MENTAL HOSPITALS OF THE DOMINION. (REPORT ON) FOR 1934.

Appendix to the Journals of the House of Representatives, 1935 Session I, H-07

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1935. NEW ZEALAND.

MENTAL HOSPITALS OF THE DOMINION. (REPORT ON) FOR 1934.

Presented to both Houses of the General Assembly 'pursuant to Section 78 of the Mental Defectives A-Ct, 1911.

The Director-General to the Hon. Sir Alexander Young, Minister in Charge of the Department of Mental Hospitals. g IR Wellington, Ist July, 1935. I have the honour to present the annual report on the Department of Mental Hospitals for the year ended 31st December, 1934. At the end of the year there were 7,814 persons on the registers of the mental hospitals of the Dominion, including 43 patients and boarders at Ashburn Hall private licensed institution, and 548 persons who were on probation in the care of friends and relatives. In actual residence in Government mental hospitals there were 7,224 persons at the end of the year, an increase of 145 over the figure for the previous year, and of this number 6,890 were detained under a Magistrate's reception order, whilst 334 persons were under treatment as voluntary boarders at their own request. It is pleasing to record that the number of admissions was 129 less than in last year. A certain number of patients who suffer from chronic and relapsing forms of mental disorder are able to be discharged each year, and in due course many of them return to swell our admission rate, and allowance must be made for these cases when we are trying to ascertain the incidence of mental disorder. The best approximate indication of " occurring insanity " is gathered from the figures relating to first admissions, and it is gratifying to note that there were 115 fewer first admissions than in the previous period of report. The total first admissions, including voluntary boarders, amounted to 1,050, as against 1,165 for the previous year. We were able to discharge 666 patients and boarders during the year, or 51-4 per cent, calculated upon the admissions, but of these only 511, or 39 - 5 per cent., could fairly be classed as having recovered ; the remainder were removed to the care of relatives or friends. The relative figures for the county and borough mental hospitals of England and Wales were : Percentage discharged, 53 per cent. ; percentage recovered, 31-9 per cent., which goes to show that there is certainly no undue detention in mental hospitals after recovery. The number of deaths was 436, or 6-28 per cent, calculated upon the average number resident. Classification or Mental Patients. The last decade has witnessed a substantial improvement in New Zealand in the means provided for classifying patients according to the needs of each case, and particular attention has been directed towards shielding the recent and presumably recoverable patients from with those of a more chronic and sometimes degraded type. In this connection one may cite with satisfaction the establishment of the outdoor clinics at the general hospitals, our reception cottages, the separate homelike neuropathic units, and the great development of the villa system in all our institutions. All these provisions, combined with the different system of admission introduced in the Mental Defectives Amendment Act, 1928, have done much to lay emphasis upon the curative and preventative functions of mental hospitals, to individualize the treatment, and to lessen as far as possible the disadvantages associated with the temporary loss of personal liberty.

