge of the male stall', has co-operated well with the female side, and his enthusiasm for the development of the new Institution has been most helpful and encouraging to me. My thanks are due to the Rev. G. Jackson, who has held monthly services, which have I n well attended by the patients. I wish to put on record the yeoman service that has been given ungrudgingly by Mr. McFarlane, of the Public Works Department. Fortunately for us, he has taken a keen interest in the development of the new Hospital, and in every way has proved himself a valuable official and true friend. Finally, I would like to express my great appreciation of the good services performed by the whole staff, whose keenness has rendered the pioneer work of this Hospital a pleasure.

TOKANUI MENTAL HOSPITAL. Dr. Prins reports : — I have the honour to submit my annual report for the year ending 31st December, 1932. The total number of cases under care has been 679, with a weekly average of 544. The admissions were 99 (53 males and 46 females) of whom 83 (43 males and 40 females) were admitted for the lirst time, an increase of 11 over last year. Thirty cases were admitted under section 8, the provisions of which outside the main centres appear to be very little known. The general health of the Hospital has been good. Deaths numbered 26 (14 males, 12 females), senile decay being the principal cause. Thirty-nine patients (19 males and 20 females) were discharged recovered. The number of voluntary boarders under treatment during the year was 31 (16 males and 15 females), 10 (6 males and 4 females) being new admissions." The dischargee were 15 (9 males and 6 females). During the year the alterations to the main kitchen have been completed. A new boiler has been installed in the engine-room and a smaller one is awaiting installation. The sports-ground was sown. a good si like being obtained, and it lias already been made use of for cricket. This lias much improved the appearance of the Hospital. A number of ornamental trees and shrubs have been planted in the grounds and on the pathway to the Nurses' Home. At present much needed ventilation additions are being made to all the single fOOmS in the Hospital. The weekly pictures have unfortunately ceased, bin it is hoped thai it will soon be possible to convert the machine into a " talkie." Amusements and recreation have consisted of tennis, swimming, bowls, concerts, dances, and bands. Loud-speakers have been fitted to all the wards in the main building. Church services have been held regularly. Ten candidates were successful in the final examination, three nurses obtaining first-class passes. .Mr. Riordan, who had been main- years In , re. left on promotion to Seacliff, and was succeeded by Mr. Lilly. Mr. Battson has visited the Hospital frequently. In conclusion. 1 have to thank all the staff for their help and co-operation in the work of the Hospital.

PORIlil A MENTAL BOBPITAL. Dr. Williams reports : — I have the honour to submit my report for tin year ending 31s1 December, I i>32. The total Dumber under care and observation during the year was 2,013, of whom ] ,772 were committed cases, 224 were voluntary hoarders, and 17 were admitted on remand. Under all headings there were 440 admissions for the year, 221 were discharged, 69 were transferred, and 103 died. The total number of certified patients admitted was 302, 70 of these coming in under the provisions of section Bof the amendment to the Act. The Dumber discharged was 135 : 69 were transferred. One hundred and twenty one came in as voluntary boarders during the year: 68 were men and 53 women. Fifty-two men and 35 women, a total of 87, were discharged.

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Seventeen persons, 14 males and •'< females, were admitted on remand. All the women and r> men were discharged, while (i men were committed and the remaining 2 admitted as voluntary boarders. There were 103 deaths, a large proportion of these being due to senility and to cardiac affections. Ten of the total died while on trial, principally senile patients who had required only ordinary care and attention, and whose relatives had in consequence taken them home. It is interesting to note how rapidly the number of New-Zealand-born patients in comparison with the total under care is growing. For example, considering certified cases alone, 932 of a total of 1,465 of all nationalities are at present resident -that is, 64 per cent. Ten years ago 607 of a total of 1,123 were New-Zealand-born —that is, 54 per cent. Twenty years ago 374 of a total of 908 were New-Zealand-born — i.e., only 41 per cent. An increase of 23 per cent, over a period of twenty years appears on the surface, at any rate, to lie greater than the ratio one would expect, and possibly indicative of an increasing proportion of mental disorder in the country. On the other hand, however, it must not be forgotten that probably the examination of immigrants as to their suitability mentally has no doubt been more strict in recent years, though regarding this 1 am by no means certain of the real facts. Other factors, too, of course, must be taken into account in a detailed consideration of a matter like this: the figures, however, seem to give food for thought, particularly after your own remarks last year concerning the increase in mental disorder in New Zealand, and for that reason I Lave mentioned I hem. Overcrowding, as for a number of years now, continues to be a problem, and although the situation has been periodically eased by the transfer of numbers to other hospitals, the admission rate continues to grow so much that further transfers will soon be necessary. Not a great deal of work other than maintenance has been done during the year, the erection of a Dutch barn and a temporary bulk-store being the principal new structures. The renovations of the hot-water service at Rauta and the glassing-in of the verandas at some of the villas, thus providing a little extra accommodation, are also to be mentioned. A painting gang, comprised of patients, has done much good work. The Psychiatric Clinic at Wellington Hospital continues to flourish. During the year there were 1,078 consultations, 233 of these being lirst visits. The advantages of this early treatment have already been stressed ; suffice it to sa \ thai only a small proportion of those appearing required eventual in-patient treatment in this Hospital. Thirty-two were admitted as voluntary boarders and 17 were certified. Of the latter nearly all suffered advanced mental deterioration when first seen, the classes of disorder represented being senile decay, general paralysis, imbecility, and schizophrenia. There were also two cases of cerebral tumour with marked mental symptoms in addition. The general health of the patients has been satisfactory, and then- have been no epidemics. I have to record with deep regret the unfortunate death by accident on l-'ith July of Dr. Christie, one of our medical officers. He was a most capable and conscientious physician. Amusements and recreations have been provided in abundance for all, and my grateful thanks are due to all who, in spite of the depression, have continued to support us in this connection. My thanks are due also to the Official Visitors and to those organizations which continue to help us in so many ways. Their work is very much appreciated. In conclusion, I wish to acknowledge my indebtedness to my colleagues and to the staff generally for their loyal and efficient co-operation throughout the year.

NELSON MENTAL HOSPITAL. Dr. Bart reports : — 1 Lave the honour fco submit my report for the year ending on 31s1 December, 1932. On Ist January, L 932, there were 501 patients on the register. During the year 56 patients were admitted, L2 discharged, 12 transferred to other institutions, and 512 (374 males and 138 females) remained on the register at the close of the year. The total number of committed patients under care was 557. Voluntary boarders under care numbered 27. L 3 were admitted, II discharged, and L 3 remained at the end of the year. The general health of the patients was good, deaths numbered 21. Although few major works have been undertaken during the year, alterations, additions, and renovations have been carried out by the Hospital staff. The store, interior and exterior of the main building, Nelson, Medical Superintendent's residence, and numerous outbuildings and fences have been painted. The work done shows well what can be accomplished by mentally defective youths with the minimum amouni of supervision and direction. The old lavatory wash-hand basin block in the male ward was demolished, and a new structure with modern conveniences erected. Fire mains have been carried to Braemar Lodge and a water-service laid through the vegetable garden at Ngawhatu. A recreation-room was set aside and furnished for the use of staff at Nelson. An area of garden was fenced and taken as an additional playground for the children at El Nido. Much work has been done and is continuing, reading, levelling, and laying out grounds in the vicinity of the villas a! Ngawhatu. Apart from the routine work on the farm and orchards, some thousands of Pinus insignis and ijllllis were planted at Ngawhatu. I take this opportunity of thanking members of the Nelson Radio Club, through whose kindly offices a radio fund was successfully organized. The wireless set has since been installed and is a source of greal pleasure and entertainment to the patients. Thanks are due to tin people of Nelson for their generous donations in cash and goods to the patients' recreation fund. Mis. Scantlebury's untiring efforts have again resulted in a most welcome donation to the Children's Fund from the Sunshine League. In conclusion. 1 wish to thank all members of the staff for their loyal co-operation in the work /lining the year.

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IFOKITIKA MENTAL HOSPITAL. Dr. CiiiLiis reports : — I have the honour to submit my report for the year ending 31st December, 1932. At the beginning of the year the patients on the register numbered 290. The admissions proper for the year numbered 17. while 1(1 were received on transfer from Christchurch Mental Hospital. The discharges were 17, and Hie transfers to ('hnstchurch Mental Hospital 2. The total number under care during the year was 353, while the number remaining on the register at the end of the year was 322. There were 4 voluntary boarders on the register at the beginning of the year, and during the year 4 were admitted, 2 being discharged. The general health of the patients has been uniformly good, the number of deaths being 12. The policy of taking in more land for cultivation has been continued, and 16 acres of land has been cleared, drained, ploughed, and left fallow ; 13 acres of last year's fallow land has been grassed, while a comprehensive draining scheme in connection with the farm is also being carried on. The drainage of the hospital grounds and gardens has been completed. A new modern villa with accommodation for 48 female patients was opened and occupied in May. The villa i- an open one. and occupied by the better class of female patients, all of whom enjoy some kind of parole. The usual monthly visit to the Greymouth clinic has been carried on during the year. The painting gang has been active during the latter part of the year, and the Hospital wears a brighter appearance in consequence. The usual games and recreations have been carried on during the year, tennis and bowls being the most attractive of the outdoor activities. The usual parties visited the races. Thanks are given to the Municipal Band, the Church choirs, and others for providing entertainments, the band in particular for providing dance music on several occasions. As usual, manv of Hokitika people have earned thanks by donating various gifts to the Hospital. Mr. Coulson, the Official Visitor, has paid periodical visits to the Hospital. Thanks are due to the staff for their 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, 1932. On the Ist January, 1932, there were I.hi!) patients on the register. During the year 242 patients (117 men and 125 women) were admitted, 96 patients were discharged, and fifty-six transferred to other institutions. The total Dumber "I committed patients under care during the year was 1,411, and 1,191 remained on the 31i ber, 1932. One hundred and eighteen voluntary boarders received treatment during 1932, 52 (33 men and 111 women) were discharged, 1 died, and 15 wen , committed. The health of the has been very satisfactory ; there were 65 deaths (37 men and 28 women), the chief cause of death being senile decay. There were only four deaths from general paralysis. This is the lowest death-rate from this disease recorded for many years, and the special treatmeni carried out during the past few years is obviously responsible for the result. During 1932 our artisan staff has kept the Hospital buildings and property in a satisfactory state of repair; several extensive additions and alterations have been carried out. A second sun veranda has been completed ai the female reception-house and is now in occupation. A new villa is being erected ai Tenipleton and is Hearing completion. The addition of a second fireplace, together with the hot-water circulation through the dormitories, will add to the comfort of the patients in the annexe. The farming returns for the pasl pear have been very satisfactory, and the prospects for harvest are very bright. It is a matter for regrei thai the picture entertainments had to be curtailed owing to the inability to procure silent films. This form of entertainment appealed more to the patients than any other, and there was general disappointment when they were stopped. To the District Inspector, Mr. H. D. Acland, to the Official Visitors (Mrs. Williams and Mr. H. Hanna), and to the clergy of all denominations, 1 tender my thanks for their regular visits and for their attention to our pal iente. 1 desire to thanlc my colleagues and the staff generally for loyal and efficient assistance rendered during t he year.