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During my recent sojourn in Great Britain I visited several of the most modern mental hospitals, and discussed modern trends with leading authorities, and I can state without reservation, that our facilities for the treatment of recent and recoverable cases are well abreast of modern standards, whilst the general level of comfort enjoyed by the chronic patients is in no way lower than that of home institutions. Whilst it is satisfactory to know that in these matters we are not lagging behind other countries, I feel bound to indicate certain directions in which the Department could advance with considerable benefit to patients and staffs, and the administration generally. Difficult and Dangerous Defectives. For a number of years we have felt the increasing need for a separate institution for the segregation and care of mental defectives who show pronounced tendencies to violent and dangerous conduct. The vast majority of mentally defective persons who come to us because of their inability to maintain an independent existence in the community are quite harmless within the sheltered life of an institution, and many of them, indeed, become useful and trusted workers inside the wards and outside on the farms and gardens. Intellectual deficiency by no means connotes impulsiveness or an inability to respond to proper treatment, and one of our main difficulties at Templeton Farm lies in the fact that certain parents, realizing the great improvement in habits, manners, and industry, desire to remove their offspring long before we can feel confident that the stabilization process is likely to prove permanent. Our dangerous and difficult cases are not in the main recruited from the intellectually defective, but from another type, which is being increasingly recognized in all countries, largely through the extended facilities now provided for the psychiatric examination of criminals and juvenile delinquents. I refer to the " social defective," or, as he is called in Great Britain, the " moral defective." A good deal of misunderstanding exists in the lay mind regarding the social defective. The existence of this condition cannot be diagnosed from conduct alone, however anti-social, difficult, or dangerous that may be, but from a study of the patient as a whole. To understand the social defective one must realize that the infant is born without moral sense, but with instincts. Gradually through the influences of home, school, companions, and all the factors which we call environment, the primitive instincts, with their accompanying feelings or emotions, become " sublimated " or harnessed to the precepts and concepts which have been absorbed from the environment, and thus we arrive at the stage of knowing what is, and what is not " done," and of being able to hold in check instinctive or impulsive tendencies which, if translated into action, would constitute anti-social conduct. The pathology of the social defective consists of an inability to profit from the influences of his environment, so that his instincts with his emotions are not sublimated or " conditioned " to the demands and usages of Society —his instincts and emotions remain at an infantile level, and are expressed in unrestrained instinctive conduct which is liable to bring him into conflict with the law. While he may give lip service to normal standards of conduct, he has no real appreciation of the significance of either reward or punishment. The social defective is not necessarily intellectually defective, and herein lies the difficulty, and indeed the danger of their accommodation in an ordinary mental hospital. Unlike the ordinary mental defective, the social defective tends to act in collusion with others, and his ingenuity in making keys, in obtaining and secreting contraband articles such as matches, and in using less intelligent patients for his own ends, throw a great strain upon the watchfulness of our staffs. Whilst advocating the establishment of a separate institution for cases of the sort described, I have not in view an institution where the treatment would be in any sense less enlightened or more repressive than it is in an ordinary mental hospital. During my recent visit to England I visited the Hampton State Institution for Difficult Defectives, and from the industry and conduct of the inmates, and the tranquillity of the place, it was difficult to realize that in this hospital were gathered all the most dangerous defectives in England. There were not, of the parole and freedom of an ordinary mental hospital, and certain features of the lay-out of the buildings and estate had been incorporated to guard against escapes, but under an enlightened and humane administration the atmosphere at Rampton is by no means depressing, and need not be at any other institution established for a like purpose. I consider that the separation of difficult and dangerous defectives would enable us to make a great advance in the classification and treatment in our ordinary mental hospitals, and I hope during the ensuing year to submit concrete proposals in this direction. Care of Mentally Defective Children. As I have pointed out in previous reports, the problem of mental disorder is essentially different from that of mental deficiency. Persons suffering from mental disorder enter a mental hospital for treatment to recovery where such is possible, and in other cases for care and custody because of inability to live harmoniously in the general community. Congenital mental deficiency, on the other hand, is never curable, and the problem here lies in the direction of training to bring the patients to the highest degree of usefulness compatible with their mental insufficiency. This training, in my experience, cannot be carried out adequately in mental hospitals. A further, and, in my view, a strong, argument in favour of the complete separation of these two classes lies in the fact that the obvious incurability of defectives tends to lessen the emphasis which we desire to put upon the curative aspect of mental hospitals.