SKACLIFF MENTAL HOSPITAL. Dr. Hayes reports : — I have the honour to present my annual report for the year ending 31st December, 1932. During the year there were 137 patients admitted (78 male, 59 female), and discharges were 45, of which 28 were males and 17 Females. Sixty-two patients died (.'SI males. 28 females), the principal cause of death being senile decay. There were altogether 2!) voluntary boarders admitted, and the total under treatment during the year was 76. Of these. 29 were discharged, L 3 committed, and 3 died. The alterations to the old kitchen block were completed and occupied towards the end of the year. These consist ed of sculleries for the main dining-hall, sewing-room, charge-nurses dining-room : a diningrooin and recreation ward for parole patients, and lavatories for these additions. On the top floor of this portion of the building the new quarters for the clerical Btaff were completed and occupied.

2 If. 7.

9

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Alterations to the lay-out of the ground at the back of the building are in progress, improving the appearance of this reconstructed section. The male hospital ward was enlarged and a new roof erected, this work being in progress at the end of the year. K. 1 Wan! was renovated and painted throughout, and new shutters made and erected. F. 4 Ward's scullery was renovated and new fittings installed. The tower and belfry were strengthened and the windows renovated, in addition, the usual maintenance, painting, and routine renovations were carried out. At Waitati in the epileptic ward renovations were effected, and a complete new hot-water system installed and a new lavatory. Renewals of pipings were also carried out in the hot-water supply and radiator systems, and to the kitchen of F. 1. The painting of the exterior of the Waitati buildings was completed this year. On the farm some 5 acres of bush has been underscrubbed for use as a nighl and shelter paddock. In addition to the usual open draining and fencing, there has been some 7 chains of tile draining in the flooding area of Cherry Farm, and part of the low-lying parts of the paddocks filled in. There has been a gradual improvement in the milk return, and the crops have done well during the season. At Waitati a gang has been regularly cutting the manuka, providing firewood as well as clearing the land. The [nvercargill clinic has been continued, while the Duncdin clinic has been extended to two days a week. There has been as usual considerable kindness on the part of various Dunedirj organizations m giving concert parties to the patients. Mr. Cumming, in his capacity of Patient's Friend, has earned the thanks and respect of all concerned. The cessation of the patients' weekly picture shows was a matter of general regret, being their sole regular entertainment and of a nature generally appreciated. I have to extend thanks to the visiting clergy for their visits. In conclusion, I wish to thank my colleagues and the staff generally for their support and work.

STATISTICAL. The patients on the register at the end of the year numbered 6,883 (m. 3,903, f. 2,980), or 222 (m. 150, f. 72) more than at the beginning ; and the daily average under treatment during the year was 6,419 (m. 3,681, f. 2,738), or 220 (m. 178, f. 42) more than in the previous year ; while the total under care was 7,732. Patients belonging to the Native race numbered 102 (m. 53, f. 49) at the end of the year. The admissions numbered 1,071 (m. 587, f. 484), or 8 more than in the previous year. Of these, 187 had been previously under care, making the proportion of readmissions 17-46 per cent., and 884 patients were admitted for the first time. The ratio to population of all admissions (exclusive of Maoris) was 7-17 (m. 7-70, f. 6-06) to 10,000, and of first admissions 6-42 (m. 5-37, f. 5-92), so that 1,393 persons in the general population contributed one patient, and 1,691 contributed a patient admitted for the first time. The discharges (excluding transfers) numbered 461, or 96 more than in 1931. 160 (or 42 more) harmless unrecovered persons were returned to the care of friends ; and 301 (m. 141, f. 160) recovered —54 more than last year —representing a percentage of 28-10 (m. 24-02, f. 33-05) on the total admitted. With voluntary boarders added the percentage rises to 42-91. Altogether, 54-36 per cent. of the inmates admitted were able to leave institutional care. Of a total of 7,732 patients under care, 388 (m. 219, f. 169) died, or 6-06 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, 22-94 ; disease of the brain and nervous system group, 20-61 ; heart-disease, 22-94 ; tuberculosis, 6-70. 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 .. .. .. •• •■ 6-30 5-37 5-88 Congenital 20-27 17-77 19-14 Predisposed by previous attack .. .. 13-80 11-56 12-79 Critical periods .. 21-45 29-13 24-93 Child-bearing (puerperal, non-septic, and lactation) .. 2-06 0-93 Mental stress .. .. .. .. 16-17 16-94 16-53 Toxic, including — m. f. Syphilis .. .. .. 4-77 1-23"| Alcohol .. .. .. 4-42 3-10 7-19 Drug habit .. .. 0-51 0-20 J Traumatic .. .. .. .. .. 0-68 .. 0-37 Disorder of nervous system, including —m. f. Epilepsy .. .. .. 3-06 5-78 4-77 7-02 5-79 Other bodily affections .. .. .. 5-79 6-81 6-26 No definite cause assigned .. .. .. 0-21 0-24 0-19 100-00 100-00 100-00

10

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Voluntary Boarders.

It will be noted that there were 325 voluntary admissions in the year under review, that 298 were discharged, and that 56 boarders, representing 17-23 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 5-4 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 1932 was 352.

MENTAL NURSES. In December the usual examination was held for the registration of mental nurses, when the following passed : — Auckland : Second Grade—Stephen Adamson, Matthew Deazeley, James Durry, William James Hardman, Archie Lamont, Kathleen Mary Emily Marrinon, Edna Mason, Regina Kate Myrtle Reynolds, Bridget Rodgers, Ethel Moyra Ursula Turner, Annie Williams, Walter Ernest York. Kingseat: Second Grade —Emily Hoare, Doris Ethel Noble, Ethel Clara Wright. Tokanui : First Grade—Kathleen Patricia Nodwell, Louie Agnes Reed, Jean Evelyn Rickard. Second Grade —Flora Arinei Endres, William Thomas Samuel Jeffares, Robert Brown Kinnon, Margaret Ellen Mackenzie, Bertha Margaret Moir, Elizabeth Adaline Palmer, Berteard Passau. Porirua : Second Grade —Lily Athy, Edith Georgina Baucke, Ivy Mary Patricia Dashfield, Kathleen Florence Griffiths, Queenie Groom, Eunice Daphne Johnson, Dennis Kennedy, Irene Kent, Jessamine May Mclntyre, John Richard McLachlan, Agnes Aileen Morgan, Elsie Margaret Morris, Vera Mant Oldham, Edith Pickles, Nancy Rita Evelina Rodder, James Thomas Rutherford, Arthur Horace Strong, Thomas Harley Thomasson, Annie Whipp, Mayvis Hilda Wooldridge. Nelson : First Grade —George Ashworth. Second Grade—Ernest Ashton, Moana Ella Bayly, Eric Moncrieff Cuthbertson, Helen Emilie Desaunais, Percy Allan Varley, Bessie Keen White. Hokitika : Second Grade —Enid Alice Rose Muir. Christchurch : First Grade —Mabel Bennett, Isabella Elenor Mcßae, Margaret Irene O'Reilly, Doris Elizabeth Reeves. Second Grade—Zeta Mary Beri, Ronald Frank Chinnery, Jessie Caroline Clemens, Walter Malcolm Ellis, Doris Jane Friar, Jessie Gordon Kennedy, John Mac Donald, Iriver Mclntyre, James George Morrison, Marjorie Margaret Reeves, Elsie May Rowe, Thomas Eric Sincock, Eva Elizabeth Smith, Alice May Walker, Myrtle Margaret Walker, Gordon Stanley Comrie Willis. Seacliff: Second Grade—Eleanor Elizabeth Alden, Thomas John Connor, Christine Campbell Craigie, Beulah Park Finlayson, Kdith Alison Clark Hawtin, Myril Jean Hopwood, William Kaveney, Ella Jane Mcßobert Kellahan, Marguerite Helen King, James McElrea, Catherine McKelvie, Henry McLay, Annie Flora Rumsey, Dorothy Lillian Stentiford, Elise Thomson, Jessie Ellen May White, Gwendoline Edna Borrie Wilson. Highest marks in written paper : Margaret Irene O'Reilly, Christchurch, 80 per cent. Highest total marks for written, oral, and practical : George Ashworth, Nelson, 260. (Average, 87 per cent.)

11

I ii'irat Knt i,'i,«t 'i'/itii Transferred Remaining .dSsL. flaa iaSSL -*~ dw - i)isd,a - d - ,«!,, 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 13 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 .. .. IS 17 32. 1 2 3 16 19 35 3 4 7,0 1 1 8 14 22 j 11 14 25 1916 .. .. 13 23 36 i 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 j 5 11 16 28 49 77 1 4 5 2 2 4 15 30 45 j 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 j 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 L922 .. .. 47 38 85 10 16 26 57 54 111 H 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 j 16 20 36 54 64 118 4 8 12 i 6 3 9 39 48 87 54 80 134 1925 .. .. 64 59 123 15 34 49 79 93 172 10 15 28 (i 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 I f>7 133 290 8 10 18 10 8 18 102 97 199 117 141 258 1929 .. ..102 63 165 50 43 93 152 106 258 11 :S 14 it !» 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 1931 .. ..166 98 264 43 36 79 209 134 343 11 14 25 11 7 18 159 102 261 198 161 359 1932 .. ..150 85 235 50 40 90 200 125 325 24 32 56 14 5 19 190 108 298 170 141 311

H.—7.

APPENDIX.

Table I. —Showing the Admissions, Readmissions, Discharges, and Deaths in Mental Hospitals during the Year 1932.

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 1932.

12

K. F. T. M. r. T. In mental hospitals, 1st January, 1932 .. .. .. .. 3,763 2,908 6,661 Admitted for the first time .. .. .. .. 489 395 88+ \ ,„, .... , ,._, Readmitted 98 89 187 / 68, 484 l ' ml Total under care during tlie year .. .. j .. 4,340 3,392 7,732 Discharged and died — Recovered .. .. .. .. .. .. 141 160 30] Relieved .. .. .. .. .. .. 39 42 si Not improved .. .. .. .. .. 38 41 79 ' Died .. .. .. .. .. .. 219 169 388 ! 437 412 849 (Not including tra i (era Males, 234; females, 56.) Remaining in mental hospitals, 31st Deoember, 1932 .. .. 3,903 2,980 6,883 Increase over 31st December, 11;i:!l .. .. .. .. L50 72 222 Average number resident during I lie war .. .. .. .. .'!J>81 2,738 6,419

In Mental Hob- Admissions in 1932. Tota l Number Mental Hospitals. pitals on PatientR 1st January, 1882. Admitted for the Not First T r»n«f P v a nmwr«r B First Time. Admission. Transfeis. imdi'i Care. ,M. t. T. M. V. T. M. F. T. M. P. T. M. F. T. Auckland .. .. 754 603 1,357 i 115 91 206 25 26 .">l 21 r> 29 918 725 1,643 tingseat .. .. .. .. .. 164 0 L64 164 (i 164 Tokanui .. .. 305 276 580 43 40 83 8 3 11 2 3 5 358 321 679 Porirua .. .. 848 622 1,470 142 102 244 23 18 41 14 3 17 1,027 745 1,772 Nelson .. .. 366 136 501 23 13 36 4 1 5 14 1 15 407 150 557 Hokitika .. .. 178 112 290 9 5 14 2 1 3 10 36 46 199 154 353 Christchurch .. .. 699 r>70 1,169 97 95 192 18 26 44 2 4 6 716 695 1,411 Seacliff .. .. 889 662 1,261 60 45 105 18 It 32 3 3 6 770 624 1,394 Ashburn Hall (private 14 29 43 0 4 4 .. 11 2 15 34 49 mental hospital) , . Totals .. 3,753 2,908 6,661 489 395 884 98 89 187 234 56 290 | 4,574 3,448 8,022 Patients discharged, transferred, and died. lM j[ |llltll ] Ilos . . , _ ... i ; . liitals on Mental Hospitals. ™..i, a ! Total discharged, 81st December, ! ?eSovSrld a J5KS2SS&L | Transferred. Died. trans* k>32. M. F. T. M. K. T. M. F. T. H. F. T. M. F. T. M. F. T. Auckland .. .. 19 27 46 23 30 r>3 92 :i 96 r>1 45 96 Is;, 1(15 2'JO 733 620 1,353 Kingseat .. .. 10 1 6 0 6 14 o 14 .. 21 0 21 143 0 143 Tokanui .. .. 19 20 3<J 0 r> r> 32 3 35 It 12 26 65 40 105 293 281 574 l'orirua .. .. 59 56 115 9 11 20 66 3 69 69 44 103 193 114 307 834 631 1,465 Nelson .. .. 3 4 7 5 0 5 11 I 12 14 7 21 33 12 45 374 138 512 Hokitika .. .. :S 4 7 6 5 10 0 2 2 8 4 12 16 16 31 183 139 322 Christohuroh .. -'I 35 56 17 23 40 16 40 56 37 28 66 III 126 217 625 569 1,194 Seaolifi .. .. 16 8 24 12 9 21 3 0 3 34 28 02 66 45 110 705 579 1,284 Ashburn Hall (private 0 6 6 .. 0 4 4 2 1 3 2 11 13 13 23 36 mental hospital) — ■— Totals .. 141 160 301 j 77 8!) 160 234 66 290 219 169 388 671 468 1,139 3,903 2,980 6,883 Avenue Number ota * e Percentage of ,, . . „ ... Aveia*,L ;•. . of Recoveries ou Deaths on Average Mental Hospitals. resident during Admissions Number resident the Year. during the Year. during the Year. M. F. T. : M. F. T. M. F. T. Auckland .. .. .. .. ..678 563 1,241 13-57 2308 17-90 7-52 7-99 7-73 Kingseat .. .. .. • • • • 142 .. 142 Tokanui .. .. .. .. .. 283 261 r>41 37-26 46-51 41-48 4-94 4-60 4-79 Porirua . .. .. ..779 577 1,356 35-75 46-66 40-35 7-57 7-62 7-60 Nelson .. .. .. .. ..360 133 493 11-11 28-67 1707 3-88 5-26 4-26 Hokitika .. .. .. .. .. 177 121 298 27-27 66-66 41-17 1-62 3-30 4-02 Christchurch .. .. •• •• ..572 523 1,095 18-26 28-92 23-73 6-46 5-36 5-93 Seacliff . .. .. .. .. ..677 r>:!t 1.211 2ik-.ii 16-25 17-52 502 5-24 5-12 Ashburn Hall (private mental hospital) .. .. 13 26 39 .. 160-00 160-00 16-40 3-84 7-69 Totals .. .. .. .. 3,6812,738 6,419:2402 3305 2810 5-97 617 606

H.—7.

Table IV.—Duration of Disorder on Admission.

Table III.— Ages of Admissions.

13

Aehburn Hall Ages. Auckland. Kingseat. Tokanui Porirua. Nelson. Hokitika. Christchurch. Seacliff. (Private Mental Total. Hospital). II. i\ T. I M. F. T. M. F. T. M. F. I. M. F. T. M. K. I. M. P. T. M. F. T. M. F. T. II. F. T. Under 5 years .. .. .. .. .. 022 .. .. 022 .. .. 044 From 5 to 10 years ..426 .. .. 224 718 .. 42G 112 .. 18 8 26 10 15 „ .. 0 11 .. .. 5 1 (i 3 2 5 .. 8 8 16 0 11 .. 16 13 29 15 „ 20 „ .. 13 7 20 ■.. 2 3 5 10 7 17 4 2 6 .. 18 15 33 8 2 1(1 .. 55 36 91 •>0 „ 30 „ .. 26 18 44 .. 13 12 25 38 25 63 4 2 6 10 1 15 25 40 18 9 27 0 11 115 92 207 30 „ 40 „ .. 15 24 31) .. 12 8 20 26 19 45 12 3 2 13 12 18 30 17 6 23 0 11 85 79 164 40 „ 50 „ .. 25 2IS 48 .. 8 11 19 31 24 55 4 15 2 0 2 16 13 2<J 13 19 32 0 2 2 99 93 192 „ 50 „ 60 „ . . 24 25 49 .. 7 5 12 24 19 43 2 13 2 2 4 18 22 40 9 8 17 .. 86 82 168 , 60 „ 70 „ .. 19 7 2(> .. .-,3 8 15 14 29 0 11 3 2 5 12 9 21 5 9 14 .. 59 45 104 „ 70 „ 80 „ .. 12 SI 21 .. 2 1 3 9 0 1:, 112 0 11 !l 5 14 4 4 8 .. 37 27 64 „ 80 „ 90 „ .. 10 1 .. 2 0 2 :,16 0 11 10 1 12 3 3 0 3 .. 13 4 17 Over 90 .. ..Oil .. .. .. .. •• 202 .. .. 1' I 3 Unknown .. ..101 .. .. .. 101 .. .. .. .. 202 Transfers .. .. 24 5 29 164 0 164 2 3 5 14 3 17 14 1 15 10 36 46 2 4 (» 3 3 6 112 234 56 290 Totals .. .. 164 122 286 164 0 164 53 46 9!) 179 123 302 41 15 56 21 42 63 ! 117 125 242 81 62 143 15 6 821540 1,361

Ashburn Hall Auckland. Kingaeat. Tokanui. Porirua. Nelson. Hokitika. Chrietchurch. Seacliff. (Private Mental Total. Hospital). i i M. F. T. M. F. T. M. F. T. M. F. T. It. F. T. M. F. T. M. F. T. M. F. T. M. F. T. M. F. T. First class (first attack and 58 54 112 .. 23 17 40 88 59 147 8 4 12 5 4 9 37 35 72 20 24 44 0 3 3 239 200 439 within 3 months on admission) Second class (first attack 6 4 10 .. 2 3 5 12 12 24 10 1 .. 11 13 24 11 8 19 0 11 43 41 84 above 3 months and within 12 months on admission) Third class (not first attack, 22 33 55 .. 4 2 6 24 17 41 4 3 7 3 14 14 15 29 10 0 10 .. 81 71 152 and within 12 months on admission) Fourth class (first attack or 30 17 47 .. 22 21 43 41 32 73 14 7 21 3 14 53 58 111 37 27 64 .. 200 163 363 not, but of more than 12 months on admission) Unknown .... 24 9 33 .. .. .. .. .. .. .. .. 24 9 33 Transfers .. .. 24 5 29 164 0 164 2 3 5 J4 3 17 [4 1 16 10 36 46 2 4 6 3 3 6 112 234 56 290 Totals .. 164 122 286 164 0 164 53 46 99 179 123 302 41 15 66 | 21 42 63 117 125 242 81 62 143 1 5 6 821540 1,361

H.-7.

Table V.—Ages of Patients discharged "Recovered" and "Not Recovered" during the Year 1932.

14

Auckl»nd. Kingseat. Tokanui. Porirua. Nelson Age.. — _ _ , Recovered. I Not recovered. Becoyered. Not recovered. Recovered. Not recoveted. Eecovered. Not recovered. Becovered. Not recovered. Under over- "' ''. * * "' *' * T " M ' *" T - "" F " T " M< »" T ' M " F " T " M F " T ' M " '• T " M ' F - T - From 5 to 10 years .....Oil .... ., 10 „ is „ .... .. .. :; ;; •• "-*| - , •: „ 3 J 3 •• •• i i -• .. lie loi loi :: " 20 „ 30,, .. 3 4 7 . o 2 7 .. 10 1 5 6 11 0 2 2 15 10 26 4 3 7 10 1 .. 30 ,,40 .. .. 5 3 8 7 'J 16 .. 2 0 2 5 7 12 j 0 3 3 8 13 21 14 5 0 'l 1 .. 40,, o0 „ .. 4 10 U 6 0 12 .. 10 1 4 4 8 .. 14 10 24 12 3 2 13 2 0 2 .. op . 60 „ .. .. 5 8 13 0 4 4 10 1 2 0 2 3 2 5 .. 11 15 26 2 2 4 0 11 . 5» ™ " '• ■' J ? I ' J t I • ■■ 10 1 •• 7 3 10 .. 0 1.12 0 2 „ <u ,, ou ,, .. . . 1 1 2 1 4 d .. o 1 •> .. 80 „ 90 „ .. . . .. .. .. '' '' 10 1 Over 90 years ...... Unknown .......01].. Transfers - •■ 3 95 14 0 14 I! 32 '3 35 '.'. 66 3 69 '.'. 11 1 12 Totals •• ■ 19 27 46 115 33 148 10 1 20 0 20 19 20 39 32 8 40 59 56 115 | 75 14 89 4 1 16 1 17 U.,kitika. Christehoroh. Seaclifl. Total. Recovered - Not Kecovered. Recovered. Not recovered. Recovered. Not recovered. Recovered. -Not recovered. Recovered. Not recovered. TT , . M " *'• T ' M - F - T - M - F - T. M. F. T. M. F. T. M. F. T. M. P. T. M. F. T M F T M F T Under o year- ........ . From to 10yeare .. .. " " oil " 101 '.'. '.'. ','. 1 ~2 3 " M " i; 0 - 1 6 1 0 2 2 1 i 2 3 2 5 1 0 1 j 1 i 2 i; '■ 6 6 12 8 5 13 :: S:S :: . ;| , :: J { J : J • V :: :: »1 S S 11 OTer90years " 0 11 0 3 3 .. .. .. .. 10 10 4 4 Unknown . . . . . . " " " .. " " " "" { 10 1 TransferS 0 '2 2 J! 16 40 56 V. 3 0 3 " 0 'i 4 . J X 234 56 290 Totals •• •• 3 4 7 5 7 12 21 35 56 33 63 96 16 8 24 15 9 24 "" 0 6 <> I 141 160 301 311 139 450 _ I

H.—7.