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Towards the desired separation we have now two institutions being used exclusively for congenitally defective patients. Templeton Farm Colony, near Christchurch, has grown from its modest beginning in 1929, and there are now five villas accommodating 250 boys and girls with staff. These children are those for the most part who have failed to benefit by the courses provided in special schools and special classes, but whom we deem to be capable of learning simple domestic or farm or garden work. Templeton has been a success from the beginning : it has carried out a useful function, and it has the confidence of parents. There is a growing demand from parents concerned that a similar institution should be established in the North Island, near Auckland ; one cannot fail to sympathize with the viewpoint of the parents, who find the distant separation and lack of ability to visit to be a hardship, and it is only for lack of funds that I refrain in the meantime from bringing down proposals in this direction. Our other institution reserved for defective children is the old Nelson Mental Hospital, the adult patients having for the most part been transferred to the new hospital at Ngawhatu (Stoke Farm). This old building, which was erected in timber in 1874, is fast drawing to an end of its structural life, and a decision must soon be faced as to whether or not we should rebuild on the same site, or go farther afield, perhaps to the North Island. The children at Nelson are definitely of a lower grade than those at Templeton.. For the most of them all that can be done is to give them care and protection. Infringements op the Mental Defectives Act. From time to time information is received by the Department regarding the unlawful detention of mentally defective persons in so-called " nursing homes," which are conducted for the profit of the proprietor or lessee, but are not licensed under the Mental Defectives, or any other Act. Ample provision is made in the Act for the care of people in their own homes, and, in certain cases of temporary breakdown, for care in a general or special hospital, but the law is very stringent, and necessarily so, regarding the private care of patients for profit. An inspection is at once made of all such houses reported to us, and almost invariably the conditions regarding sanitary amenities and other matters involving the comfort and safety of the patient are found to be much below the desirable standard. We have so far been content to order the closing of these " homes " and to issue a warning, but it may be necessary to order a prosecution so as to give publicity of the relevant sections of the Act. Alterations, Additions, and Improvements. Capital expenditure on new buildings and additions and improvements amounted to £98,625 during the year, and the following summary shows the principal items making up the total, including new buildings in progress, but'not completed by the 31st March : — Auckland (£2,321). The new residence for the medical officer was completed. Formation and tar-sealing of main drives, &c., was'carried out, and extensive repairs and renovations were undertaken. Kingseat (£29,783). Four new villas were completed during the year. Additional roading, water-supply, sewage works and electric service reticulation was carried out. Tokanui (£3,797). A new villa for farm labourers was completed. Water-mains were extended and renewed, and a complete remodelling of the sewage system was undertaken. Porirua (£170). Only minor works were carried out. Nelson and Ngawhatu (£28,552). Two additional villas and a new laundry and boiler-house were completed, and the installation of the necessary machinery is well in hand. The water-supply system, including a new reservoir, was completed. A rearrangement of the electrical reticulation is in hand. Hokitika (£5,629). A new villa was completed, a new morgue erected and extensive repairs and renovations were carried out. Christchurch (£23,485). A new villa for women was erected at Sunnyside, and two additional villas were erected at Templeton. The fire-mains at Sunnyside were extended and the fire-alarm system overhauled. Good progress was maintained with the water-supply scheme at Templeton, and a kitchen was constructed at the Reception Home. Seacliff (£4,888). The Nurses' Home was rebuilt and repairs and renovations generally were undertaken.

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Valedictory. The Department suffered a great loss in the retirement on superannuation at the end of the year of Mr. G. C. Holder, Chief Clerk of the Department, and Mr. A. T. Wells, Receiver. Both these officers had served the Department well and faithfully for over forty years, and each in his own branch has left a record of conscientious and highly meritorious service. They left the Department with the sincere good wishes of all their fellow-officers. Appreciation. I have to express my indebtedness to Dr. Russell, Deputy Director-General, the medical superintendents, and the other officers of the service for their loyalty and co-operation at all times. I cannot speak too highly of my head office staff, who have carried out the work harmoniously and efficiently in spite of unusual difficulties encountered during the past year, and I tender to them my sincere thanks. I have, &c., Theo. G. Gray.

MEDICAL SUPERINTENDENTS' REPORTS.