Table VI.— Ages of Patients who died.

15

AgM ' Auckland. King»at. Tokanai. Porirua. Netaon. Hokltiks. Ohrtetchoroh. Seacllfl. (Mvatfltn") Total - From 5 to 10 years .. * ** *' F " | F " T " M " F " T " *•- »• «• »• *• *• *• *• *• M. P. T. M. F. T. M. f. T. 10 It nil " , " 2 0 2 1 2 3 1 0 1 .. 4 2 6 " 15 " o 0 " " ? I 101 011 202 .. 011 101 .. 437 " 20 "30 " " 9 '• •• 112 10 1 .. 10 1 .. .. 4 2 6 30 " 40 " ! ! ? •• „ •; . 347 .. 3 03 213 101 .. 10 6 16 40" 50 ;; :: I I i5 2 t I I 7 !S 101 101 213 336 .. is n 35 50 60 11 q on " „ T „ 3 7 10 .. .. 1 2 3 7 4 11 .. 19 24 43 " 60 " 70 " " ! S |S • ■ I I a !o 8 23 3 1 4 1 1 2 7 7 14 5 4 9 .. 44 31 75 " 70 " 80 " 12 7 1Q " s o z 1 17 3 2 5 3 2 5 7 6 13 5 5 10 .. 43 32 75 80 " so " "III " ? n i J 2 1 2 3 0 1 1 6 4 10 8 8 16 .. 37 34 71 Over 90 veais " " 0 1 1 " 1 0 1 11 3 14 1 2 3 .. 6 2 8 3 4 7 2 1 3 30 14 44 Unknown 10 1 " 1 1 2 .. .. 4 2 6 .. .. 5 4 9 U '• •• .. .. .. .. 10 1 T0ta ' S " '• 51 45 96 .. 14 12 26 59 44 103 14 7 21 8 4 12 37 28 65 34 28 62 ! 2 1 3 219 169 388

H.—7.

Table VII.—Condition as to Marriage.

16

—- Admissions. Discharged. Deaths. Auckland — m. r. t. m. f. t. u. f. t. Single.. .. .. .. .. .. 70 f>3 123 20 19 39 26 15 41 Married .. .. .. .. .. 49 42 III 10 34 63 19 18 34 Widowed .. .. .. .. .. \1 2-1 39 :i 4 7 S Lβ 20 Unknown .. .. .. .. .. 4 0 4 .. 10 1 Transfers .. .. .. .. .. j i>4 5 29 I 92 8 Bβ Totals .. .. .. .. .. 164 122 286 134 60 194 51 45 96 KlNOSEAT — Single .. .. .. .. .. .. .. r> 0 5 Married Widowed Unknown .. .. .. .. .. .. 2 0 2 Trail .. .. .. .. 164 0 164 14 0 14 Totals .. .. .. .. .. 164 I) 164 21 o 21 TOKANUI— Single.. .. .. .. .. .. 24 1!) 4.{ In 8 18 8 7 Iβ Married .. .. .. .. .. 22 16 38 S 17 26 6 4 10 Widowed .. .. .. .. .. 5 8 13 10 1 0 11 Unknown Transfers .. .. . . .. .. 2 3 5 32 3 35 Totals .. .. .. .. .. 53 46 99 51 28 7!) 14 12 36 PORIRUA — Single .. .. .. .. .. .. 102 50 152 39 21 60 27 15 42 Married .. .. .. .. .. 56 54 110 27 40 67 24 19 43 Widowed .. .. .. .. .. 7 16 23 2 6 8 8 10 18 Unknown Transfers . . .. .. .. .. 14 *3 17 66 3 69 Totals .. .. .. .. .. 179 123 302 134 70 204 59 44 103 Nelson — Single.. .. .. .. .. .. 18 10 28 4 3 7 9 2 11 Married .. .. .. .. .. 8 2 10 3 0 3 2 3 5 Widowed .. .. .. .. ..123 1 J 2 :s 2 5 I iiknown .. .. .. .. Transfers .. .. .. .. .. 14 1 15 11 1 12 Totals .. .. .. .. .. 41 15 56 l<) 5 24 14 7 21 HOKITIKA— Single .. .. .. .. .. .. 8 2 ID f> 4 i) 7 18 Married .. .. .. .. .. 3 2 5 8 3 6 13 4 Widowed .. .. .. .. .. 0 2 2 0 2 2 I Fnl Mown Transfers .. .. .. .. . . 10 36 46 0 2 2 Totals .. .. .. .. .. 21 42 63 8 11 19 8 4 12 Christchurch — Single.. .. .. .. .. .. 75 73 148 20 20 46 12 13 25 Married .. .. .. .. .. 31 36 HI. L6 22 :S7 21 10 :S1 Widowed .. .. .. .. .. 9 13 I'l' 3 10 13 I 6 9 Unknown Transfers .. .. .. .. .. 2 4 6 16 40 56 Totals .. .. .. .. 117 125 242 54 98 152 37 28 65 Si vri ii i Single .. .. .. .. .. ..67 30 87 [6 6 21 26 12 37 Married .. .. .. .. .. 18 2:! 41 1 1 10 21 s 10 18 Widow eil .. .. .. .. .. 16 7 2 13 1 5 6 Unknown .. .. .. .. .. 202 .. 011 Trail .. .. .. .. .. 3 3 6 3 0 3 Totals .. .. .. .. .. 81 62 143 I 31 17 48 34 28 62 ASHBTTRN II M.I. — Single .. .. .. .. .. .. 0 11 0 3 3 2 13 Married .. .. .. .. .. 0 3 3 0 3 3 Widowed Unknown Transfers .. .. .. .. .. 112 0 4 4 Totals .. .. .. .. .. 15 6 0 10 10 2 13 Totals Single.. .. .. .. .. ..354 238 692 Ms 90 208 116 66 182 Married .. .. .. .. .. 187 177 :!t;i 86 129 216 81 04 145 Widowed .. .. .. .. .. 4() (i!i In'.i |2 L > t :; ( ; ;>| :!« 59 Unknown .. .. .. .. ..600202 112 Transfers .. .. .. .. .. 234 r>6 290 234 .">ii 290 Totals .. .. .. .. .821 540 1,361 452 29!) 751 219 169 388

3 —H. 7

H.—7.

Table VIII.— Native Countries.

Table IX.—Ages of Patients on 31st December, 1932.

17

Ages. Auckland. Kingseat. Tokanui. Porirua. Nelson. Hokitika. Cbristchurch. Seacliff. Tota1 ' M. F. T. M. F. T. M. F. T. M. F. T. M. F. T. M. F. T. K. F. T. M. F. T. M. F. T. M F T From lto 5 years .. .. .. .. 2 4 6 2 0 2 .. 3 6 8 .. •• 7 J lb „ 5 „ 10 „ .. 4 3 7 .. 2 1 3 1 5 6 39 2 41 .. 14 7 21 6 5 11 .. ,no r, ,?q 10 15 .. 1 3 4 .. 1 1 2 11 15 26 37 3 40 0 3 3 47 28 75 5 4 9 .. 02 57 j>9 ;. 15 20 „ .. 28 23 51 .. 6 <J 16 29 27 56 65 13 78 3 4 7 80 52 132 16 11 27 .. 227 139 366 „ 20 „ 30 „ .. 96 72 168 17 0 17 32 27 59 L05 82 187 53 17 70 7 9 16 81 66 147 115 34 149 .. o06 307 813 „ 30,, 40 „ .. 128 98 226 28 0 28 39 44 83 161 94 255 40 21 61 17 16 33 99 66 165 133 81 214 1 0 1 64b 420 1,066 40 „ 50 „ .. h>0 142 302 37 0 37 49 74 L23 208 160 368 34 19 53 49 30. 79 124 107 231 136 140 276 4 8 12 801 680 1,481 .. f>0 ,,60 „ .. 151 146 297 41 0 41 77 r>7 134 165 121 286 45 19 64 46 49 95 94 122 216 136 130 266 2 3 5 757 647 1,404 60 ,,70 „ .. 86 72 158 17 0 17 58 47 105 95 77 172 31 25 56 44 19 63 48 69 117 100 110 210 3 7 10 482 426 908 70 „ 80 „ .. 50 40 90 .. 18 16 34 43 36 79 20 14 34 9 2 11 33 41 74 36 51 87 2 3 5 211 203 414 80 90 " 12 7 19 .. 6 0 6 13 8 21 3 4 7 4 1 5 2 6 8 13 12 25 1 1 2 54 39 93 Over 90 years.. ..101 .. .. 123 .. 011 .. 1 0 1 .0 1 1 3 * ' Unknown .. . . 16 14 30 3 0 3 5 5 10 .. 5 16 4 5 9 .. 8 1 9 - 41 26 67 Totals .. 733 6201,353 143 0 143 293 281 574 834 6311,465 374 138 512 183 139 322 625 569 1,194 705 579 1,284 13 23 36 3,903 2,980 6,883

• , ...» Ashbuin Hall Total Countries. Auckland. Kingseat. Tokanui. Porirua. Nelson. Hokitika. Chrietchurch. beaoliff. (Private M.H.). M F T M F T. M. F. T. M. F. T. H. F. T. M. F. T. M. F. T. M. F. T. M. F. T. M. F. T. England and Wales .. 115 90 205 27 0 27 52 37 89 148 90 238 36 15 51 33 15 48 72 70 142 84 47 131 4 3 7 47 3b7 W Scotland .. .. 31 13 44 6 0 6 17 6 23 39 31 70 22 5 2 7 7 2 9 25 14 39 52 35 87 2 13 201 Ireland .. .. 46 38 84 4 0 4 18 17 35 42 32 74 10 2 12 17 9 26 22 26 48 33 39 72 1 0 1 193 MU *« New Zealand.. .. 392 380 772 65 0 65 167 187 354 504 428 932:276 103 379 93 91 184 492 433 925 488 413 901 6 17 22 2 4,o34 Australian Stat,-. .. 39 40 79 7 0 7 10 11 21 34 21 55 7 6 13 13 6 19 7 13 20 Iβ 21 4.5 1 2 3 134 Ub Austria .. . . 30 4 34 8 0 8 5 0 .", .. 2 0 2 .. 0 1 1 1 0 1 .. 46 o ol Norway .. ..20220210120- .. 1 0 1 .. .. •• U 3 17 Sweden .. .. 0 1 1 1 0 1 0 1 1 6 1 7 1 0 1 2 0 2 1 0 1 3 0 3 .. * « Denmark .. ..202 .. 202325202101 .. 1*7 " 5 Iβ Italy .. ..314 .. 101437011202 .. " 10 2 12 China .... 2 0 J .. .. 5 2 7 .. 2 0 2 10 1 .. 10 - Maoris .. .. 16 22 38 2 0 2 2 8 10 24 15 39 6 1 7 1 1 2 2 2 4 - : •• 86 45 131 Other countries .. 25 12 37 8 0 8 13 13 26 20 2 22 4 1 5 .1 1 7 2 9 11 8 7 15 .. 8& 4o Ml Unknown .. .. 28 17 45 12 0 12 .. 0 1 1 7 4 11 4 14 18 U 10 24 „ 65 4B U1 Totals .. 733 6201,353 143 0~ 143~ 293 281 574 834 6311,465 374 138 512 183 139 322 625 5691,194 705 5791,284 ! 13 23 36 3,903 2,980 6,883

H.—7.

Table XI.—Length of Residence of Patients discharged "Recovered" during 1932.

Tahle X.—Length of Residence of Patients who died during 1932.

18

Length of Residence. Auckland. Kingseat. Tokanui. Porirua. Nelson. Hokitika. Christchurch. SeaclilT. (Private'jl'a , ) Total. M. F. T. M. F. T. M. F. T. M. F. T. M. F. T. M. F. T. M. F. T. M. F. T. M. P. T. M. F. T. Under 1 month .. .. 459 .. 101 7 13 20 101 .. 617 123 .. 20 21 41 From 1 to 3 months .. 314 .. 404 448 .■ 101 426 202 .. 18 7 25 3 „ 6 .. 9 2 11 .. .. 6 3 9 2 0 2 .. 2 0 2 4 0 4 .. 23 6 28 „ 6 „ 9 „ .. 123 .. 134 404 112 .. 213 325 .. 12 9 21 ,,9,, 12,, .. 101 .. 101 213 •• 011 022 .. .. 448 1 ., 2 years .. 3 4 7 .. 0 11 4 4 8 i 3 1 4 .. r> r> 10 2 13 .. 17 16 33 „ 2 ,, 3 „ .. 6 5 11 .. 112 2 0 2 2 0 2 10 1 .12 7 12 3 .. 18 10 28 „ 3 „ 5 „ .. 3 4 7 .. 2 0 2 5 16 10 1 2 13 12 3 3 3 6 .. 17 11 28 ,,5,, 7,, .. 055 .. 112 347 112 .. 224 224 .. 9 15 24 „ 7 „ 10 ,, .. 033 .. 101 112 202 .. 246 145 .. 7 12 19 „ 10 „ 12 „ .. 13 4 .. 0 11 12 3 112 .. 112 10 11 .. 4 9 13 ,, 12 „ 15 „ ..325 .. 011 213 .. 213 .. 101 .. 8 5 13 Over 15 yean .. .. 13 7 20 .. 2 3 5 10 8 18 0 3 3 10 1 5 5 10 12 10 22 2 13 46 37 82 Died while absent on trial.. 426 .. 011 82 10 .. 112 213 213 .. 17 8 25 Totals .. 51 45 96 .. 14 12 26 59 44 103 14 7 21 8 4 12 37 28 66 34 28 62 2 13 219 169 388

Length of Residence. Auckland. Kingseat. Tokanui. Porirua. Nelson. Hokitika. Christchurcb. Seaclifl. (Private"]^!-! 1 ) Total. M. F. T. M. F. T. M. F. T. K. K. T. M. F. T. M. F. T. M. F. T. M. F. T. M. I'. T. H. t. T. Under 1 month .. .. 101 .. 202 2 0 2 202 .. Oil .. • 022 73 10 From 1 to 3 months .. 0 2 2 .. 7 2 9 3 2 5 .. .. li 3 0 .. 0 11 16 10 26 3 „ 6 .. 13 4 .. 5 4 9 10 9 19 .. .. 4 8 12 2 0 2 0 11 22 25 47 6 „ 9 .. 5 7 12 10 1 2 3 5 11 11 22 0 2 2 0 11 2 6 8 112 .. 22 31 53 9 „ 12 .. 4 2 6 .. 0 11 9 6 15 0 11 .. 3 3 6 3 4 7 0 2 2 19 19 38 1 „ 2 years .. 4 7 11 .. 3 9 12 12 14 26 .. 3 3 (i 3 11 14 6 2 8 .. 31 46 77 2 „ 3 „ .. 4 2 6 .. .. 3 4 7 0 11 .. 12 3 2 13 .. 10 10 20 3 „ 5 „ .. 0 3 3 .. Oil 5 5 10 .. .. .. 101 .. 6 9 15 5 „ 7 „ .. .. .. .. 3 3 6 .. .. 10 1 .. .. 4 3 7 7 „ 10 „ .. .. .. .. Oil 101 .. .. .. .. 112 „ 10 „ 12 „ „ 12 „ 15 „ Over 15 years .. ..Oil .. .. 112 .. .. 112 101 .. 336 Totals .. .. 19 27 46 1 0. 1 19 20 39 59 56 115 3 4 7 [ 3 4 7 21 35 56 16 8 24 0 6 6 141 160 301

H.—7.

Table XII.—Causes of Death, 1932.

19

I I Causes. f | I a | 1 5 | _, J_ _5_ I _J_ jig l 1 J g I. Genkhai. Diseases. Tuberculosis— M. F. M. F. M. F. M. F. M. F. M. F. M. F. M. F. M. F. M. F. General . . .. .. ..02 .. ..... .. .. 1101 .. 14 Of lungs .. .. .. ..35 .. 02213010 .. 22 .. 11 10 Cancer .. .. .. ..32.. 201221 .. 021111 10 9 Addisons disease .. .. .. .. .. .. .. •• .. 10 .. .. 10 Pernicious anaemia .. .. .. .. .. .. 10 .. .. 01 .. .. 11 Toxemia .. .. .. .. .. .. 0130 .. .. .. 20 .. 51 Diabetes .. .. .. .. .. .. .. .. .. .. ..01 .. 01 Dysentery .. .. .. ..20.. .. .. .. .. .. .. .. 20 II. Diseases of the Nervous System. Mania, exhaustion from .. ..21 .. .. 10 .. .. .. 10 .. 41 Melancholia, exhaustion from ..01 .. 011401 .. 0101 .. 19 Confusional insanity, exhaustion from .. .. .. .. - - .. .. .. .. .. 2 2 General paralysis of insane .. ..40.. 2 1 I 4 1 .. .. 3120 .. 15 3 Meningoencephalitis .. ..Oil.. .. .. ■• .- .. .. .. 01 Myelitis .. .. .. ..01 .. .. .. .. 10 .. .. .. 11 Epilepsy .. .. .. ..10 .. .. 3220 .. 2301 .. 86 Huntingdon's chorea .. .. .. .. .. 10 .. .. .. .. .. 10 Tabo-paresis .. .. ..10 .. .. .. .. .. .. .. .. 10 Cerebral tumour .. .. ..10 .. .. 10 .. .. .. .. .. 20 Cerebral hemorrhage .. ..11 .. .. 2320103116 .. 10 11 Cerebral thrombosis .. .. .. .. .- .. •• 10 .. .. .. .. 10 III. Diseases of the Respiratory System. Pneumonia .. .. ..35 .. 110424102022 .. 11 16 Bronchitis .. .. .. ..13 .. .. .. .. .. .. .. .. 13 Empyema .. .. -. .. •■ •• •• •• ■• ■• 10 .. .. 10 IV. Diseases of hie Circulatory System. Heart disease .. .. .. 11 20 .. 3 1 7 10 .. 2 3 3 7 6 2 .. 32 43 Arterio-sclerosis .. .. .. .. .. .. 83 .. .. 11 .. .. 94 Embolism .. .. .. .. .. .. .. .. •• .. .. 01 .. 01 V. Diseases of the Digestive System. Colitis .. .. .. .. .. 10 .. ..10 Peritonitis .. .. .. .. .. .. .. .. .. .. .. 11 .. 11 Gangrene of Colon .. .. .. .. .. .. .. 10.. .. .. .. 10 VI. Diseases of the Genito-Urinary .System. Nephritis .. .. .. ..10 .. 01 .. .. .. .. 11 .. 22 Uramia .. .. .. .. .. •• •• ■• 10 .. .. 10 VII. Old Aoe. Senile decay .. .. .. 13 1 .. 6 3 13 9 .. 1 1 15 9 11 6 1 0 60 29 VIII. External Causes. Shock following scalding ;. .. .. .. -. 01 .. .. .. .. .. 01 Found drowned .. .. .. .. .. .. 10 .. .. 10 .. .. 20 Suicide .. .. .. .. •• •• ■• •• •• •■ •• 11 •• 11 Asphyxia .. .. .. .. .. .. •• •• •• •• •• 10 .. 10 IX. Died while on Trial .. ..42 .. 01821110:2121 .. 18 8 Totals .. .. .. 51 45 .. 14 12 59 44 14 7 8 4 :!7 28 34 28 I 2 1 219 169 I ■_ 1

H—7.

Table XIII.—Principal Assigned Causes of Insanity, 1932.