AUCKLAND MENTAL HOSPITAL. Dr. Buchanan reports : — I have the honour to present my annual report for the year ended 31st December, 1934. The total number of cases under care during the year was 1,601, with a weekly average of 1,211. The admissions numbered 255 (128 males, 127 females). Of this number, 199 were admitted for the first time. Under section 8 of the Mental Defectives Amendment Act, 127 patients were admitted. Ninety-two voluntary boarders were admitted during the year, making a total of 200 under care, and of these 73 were discharged. At the end of the year 152 patients were on probation, 118 on full parole, and 216 on limited parole. The general health of the patients continued to be good. Deaths totalled 99 (55 males, 44 females). During the year a new house was built for the accommodation of the Senior Medical Officer who is now in occupation. An additional boiler is now being installed in the engine-room. This wil'f relieve the increased work that has been demanded of the two permanent boilers in operating the new hot-water system. This system has proved very satisfactory. A new and separate clerks' office has- been established in the main building. This was deemed a necessity owing to the gradually increasing work due to the expansion of the hospital and the additional labour involved in the administration of Kingseat Mental Hospital. The large dayroom in Female 6 has now been converted into a sick dormitory for the accommodation of old and feeble patients, of whom we have a great number. Nursing under the new conditions is much better for the patients and easier for the staff. The appearance of the roads around the Main building has been improved by remaking, tarsealing, and finishing off with red gravel. A steady painting programme has been carried out, and attention has been paid to necessary maintenance-work. The Lodge continues to be of the greatest service. Under the conditions there the patients seem to become better adapted to take up their home life again. The result is that there are fewer readmissions, and those that in the course of events are bound to have recurrences of their malady stay a longer time well in the. outside world. Additions have been made to our list of criminal lunatics. The majority of them are difficult to manage with our ordinary facilities. They are impatient of restraint and feel hardly done by in not being granted the same privileges as other patients may get. Many are capable of conspiracy, and in doing so cause great uneasiness to those in charge. The establishment of a criminal asylum would ease the position greatly and at the same time allow these men to partake of organized work under adequate supervision. This cannot be done under our present circumstances. The Psychiatric Clinic at the hospital continues to fulfil a useful function, and I submit the following summary of the work : — *«-«■*• <S"SX> «*'■ (1) Number of separate persons seen .. . . . . M. 272 42 314 F. 55 33 88 327 75 402 (2) Number of— (а) First visits . . . . . . . . • • • • 258 56 314 (б) Subsequent calls .. .. . • •• 751 525 1,276 1,009 581 1,590

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(3) Sources of reference Tuesdays. Thursdays. Total. Pensions Department .. • • • ■ ■ • • • 192 8 200 Medical practitioners .. • • ■ ■ • • • ■ 83 55 138 Voluntary calls .. .. . • • ■ • ■ • • 31 12 43 Prisons Department .. . . . ■ • • ■ • 13 . . 13 Justice Department .. .. . ■ . • ■ • 2 .. 2 Education Department .. .. • ■ • ■ • • 2 .. 2 H.M. Navy .. .. .. • • •■ ■ ■ 2 .. 2 Police Department .. .. . • • • • • 1 • • 1 Counsel .. .. .. ■ • • • • • • • 1 • • 1 327 75 402 (4) Of the 402 persons who attended the Clinic, 21 became voluntary boarders, 27 were committed to the Mental Hospital, and 2 were admitted on remand, 1 of whom was discharged therefrom. Of the 21 voluntary boarders 2 were discharged " recovered," 4 discharged " relieved," and 1 was committed. Of the 27 committed cases, 3 were discharged on probation, 1 was discharged " unrecovered," and 1 died. Monthly visits have been paid to the Inebriates Homes on Pakatoa and Rotoroa Islands. lam of the opinion that it is necessary to have a trained nurse attached to the staff there. She could be available for both islands. Many of the inmates suffer from minor physical disabilities which they occasionally exaggerate to such an extent as to cause worry and anxiety to those in authority. The staff's observation of such people is naturally untrained, and for safety's sake when I hear alarming reports about these inmates (over a very bad telephone) I feel that the only safe and wise course is to send them to the Auckland Hospital —a trip which they hanker after and which is often the raison d'etre of their complaint. Most cases so sent up have proved to have had no serious disability whatsoever. The Women's Hospital Auxiliary have formed a Mental Hospital Branch, which promises to be of great help to us. An after-care committee has been formed which should in time be invaluable. Already good work is being done in this direction. The founding of this branch has been largely due to the enthusiasm of Mrs. David Nathan. An endeavour is being made by the branch to procure money for the building of a library. This would be a useful adjunct to the Mental Hospital. I should like to record my thanks to all the ladies of the branch for taking such an active interest in the Institution. The Official Visitors continue to show their keen interest in the Hospital and in the patients' welfare. Many entertainments for the patients were held throughout the year, and I wish to thank the organizers and participants for their cheerful and willing services. Mr. Neville Carlsen has been particularly generous in this respect. Mr. L. 0. Hooker continues to favour us with his interest in the supply of reading matter for the patients. I now gratefully acknowledge his services. Finally, but in no way least, I have to thank the medical officers and all my staff for the willing help they have given me during the year.

KINGSEAT MENTAL HOSPITAL. Dr. Buchanan reports :— I have the honour to submit my annual report for the year ended 31st December, 1934. The total number of cases under care during the year was 355 (255 males, 100 females), with a weekly average of 288. The health of the patients has been excellent. Patients who are transferred here usually settle down quickly and thoroughly enjoy the open air and seeming freedom from restraint. The general atmosphere is one of cheerfulness and bustle. Two villas, K. 12 and K. 13, were completed and occupied by women patients during the year. Two other villas are well on the way to completion and should be available for patients early in 1935. Work in the grounds goes oil apace. Every week changes can be observed in the laying-out of roads, planting, and preparation of new building-sites. The steady work performed reflects the greatest credit on the staff and the patients. The orchard has been extended by the planting of 234 additional trees. The main drive was laid out in generous proportions and has been planted with trees and shrubs. Some of these were bought, and a large number was donated to us through the great kindness of the Auckland Racing Club. Without its help the results would have appeared meagre, and lam now happy to have the opportunity of recording my grateful thanks to that sporting body. Thanks to our plentiful water-supply we are enabled to carry the new plantings satisfactorily through this exceptional summer drought.

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The farm is being gradually extended and shows excellent returns. Games and entertainments have taken their fair share in the routine of the Hospital. Church of England and Presbyterian services are held regularly and seem to be appreciated by the patients. Mr. McFarlane, of the Public Works Department, has shown his customary keen interest in the place and has rendered invaluable service. All the staff have been unremitting in their keenness and helpfulness, and it is with pleasure that I now extend to them my thanks.

TOKANUI MENTAL HOSPITAL. Dr. Prins reports : — I have the honour to submit my annual report for the year ended 31st December, 1934. The total number of cases under care has been 665, with a weekly average of 570. There has been a decrease in the number of admissions, which were 71 (males 40, females 31). Of these, 61 (males 32, females 29) were admitted for the first time. The general health of the hospital has been good. Deaths numbered 26 (males 16, females 10), senile decay and heart-disease being the principal causes. We discharged 20 patients during the year. The number is less than last year, but, on the other hand, a larger number was allowed out on probation. Twenty voluntary boarders were under treatment during the year, of whom 7 had been admitted in the period under review. Seven voluntary boarders were discharged. During the year the new male villa for farm workers was opened and gave much needed relief to the accommodation on the male side. The ward is very comfortable and is much appreciated generally. Two Colfix tennis-courts have been laid down, and many trees and shrubs have been planted in the grounds and on the estate. A new washing-machine has been added to the laundry and a new range in the kitchen. A booster-pump for fire purposes and new machinery has been installed in the engineer's shop. The cow-byres have been equipped with a new milking-machine and separator. A start has been made in the repainting of the hospital and houses on the estate. The usual recreations—tennis, bowls, swimming, concerts, dances, ping pong, &c. —have been carried on. The new cricket-ground has been in demand for matches, which have been followed with much interest. The weekly picture entertainment is also much enjoyed, and the Te Awamutu Band has given enjoyable outdoor programmes. Church services have been held regularly. Mr. Findlay pays his official visits, and we are again indebted to him for the excellent concert parties he arranges. Two nurses passed their final examination, one of them obtaining distinction. During my absence on sick leave Dr. Hunter was in charge of the hospital. In conclusion, I have to express my thanks to all the staff for their efficient co-operation and help in the working of the hospital.