20

Causes. Auckland. Kjnguat. Tokanui. Porirua. Nelson. Hokitika. C £ lis £ Seacliff Total cnulcn - (P.M.H.). ! J ■ \ M. F. M. P. M. F. M. F. M. F. M. I. M. y. M. F. M. F. M. F. Heredity .. ..5 1 .. 22 74 22207 14 12 2 0 1 37 20 Congenital .. 21 13 .. 5 5 28 18 10 5 I I 36 Sβ IS 8 .. 119 86 irvious attack ... 14 Iβ .. 3 0 28 17 It I 10 10 9 22 13 .. 81 Bβ J 'liberty or adolescence 12 5 .. 5 3 17 16 3 1 .. 14 !1 1 3 52 it; Climaoterio .. 0 10 .. 0 1 0 10 o 2 0 2 0 19 0 3 0 47 S'-mHty .. .. 16 9 .. 7 2 24 15 0 2 2 I 16 12 8 10 '.'. 72 51 Involution .. ..10 110 10 4 0 1 .. 2 7 Puerperal .. ..0 1 .. 0 3 0 4 .. .. .. .. 0 10 9 Lactation ...... .. ., q 01 Mental stress .. 36 37 .. 6 11 34 24 2" 0 1" 0 : 8 " <» 8*' 4 .. 95 82 Alcohol .. ..93 .. 3021 .. 309201 9 6 7 Syphilis •• .82 .. 3141 I 11 .. 8240 '.'. 28 6 Arteno-solerosis .. 11 5 .. 2 2 2 0 1.. .. 41 19 8 Organic brain-disease .. 1 2 ..6010.. 82 Poet-operative .. .. .. ,. ti _ __ 10 0 1 11 Traumatic .. .... .. .. 3010.. .. 40 Heart-disease .... .. ..11.. 11 Epilepsy .. .. 3 8 .. 24 3 5 8* 0 o" 1 4" 6 3" 4 '.'. 18 28 Encephalitis ..12.. 10 0 1.. .. 01 24 Influenza ....10.. 1001 ~> I Jl lheal, |' .;. 7 8 3 2 .. 10 .. 0"l0 I! U 2(1 Eyper-thytoidimn ..0 1.. .. 0 1.. .. 0 ■> Toxic • • ■ • • ■ .. 3 12 0.. . . . . '' -, J Drug habit .. ..11 .. .. 10.. .. .. 10 31 Privation ...... ..10.. 10 Unknown .. ..01.. .. 01 Transfers .. .. 24 5 164 0 2" 3 14*" 3 14" 1 lo"36 2" 4 3" 3 l" 1 384 56 Totals .. 164 122 164 0 53 46 17!) 123 41 15 21 42 117 125 81 62 I 5~821^40

21

H.—7.

Table XIV. —Former Occupations of Patients.

a i i Occupations. £ Occupations. g ill 1111 IJj IJIililii i Males. Agents .. .. 2 .. ..2 4 Linesman 1 I Apiarist .. 1 1 Mason .. .. 1 I Bakers .. .. 1 .... 1 1 .... 1 .. 4 Mechanics .. 2 2 .. .. 4 Barman .. .. i .. .. 1 I Merehant 1 1 Blaoksmitha .. 1 I .. 2 Messenger .. 1 1 Boilermakers .. 1 .. I 1 :i Millowner 1 .. 1 Bootmakers .. I .... I 2 Miners .. 2 I 2 1 2 .. S Bushman 1 1 Motor-drivers .. 2 .. I 1 .... I Butcher .. 1 I .Moulder .. .. 1 1 Canvasser 1 1 Orchardista 1 .. .. 1 .. .. 2 Carpenters .. 4 .... :i .. .. 2 .... 9 Painters .. .. r> .... 1 .... 1 1 .. s Carriers .. 2 .... 2 Pensioners .. 7 .... 4 .... 4 .... Iβ Chemist .. I I Plumbers .. 1 .. I 1 1 .. I Cook .. 1 I Pressor .. 1 .. l Clerks .. L 5 .... 6 4 .. 15 Printers .. 2 .... 2 Clergymen 2 2 Prisoners .. ...... 5 5 Coal-merchant I I Etabbitter 1 ..... 1 lie,Hist .. .. 1 I Saddler .. 1 1 Draper .. I .... 1 Salesmen .. 1 2 .. IS Electricians .. 1 .. I 2 Bohool-teachers :S :S Engineers 2 1 .. M Seamen .. .. 2.... 4 1 .. .. 1 .. N Engine-driver .. 1 I Showmen .. 1 .. .. 2 3 Factory workers I 2 .. :i Solioitore :).... 1 .... 4 Farmers .. .. 15 .. 9 is 5 2 7 I .. 60 Stewards .. 2 .... 1 ! 3 Farmhands ...... :i 9 I .... 4 .. 17 Storemen 2 .. 2 Fellmongers 1 1 2 Storekeepers 2 2 Fish-curer .. 1 I Student .. 1 .... 1 Fisherman 1 1 Tailors .. 1 2 :> Fitter .. 1 1 Telegraphist 1 1 French-polisher 1 I Timber worker I .. 1 Fruiterers .. 1 1 . . 2 Traffic Inspector 1 1 Gardeners .. 3 .. 2 3; .... :i 2 .. 13 Traveller 1 1 Hairdressers .. 1 ■■ 2 I .... 4 Watchmaker 1 1 Hat-manufacturer 1 I Welder .. 1 .... 1 Horse-trainers . . I I .... 2 Wireless operator .. 1 1 Insurance agent I I Wool-olaesers 1 .... 1 .... 2 Jockey .. 1 I No occupation .. 25 .. 10 21 13 .. 46 20 .. 138 Jeweller .. .. 1 .... 1 Transfers.. .. 24164 2 14 14 10 2 3 1 284 Labourers .. 52 .. 13 .",4 :i 5 26 2(1 .. 179 Leather-worker .. ! 1 1 Totals .. 164164 5317!) 41 21117 81 1 821 Females. Artist .. 1 1 Radiographer 1 1 Clerk .. 1 .... 1 School-teacher .. 1 I Confectioner .. 1 .... 1 Storekeeper .. 1 1 Canvasser 1 .... I T\ piles.. .. 2 1 .. .. 3 Domestics .. 79 .. 36 106 8 6 83 46 4 368 Tailoresses .. 1 2 .. .. 3 Factory workers .. 2 1 .. 3 [ Telephonist .. 1 1 Machinists .. 2 1 .. 3 No occupation .. 23 .. 7 11 5 .. 28 10 .. 84 Milliner .. .. 1 ' 1 i Transfers.. .. 5 .. 3 3 1 36 4 3j 1 56 Musician .. lj 1 I 1 Nurses .. .. 2 .... 1 .... 1 1 .. 5 Totals .. 122 .. 46123 15 42125 62 5 540 Pensioners .. 1! 1 .. 3, .... 5 I ! I L_

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.

22

Remaining, i,,™,ii™ih m Percentage Percentage of Deaths Year. Admitted. Died. 31st December in r».i,w of Recoveries on on Average Numbers Recovered. Relieved. Not Improved. each Year. rewaent. Admissions. resident. M. F. T. M. F. T. M. F. T. M. F. T. 51. F. T. M. F. I T. M. F. T. M. F. T. M. F. T. 1875 482 254 7:i(i 1876 .. 221 117 338 129 ' 79 208 17 8 25 2 8 10 36 12 48 .519 264 783 491 257 748 54-53 6601 1 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 i 14 14 28 4 4 8 51 17 68 638 :S19 957 601 303 904 Its- 9* 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 l,056J 666 337 1,003 46-16 50-33 47-11 8-25 4-74 7-07 1880 229 149 378 100 67 167 ' 36 25 61 5 2 7 54 20 74 729 396 1,126 703 371 1,0741 43-66 44-96 44-17 7-68 5-39 6-89 1881 .. 232 127 359 93 65 158 41 36 77 9 2 11 49 14 63 769 406J 1.175J 747 388J 1, 136 1 4008 5110 4401 6-29 3-60 ! 5-55 1882 .. 267 152 419 95 59; 154 I 49 32 81 5 6 11 60 19 79 827 442 1,269 796 421 1,217 36-58 38-81 36-75 7-53:4-51 6-49 1883 255 166 421 102 j 78 180 13 20 33 10 9 19 65 18 83 892 483 : 1,375 860 475 1 ,335 i 40-00J 46-98J 42-75 7-55 3-78 6-21 1884 .. 238 ! 153 391 i 89 77 166 17 9 26 18 12 30 68 24 92 938 514 1,452 911 497 l,40S 37-39 50-32 42-45 7-46 4-82 6-53 1885 .. 246 ! 133 379 95 76 171 10 6 15 25 2 27 73 22 95 981 542 1,523 965 528 1 , 493 i 38-62 5714 45-12| 7-56 416 6-36 1886 .. 207! 165 372. 99 60 159 11 17 28 12 7 19 57 19 76 1.(109 604 1,613 984 559 1,543 47-82! 36-36 42-74 1 5-79 ' 3-39 4-91 1887 .. 255 161 416 103 j 78 181 34 17 51 : 74 27 101 1.053 643 1,690 1.034 613 1,647 40-39! 48-75 43-61 715 4-40 613 1888 .. 215 146 361 116 ! 92 208 31 28 59 2 3 5 78 26 104 1,041 640 1,681 1,045 641 1,686 53-95 63-01 57-62 7-56 405 616 1889 .. 230 161 391 93 53 146 31 30 61 3 1 4 70 30 100 1,074 687 1,761 1,046 660 1,707 40-43 32-92 37-34 6-69 4-54 5-86 1890 .. 230 I 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 5500 47-69 705 5-11 6-29 1891 .. 234 171 405 88 74 162: 33 24 57 14 .. 14 79 41 120 1,115 734 1,849 1,089 699 1,789 37-61 43-27J 4000 7-25 5-86 6-71 1892 .. 231 ! 158 389 89 76 165 21 17 38 8 2 10 74 34 108 1,154 763 1,917 1,125 714 1,839 38-53 4810 42-42 6-68 4-76 5-87 1893 .. 281 179 460 101 89 190 17 12 29 10 8 18 78 23 101 1,229 810 2,039 1,172 758 1,930 35-94: 49- 72J 41-30 6-66 303 5-23 1894 .. 270 176 446 107 76 183 15 11 26 5 4 9 64 35 99 1,308 860 2,108 1.241 812 2,053 39-63 4313 4103 516 4-31 4-82 1895 .. 252 1 165 417 105 77 182 24 19 43 1 2 3 101 42 143 1,329 885 2,214 1,313 849! 2,162 41-67 46-66 43-64 7-69 4-94 6-61 1896 .. 278 159 437 104 70 174 25 16 41 2 1 3 86 32 118 1,390 925 2,315 1.347 882 2,229 37-41 44-02 39-13 6-38 3-63 5-29 1897 .. 284 193 477, 102 73 175 17 12, 29 10 .. 10 105 43 148 1,440 990 2,430 1,411 944 2.355 36-92 37-82 36-69 7-44 4-55 6-28 1898 .. 254 ; 212 466 I 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 48-07 612 617 6-14 1899 .. 259 199 458 88 : 99 187 15 19 34 2 1 3 114 43 157 1.512 1,045 2,557; 1,487 1,004 2,491 33-98 49-49 40-83 7-67 4-28 6-30 1900 .. 300 I 202 502 103 96 199 29 10 39 4 4 99 46 145 1,581 l,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 3906 46-64 4217 6-29 6-58 6-41 1902 .. 352 192 544 136 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 43-01 718 4-94 6-28 1903 .. 355 226 581 144 101 245 26 24 50 ..2 2 129 44 173 1.771 1,188 2.959 1.741 1,160 2,901 40-66 44-69 4217 7-41 3-79 5-96 1904 .. 332 236 568 ! 157 106 263 24 11 35 1 .. 1 120 70 190 1,801 1,237 3,038 1.780. 1,198 2,978 47-59 44-91 46-30 0-74 5-84 6-38 1905 .. 360 251 611 149 121 270 29 24 53 147 ! 67 214 1,836 1,276 3,112 1,796 1,232 3,028; 41-39 48-21 4419 818 5-44 707 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.OS8 39-75 47-73 42-94 801 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 57-08 49-84 908 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 5-60 6-86 1909 .. 419 I 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 .. 474 314 788 182 146 327 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 3,60l! 36-38 53-00 43-27 9-41 7-02 8-41 1912 .. 458 381 839 184 141 325 17 44 61 11 5 16 193 87 280 2,273! 1,640 3,913 2,146 1,551' 3,697 40-17 37-01 38-74 8-99 5-61 7 57 1913 .. 466 j 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 .. 509 j 359 868 207 162 369 27 29 56 6 9 15 193 88 281 2,408 1,703 4.111 2.309 1,641 3,950 j 40-67 45- 12J 42-51' 8-36 5-36 711 1915 .. 450 ; 361 811 i 202 157 359 26 32 58 10 11 21 172 112 284 2,448 1.752 4,200 2.391 1.703 4.094 44-89 43-21 44-88 7-19 i 6-58 6-94 1916 .. 518 : 361 879 160 171 331 35 34 ' 69 7 8 15 209 80 289 2,555 1,820 4,375 2,483 1,768 4,251 30-89 47-37' 37-66 8-42 4-52 6-80