PORIRUA MENTAL HOSPITAL. Dr. Williams reports : — I have the honour to submit my report for the year ended the 31st December, 1934. During this period the total number of persons under care was 2,055, of whom 1,828 were committed patients, 225 were voluntary boarders, and 2 were people on remand whom it was considered unnecessary to detain further. Two hundred and eighty persons were admitted under certification ; of these, 8 were transfers, and 51 came in under section 8 of the Mental Defectives Amendment Act, 1928. Ninety-nine patients were discharged, 66 were transferred, and 131 died. Applications for voluntary admission were received from 107 persons, of whom 58 were men and 49 were women. Ninety-four voluntary boarders were discharged ; 3 were certified, and 7 died. It will be noted that the death-rate was somewhat high, but a great percentage were senile people or those suffering from systemic disorders associated with advancing years. Seven people died of phthisis pulmonalis, which is more than usual here. Ido not think, however, that any particular significance attaches to this, as there is no marked increase in the number affected, and all were cases of fairly long standing. A point worthy of remark is that 17 deaths occurred within one month of admission ; indeed, some of them within a few days of admission, and 1 woman actually within an hour or so. Certainly most of these people were senile and frail, but my impression was that in some instances hardly sufficient consideration had been given to the fitness of the patient to sustain the journey. Little new work has been done by the Public Works staff during the year. A new scullery in M. 4 ward, one or two minor additions to other wards, ventilation to floors at Rauta, and some drainage alterations comprise the total.

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The maintenance staff has had a somewhat more busy time, and a good many residences and hospital buildings have been painted and renovated generally. It might be remarked here that for some time now practically all inside painting has been done by a working party of patients under supervision and directions of an attendant-painter. The work has been done very well on the whole, and in addition to the saving effected, and the greater amount of painting possible, the men concerned have been put in the position of gaining in some degree an acquirement which might readily be of much use to them later in outside life. We are again experiencing great difficulty in accommodation for patients ; also accommodation for office staff and for stores. On the female side particularly the position has become acute, and every ward is crowded. Not unnaturally the hot weather has aggravated matters. The accommodations for medical and office staff is also insufficient, largely owing to the building of filing cabinets in every available space. These are now full, and further provision for a filing-room, clerk's office, and visitors' room is very necessary. The storage space for victuals and other goods is taxed to more than its capacity, and the instability and deteriorated condition of the walls of the store do not tend to better matters. Indeed, it might be said with regard to the whole block of buildings, comprising store, bakery, kitchen, and engine-room adjoining, that it is antiquated and inadequate. The store has been referred to already ; the bakery is in frequent need of expensive repair ; and the boilers in the engine-room are at a stage where replacement will shortly be a necessity. As it is, the inspectors will allow a pressure of only 70 lb. per square inch as compared with a requisite 100 lb., and suggested further that they considered 60 lb. gave the reasonable margin of safety. It would seem imperative, then, that some consideration be shortly given to the erection of the kitchen and stores block. The completion of this would, remedy matters greatly, and, in addition to giving greater general efficiency and comfort, would in the long-run, I am sure, be an economical measure. The summer has been a particularly dry one, with consequent detrimental effect to farm and garden. It is pleasing to note, however, that the water-supply has kept up splendidly, and has shown no sign of failing. As a precautionary measure, however, and to protect the native bush of the catchment area from damage by cattle, the fencing-in of the whole area has been authorized, and was begun fate in the year. The work is being done by contract. Staff changes have not been many, being most noticeable among the nurses, and no difficulty has been experienced in keeping the nursing staff up to the full strength. We have been less fortunate in obtaining and keeping a full medical staff, and after Drs. Norris and Blair left us early in the year, two A.M.O.'s only were left to carry on until the arrival of Dr. Hunter from Seacliff in September. I am not complaining of this, of course, for we have not, on the whole, perhaps been so badly off as some other hospitals, and, in addition, I know of the difficulty you have experienced in getting adequate and suitable staff, and the efforts you have made to obtain these. There is little to note concerning the Psychiatric Clinic, which continues to function successfully, and undoubtedly much good is done, and much serious mental illness prevented. During the year 172 new cases were seen, a slight diminution, and there was a total of 931 consultations. Patients were referred from many sources, the largest single groups being 65 hospital in-patients, and 33 from various relief depots. Regarding disposal of those seen, it was necessary to send only 36 to Mental Hospital for further treatment. Of these, 20 went as voluntary boarders, and 16 were admitted under one or other sections of the Act. Practically all the latter 16 suffered advanced psychoses, principally due to senility and other organic disorders. Three who suffered acute confusional delirium did very well, and were subsequently discharged recovered. I have to thank the Hospital Board for their continued interest in the Clinic and for the extra facilities given me for the better care and treatment of those appearing, and particularly for those in indigent circumstances. Amusements and recreation have been provided in abundance for all, and sincere thanks are due to the many who have helped so much. Particularly must I mention Rev. Mr. Harding for his personal efforts, and also the members of the numerous concert and other parties he has brought. Mr. Hooker's generosity has continued, and thanks are due also to the Commercial Traveller's Association, to the Women's National Reserve, to the Victoria University Social Service Club, and to many others. Our Official Visitors have done much, and to these and to all others who have helped with service, and with advice, I am very grateful. 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. Hart reports : — I have the honour to submit my report for the year ended 31st December, 1934. The number of cases under care during the year was 774, as against 631 during 1933. At the commencement of the year there were 567 patients on the register. During the twelve months 207 (including 129 transfers and 9 voluntary boarders) were admitted, 33 (including 5 voluntary boarders) were discharged, 22 died, and 9 were transferred to other hospitals, leaving 710 on the register at the end of the year. On the whole, the health of the patients was satisfactory, but during the winter and early spring there was, as was general throughout the* district, more than the average amount of minor sickness amongst the children.