H.—7

23

\l\l :: 43? 402 III \ll 283| H II « I ,2 .5 " «" J* 3 318 2,611 1,904 4,615 2,643 1,826 4,368 36-38 40-64 38-27 8-06 ' 6-19 7-28 1919 .. 512 371 883 90 47 337 a? A Si q H % 51 J 4 **? 2 > 6 ° 3 3 4 >546 2,602 1,899 4,501 32-49 3507 33-7310-53 916 9-95 1920 .. 455 8 873 162 148 310 27 W A I m fa l\l 122 U2 2 - 667 !- 980 4 2,620 1,907 4,527 37-11 39-62 38- 17 8-09 j 6-82 7-55 1921 .. 479 402 881 78 93 37? 30 II « IK o o2 om J?2 f 6 2 > 717 2 ' 037 4 > 7 5 4 2 >674 1,980 4,654 35-63 35-32 ; 35-51 7-85 8-40 8-08 1922 453 386 839 156 157 sis 30 on » in a ?t o 01 U7 318 2 ' 772 2 '°" 4,871 2 ' 723 2 ' 031 4 ' 754 3723 47 ' 88 42 "H 7-38 5-76 6-69 923 440 366 808 68 5 3 9 It S8 SO !2 2 on Tol Iff 395 2 ' 816 2 ' 116 4>932 2 ' 747 2 ' 062 4 ' 809 3444 4067 37 "31 8-92 8-21 1924 446 377 823 152 128 280 SO 11 -0 o 1? !a I 94 131 325 2 ' 839 2,15? 4 ' 996 2 ' 789 2 ' 079 4 ' 868 38 -°° 4125 39 ' 48 6-95 6-30 6-67 925 ■' 445 430 875 1U \f 5 319 H S 2 1 II *° 22 J 316 2 ' 873 2,258 5,131 2,808 2,146 4,953 3408 33-95 34-02 7-87 4-42 6-37 1926 508 439 947 itfi ils 9«? 07 ol 22 ?£ i 7 201 123 324 2 ' 921 2 ' 336 5 ' 257 2 > 830 2 - 203 5 ' 033 ' 323 6 40-69 36-45 7-45 5-57 6-43 927 531 4H 945 1« 28 1 2, «o \i 2 a 12 7 U7 354 3 .W 4 2 ' 423 5. 4 6 7 2 .926 2,287 5,213; 26- 18 30-75 29-67 6-16 6-42 6-77 1928 " 506 450 956 llfi Is! uz In tl II \n , 23 217 132 349 3 > 147 2 >5 2 6 5,673 3,022 2,373 5,395i 29-56 30-91 3016 7-17 5-65 6-47 929 I: 549 40? 956 « ]£ HI i 12 !2 ' 00 ?2 2 ° 7 161 368 3,274 2,628 5,902 3,120 2,459 5,579 22-72 29-77 2604 6-63 6-55 6-59 930 I: 621 l?IlO96 138 Iffl 266 It 11 S ?? S of? 153 38 ° 3 - 3 99 2,694 6,093 3,215 2,495 26-41 35-37 30-23 7-06 6-13 6-65 1931 587 476 1063 127 !fn 12? 9Q fn oi !n M 251 172 423 3 > 572 2 ,811 6,383 3,342 2,590 5,932 22-22 27-00 24-29 7-51 6-64 7-15 932 I: 587 484 1 071 ill ]m W II lo S? tl !? 52 2?J X " 420 3 ' 7 5 3 2 >908 6,661 3,50 3l 2,696 6,199 21-64 25-21 23-37 6-31 7-39 ! 6-76 t>87 4S4 l,U71 141 160 301 81 38 41 79 219 169 388 3,903 2,980 6,883 3,681 2,738 6,419 24-02 33-05 28-10 5-97 617 6-06 20.882 16,327 36,209 7,650 6,482 14,132 1,473 1,364 2,837 , 501 391 892 \7, 837 |4,364 12.201 ~ ~'~~ 7. ~ 7. Excluding transfers between institutions— 1,988 males, 1,279 females.

EL—7.

Table XVI. —Showing the Admissions, Discharges, and Deaths from 1st January, 1876, to 31st December, 1932 (excluding Transfers).

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

24

M. F. T. In hospitals, 31st December, 1875 .. .. .. .. 482 254 788 Admissions .. .. .. .. .. .. .. 20,882 15,327 36,209 21,364 15,581 36,945 Discharged— M. p. t. Recovered.. .. .. 7,650 6,482 14,132 Relieved .. .. .. 1,473 1,364 2,837 Not improved .. .. 501 391 892 Died .. .. .. .. 7,837 4,364 12,201 17,461 12,601 30,062 Remaining on 31st December, 1932 .. .. .. 3,903 2,980 0,883

Males. Females. Both Sexes. Recovered .. .. .. .. .. 35-81 41-60 38-25 Relieved .. .. .. .. .. 6-90 8-75 7-68 Not improved .. .. .. .. .. 2-34 2-51 2-42 Died .. .. .. .. .. .. 36-68 2800 3302 Remaining .. .. .. .. .. 18-27 19-14 18-63 100-00 10000 10000

H.—7.

25

4—H. 7

Table XVIIIa.— Credits for the Financial Year, 1932-33.

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

— Auckland. Kingeeat. Tokanui. Poririw. Nelson. Hokltika. Chriatchurch. Seaclifl Head Office. Total. £ s. d. £ s. d. £ s. d. £ s. (1. £ s. d. £ s. d. £ s. d. £ s. d. £ s. d. £ s. d. Receipts for maintenance .. .. .. 23,699 5 5 2,479 11 5 9,580 14 0 28,845 10 5 7,641 19 8 2,826 3 3 25,033 IK 5 25,220 12 0 .. 125,327 15 1 Receipts from farms .. .. .. 156 3 5 1,267 17 8 1,615 16 2 781! 7 1 653 17 10 38 9 3 2,488 3 3! 977 8 6 . 7,981 3 2 Miscellaneous .. .. .. .. 5,482 3 5 141 14 0 3,199 12 5 7,230 13 5 2,516 0 5 1,815 4 0 5,702 6 9 7,0(57 13 8 27 10 7 33,189 4 8 29,337 12 3 3,889 3 1 14,396 2 7 36,865 10 11 10,812 3 11 4,679 16 6 33,224 8 5 33,265 14 8 27 10 7 166,498 2 11 i !

Average | , _ ,. . Number Bedding Buildings Fuel, Light, Surgery w| Total Cost „??{??" Other Net Coat Net Cost Decreane Increase Mental Hospital. resident Salaries. and and Farm. Water, and Provisions. and ,1 " 1 .M 1 " 061 " per menta for Re _ per previous iu in (Inclusive of Clotliing. Eepalre. Cleaning. Dispensary. s P mtt - laneous. patient tinanee Payments. Patient. Year. 1932-33. 11932-33. £ s. d. £ s. d. £ s. d. £ s. d. £ s. d. £ s. d. £ s. d. £ a. d. £ s. d. £ s. d. £ s. d. £ s. d. £ s. d. £ e. d. £ s. d. Auckland .. 1,344 27 1 1 3 6 10 0 9 5 0 14 1 4 6 8 9 6 5 0 5 2 0 0 3 3 5 3 48 15 2 17 12 8 4 3 11 26 18 8 29 12 3 2 13 7 Kingeeat* .. 142 23 11 0 4 5 3 0 1 5 3 13 7 3 5 4 14 18 9 0 0 8 .. 5 19 6 55 15 f> 17 9 3 9 18 6 28 7 8 Tokanui* .. 554 32 18 3 4 9 2 1 10 8 3 10 6 5 2 2 8 6 0 0 3 9 .. 4 15 6 60 16 0 17 5 10 ! 8 13 10 34 16 4 38 6 11 3 10 7 Porirua .. .. 1,476 31 18 11 3 18 4 0 17 1 13 0 4 1 2 10 14 9 0 7 5 0 0 4 5 4 6 58 5 6 19 10 10 i 5 8 8 I 33 6 0 36 16 3 3 10 3 Nelson .. .. 510 36 5 0 3 12 3 0 18 3 2 8 7 6 2 0 10 10 5 0 4 3 .. 4 17 6 64 18 4 14 19 8 6 4 4 43 14 3 49 9 7 5 15 4 Hokitika .. .. 318 42 9 2 4 2 4 0 16 7 0 15 11 3 7 0 12 10 0 0 2 11 0 0 2 4 4 4 68 8 5 8 17 9 5 16 7 53 14 1 64 19 6 11 5 5 Christchurch .. 1,158 33 19 0 3 15 3 0 19 4 1 17 10 5 5 2 9 13 0 0 7 1 0 0 3 5 4 2 61 1 2 21 12 4 7 16 32 7 4 36 16 9 4 9 5 Dunedin (Seacliff) .. 1,266 36 18 11 4 7 7 0 19 6 1 7 11 4 8 3 10 5 11 0 5 3 .. 4 6 2 62 19 7 19 18 5 6 7 1 36 14 0 43 13 11 6 19 11 Head Office .. .. 0 19 0 .. .. .. 002 .. .. .. 045 136 .. 001 135172039 Totals .. 6,768 33 18 6 3 18 0 0 17 3 1 11 3 4 11 7 10 2 10 0 5 7 0 0 2 4 15 9 60 0 11 18 10 4 6 18 35 8 11 40 6 9 4 17 10 * Note. —Aβ from the 1st April, 1932, Kingseat became a separate institution, having been run in previous years in conjunction with Tokanui. Cost does not include interest and depreciation on land and buildings.