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The past year saw the erection and occupation of the first three villas of the female division at Yorks Valley. The pleasing appearance and ideal location of these wards are commented upon by all visitors. A modern laundry, boiler-house, and electric generating plant have been erected at Ngawhatu, and when minor machinery installations are completed the plant will be ready for operation. As a reserve water-supply for Yorks, a 40,000 gallon ferro-concrete reservoir is at present under construction, which, when completed, will be connected with the fire-reticulation service which has recently been extended to Yorks and around the female wards. All wards at Ngawhatu have been connected up with a modern telephone system. Apart from general maintenance work, the following have been constructed by the Artisan staff : At Ngawhatu the erection of a glass-house, shearing-shed, a pavilion for the sports ground, and additions to the farm-manager's cottage. At Nelson the glassing-in of a sun veranda for the children at El Nido. Twenty-four chains of road were constructed in the vicinity of the new villas. A croquet-lawn was laid down near Rata, and an area has been set aside and planted as a nursery for shrubs and flowers. A considerable amount of labour has been employed in excavating, laying out of grounds, flower-beds, and the planting of trees in Yorks Valley. The usual activities have continued on the farm, orchards, and vegetable gardens. The farm returns for the year ending March, 1934, were somewhat below those for the previous year, mainly due to the dry spell experienced during the latter part of the season. Present indications are for improved returns for the year ending March, 1935. By the addition of seven wireless sets during the year all wards at Nelson and Ngawhatu are now equipped with radio. Two additional billiard-tables were purchased for the male wards. During the year the patients have been well catered for in respect to amusements and recreations. Weekly parties to the pictures, visits by the Nelson Band, concert parties, tennis, cricket, swimming sports, dances, and trips to the beach. During the year a social club was formed by the members of the staff. The funds from this club have provided for a small circulating library, magazines, and periodicals for the staff sitting-rooms. I am indebted to many individuals, business firms, and societies of Nelson for their continued interest in the patients' welfare in their donations of money and goods towards the Recreation Fund. My thanks are due to the various visiting Ministers who have held religious services at the Hospital throughout the year, and to Mrs. Scantlebury for her continued and successful efforts in the organization of the Children's Sunshine Fund. In conclusion, I wish to express my appreciation to the staff for their efficient assistance in the work of the year.