H.—7.

Table XVIII.— Debits for the Financial Year, 1932-33.

26

Auckland. Kingseat. Tokanut. Fortraa. Nelson. Hokltlka. Christchurch. Seacliff. Head Office. Total. £ s. d. £ s. d. £ s. d. £ s. d. £ s. d. £ s. d. £ s. d. £ s. d. £ s. d. £ s. d. Salaries .. .. .. .. .. 36,360 4 6 3,344 6 6 18.234 9 10 47,150 8 7 18,487 1 6 13,502 7 5 39,316 4 0 46,773 2 7 6,422 6 8 229,590 11 6 Official Visitors .. .. .. 39 Iα 2 .. .. 42 15 4 .. 1 16 11 21 14 9 .. .. 105 17 2 Advertising, books, &e. .. .. .. 17 6 .. 17 6 2 7 6 17 6 1 13 6 3 3 6 7 16 0 16 11 7 35 14 7 Bacteriological research .. .. .... . . .. 22 12 1 160 .. 1 10 6 076 .. 25 16 1 Bedding and clothing .. .. .. 4,490 18 4 606 5 2 2,470 3 6 5,782 1 10 1,842 9 7 1,308 18 0 4,359 3 10 5,544 18 .. 26,403 1 11 Buildings, including additions, &c. .. .. 633 1 3 10 0 2 849 18 2 1,26113 6 466 5 10 263 14 3 1,121 1 9 1,234 16 2 " .. 5,840 11 1 Dental services .. .. .. .. (I 12 6 .. 2 lti 4 22 1 2 3 19 8 1 15 0 10 7 4 7 15 10 .. 49 7 10 Farms, maintenance of .. .. .. 947 0 4 522 5 9 1.952 5 7 1,697 2 1 1,23'J 5 6 262 9 7 2,19117 0 !,7<>9 14 3 .. 10,572 0 1 Fencing, draining, and roading .. .. 9 5 0 46 10 0 307 15 7 348 14 3 152 11 3 42 11 2 240 5 5 111 12 1 .. 1,259 4 9 Freight, cartage, and transport .. .. 91 5 7 24 4 2 206 17 4 284 9 7 162 6 8 18 1 3 238 5 7 448 I- , 6 .. 1,474 2 8 Furl', light, water, &c. .. .. .. 5,821 10 2 463 14 0 2,830 15 9 f.,!)90 5 0 3,110 « <> 1,064 14 4 6,088 II 7 5,688 6 0 42 13 5 31,000 1!) <J Funeral expenses .. .. .. .. 108 16 0 .. 27 10 0 72 2 6 Iβ 10 0 9 8 3 -41 0 0 31 0 0 .. 306 5 !) Furniture and furnishings .. .. .. 190 18 11 20 5 1 130 5 4 27S 14 3 157 15 5 182 18 1 235 11 10 327 18 10 .. 1,524 7 9 Gardens and shrubberies .. .. .. 10 2 1 5 3 7 27 4 5 54 15 10 16 13 4 0 4 3 201 4 8 32 3 9 .. 347 11 1 1 Laundry .. .. .. .. 359 16 7 36 18 1 239 10 5 334 5 8 158 12 6 57 15 (i 292 o 0 586 0 4 .. 2,063 19 7 Legal and iiujuirv costs .. .. .. 115 3 .. .. 110 6 421 .. .. 220 .. 99 10 Machinery, repairs, and stores .. .. 158 0 1 7 19 3 102 17 5 167 18 7 39 19 0 42 4 1 115 13 8 132 6 0 .. 766 18 1 Medical fees .. .. .. .. 585 2 2 .. 1!).", 18 10 620 1 2 69 19 8 33 10 0 513 7 1 306 9 8 .. 2,324 8 7 Motor-vehicles, maintenance of .. .. 108 4 6 17 3 10 116 15 8 281 3 3 74 19 8 86 18 8 j 181 3 6 153 13 3 .. 1,020 2 4 Nursing staff uniforms .. .. .. 120 12 2 27 8 11 92 15 4 263 !> 4 31 5 10 82 19 11 160 2 10 111 1 0 .. 889 15 4 Office equipment .. .. .. .. 089 169 2 16 8 060 3 73 .. 118 8 .. 5 18 8 16 29 Patients, expenses connected with — Gratuities .. .. .. .. 44 10 0 .. 4 0 11 88 19 2 151 3 4 17 17 1 19 17 4 34 9 3 .. 360 17 1 Friends .. .. .. .. .. .. .. .. .. .. .. 85 10 0 .. 85 10 0 Recreation .. .. .. .. 1,469 8 3 423 1!) 10 544 11 3 2,702 17 7 505 10 10 333 17 9 1,330 0 II 1,326 9 0 .. 8,636 15 5 Transfers .. .. .. .. 0 9 5 .. 13 0 23 15 4 36 3 10 .. 48 16 3 0 0 6 .. 110 8 4 Postages, telegrams, &c. .. .. .. 73 13 1 7 16 0 48 17 10 139 16 1 40 3 5 17 0 8 126 2 10 69 0 10 157 4 0 679 14 9 Printing and stationery .. .. .. 182 7 !) 18 3 9 66 3 10 162 11 9 66 10 6 43 10 8 157 7 2 128 15 11 77 7 0 902 18 4 Rations.. .. .. .. .. 12,528 11 9 2,121 0 5 4,598 12 9 15,847 17 6 5,366 0 2 3,974 16 4 11,173 5 1 13,033 6 10 .. 68,643 10 10 Rents and rates .. .. .. .. .. .. .. .. 343 .. 677 2 1 5 5 0 666 7 0 1,351 18 4 Stores .. .. .. .. .. 593 18 8 79 0 8 354 4 3 1,238 19 6 451 0 1 189 5 11 1,049 18 8 865 9 11 .. 4,821 17 8 Surgery and dispensary — Drugs and instruments .. .. .. 346 4 11 4 13 2 103 8 2 5 45 1 6 108 15 8 46 8 10 411 4 2 330 2 8 .. 1,895 19 1 Wines, spirits, &c. .. .. .. j 18 8 8 .. .. 27 11 11 .. 2 14 0 12 13 7 .. .. 61 8 2 Telephone services .. .. .. 62 19 9 47 15 2 59 7 11 131 7 6 65 13 1 25 3 10 115 9 2 183 2 3 107 12 0 798 10 8 Transfer and removal expenses .. .. 2 3 1 2 17 0 80 0 6 9 6 9 87 l(i it 114 4 6 2 3 10 138 0 8 .. 436 13 9 Travelling-allowances .. .. .. 44 5 10 81 10 11 16 18 11 35 13 8 117 2 6 31 19 9 188 9 6 161 13 11 260 19 2 938 14 2 Travelling-expenses .. .. .. 59 4 1 .. 9 4 li 95 15 8 18 1 10 0 14 3 35 8 8 107 1 4 187 15 2 513 5 6 Treatment in general hospital — Patients .. .. .. .. 60 19 0 .. 5 5 0 66 18 0 43 16 0 4 14 6 21 8 0 8111 0 .. 284 11 6 Staff .. .. .. .. .. 110 .. .. 110 .. 100 220 100 .. 640 Contingencies .. .. .. .. 7 11 9 .. 007 8 17 9 520 .. .. 10 26 2 10 0 34 47 Miscellaneous .. .. .. .. .. .. .. 211 7 3 .. .. .. .. .. 211 7 3 05,533 7 10 7,919 8 11 33,684 3 0 86,016 15 11 33,106 8 11 21,757 8 3 70,706 0 3 j 79,730 1 0 7,947 4 8 406,400 18 9

H.—7.

Approximate Cost of Paper. — Preparation, not given ; printing (540 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, 1933.

Table XX.—Expenditure, out of Public Works Fund, on Mental Hospital Buildings, etc., during the Financial Year ended 31st March, 1933, and Liabilities at that Date.

By Authority : G. H. Loney. Government Printer, Wellington.— 1933. Price 9d.]

27

Total Mental Hospitals. 1877-192:). 1923-24. 1924-25. 1925-26. 1926-27. 1927-28. 1928-29. 1929-80. 1980-31. 1931-32 19S&-33 Net Expenditure, 1st July, 1877, to 31st March, 1983. £££££££££££ £ Auckland .. .. 170,075 5,188 2,393 2,07:! 19,988 12,213 12,461 2,279 3,372 621 676 231 339 Christchurch (Sunnyside) .. 196,212 1,497 6,272 2,901 7.22!' 10,104 7,777 35,291 23,993 4,650 7 960 303 946 Dunedin (The Camp) .. 4,891 .. .. .. .. .. .. ,. 4*891 Hokitika.. .. .. !t.r>00 10,21(1 16,013 8,034 1,746 141 401 3,064 14J764 3H>7 75*300 Hornby .. .. .. 11,102 .. .. .. .. .. .. .. .. ll'lO2 Motuihi Island .. .. 561 .. .. .. .. .. 561 Napier .. .. .. 147 .. .. . . .. .. .. .. .. j47 Nelson and Stoke .. .. 36,428 2,879 6,294 13,75(1 3,496 753 966 33,250 26J494 :\'.\W.) 130,319 Puhitahi .. .. .. .. .. .. .. .. .. .. .. 16,130 16,433 Id.278 42 841 Soaeliff .. .. .. 188,730 1,246 3,016 4,767 17,888 9,408 27,132 34,609 8,914 3,066 414 -"Hi 189 Tokanui .. .. .. 96,010 2.743 16,076 8,097 1,658 2,124 19,887 32,405 27,787 7,164 2,918 216*869 Waitati .. .. .. 17,468 194 .. .. 627 .. 853 2,170 9,657 936 516 32,321 Wellington .. .. 29,641 .. .. .. .. .. .. .. .. .. .. 29 64] Wellington (Porirua) .. 213,818 2,5' 18,374 38,213 16,004 16,315 27,315 9,028 3,129 1,349 207 346*330 Totals .. .. 974.583 26,541 68,438 77,835 68,635 51,118 96,782 152,096 134,140 45,938 28,756 : I ! I

M«nt,»i Hnmiitala Net Expenditure for Tear Liabilities MeDtal Hospitals, ended 31st March, 1933. ou 31st March, 1983. £ £ Auckland .. .. . . . .. 676 1 Christchurch (Sunnyside) .. .. .. 7,960 1,092 Hokitika .. .. . . .. 3,107 30 Nelson and Stoke . . .. . . .. . . 2,680 136 Porirua . . .. .. . . . . . . 207 Puhitahi .. .. .. .. .. 10,278 3,732 Seacliff.. .. .. .. .. .. .. 414 Tokanui .. .. .. .. .. 2,918 616 Waitati .. .. .. .. .. .. 516 8 Total .. .. .. .. .. 28,756 5,615