HOKĪTĪKA MENTAL HOSPITAL. Dr. Childs reports : — I have the honour to submit my report for the year ended 31st December, 1934. At the beginning of the year the patients on the register numbered 381. The admissions proper for the year numbered 19, while 54 were received on transfer, 50 of these being female patients from Seacliff. The discharges numbered 11 and the transfers to other hospitals were 3. The total number under treatment during the year was 454, while the number remaining on the register at the end of the year was 427. There were 5 voluntary boarders on the register at the beginning of the year, and during the year 6 were admitted, 5 discharged, and 2 died. Except for an epidemic of influenza, the health of the patients generally has been good, the number of deaths being 13, a majority being due to senility. A new modern villa with accommodation for 50 women was opened and occupied in August. The villa is an open one, being for the greater part occupied by patients transferred from Seacliff. All inmates of this villa are allowed parole. The usual farming operations have been carried out; 10 acres of land having been stumped, grubbed, drained, and left fallow for the year, while 11 acres of last year's fallow land has been grassed. The grounds in front of 'Wio have been drained, levelled, and grassed to make a lawn. The clinic at the Greymouth Hospital has been held monthly, while occasional visits have been paid to the Westland Hospital. The painting gang has been employed throughout the year, maintenance-work to the older buildings has been carried on, and the isolation ward has been improved. The usual games and recreations have been carried on, and I would like to thank the Hokitika Municipal Band for its many visits, especially to play dance music. Thanks are also due to others who have helped to entertain the patients during the year, and to those who gave gifts at Christmas-time. Mr. Dale, who had been an attendant at the hospital for thirty-two years, the last four of which he was Head Attendant, retired on superannuation at the end of the year. He took a great interest in the patients and the hospital generally, and, to show the appreciation in which he was held, was farewelled by the whole hospital staff. Thanks are due to the clergy and the Official Visitors, whose visits have been appreciated. I desire to thank the staff for their support and help they have given during the year.

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CHRISTCHURCH MENTAL HOSPITAL. Dr. McKillop reports : — I have the honour to forward my report for the year ended 31st December, 1934. On the Ist January, 1934, there were 1,339 patients on the register. During the year 217 patients were admitted, 75 were discharged, and 93 were transferred to other institutions, leaving 1,310 resident at the end of the year, inclusive of 51 males and 56 females absent on probation. One hundred and three voluntary boarders received treatment during 1934, 35 were discharged, 7 were committed, and 1 died, 60 remained for further treatment. The general health of the patients has been very good ; there were 78 deaths, the chief cause of death being senile decay. The new villa for women has been completed and is already in occupation ; the provision of this villa and the transfer of a large number of patients to the villas at other institutions have eased the overcrowding to a very appreciable extent. The villa for young men at Jenkin's Farm is approaching completion ; the occupation of this villa will afford congenial and healthy employment in the way of farming, gardening, and roacl-construction. The new kitchen at the Reception Home is well under way and should be in use by the Ist April. Our general maintenance-work has been well carried out by our artisan staff under the Work's Overseer, Mr. Wilson. A new bakehouse and a new laundry at Templeton are our urgent requirements for the coming year. Despite the unfavourable season, the farm returns have been very creditable. The patients recreation has been carried out on the usual lines ; the " talkie plant " has been installed and is proving a great success. The pictures have been very suitable, and our gratitude is due to the companies who have provided them for our use. I regret to have to report the death of Mr. Barnes, who recently retired after forty years' service with this department. Mr. Acland, District Inspector, and the Official Visitors (Mrs. Williams and Mr. Hanna) have paid regular visits to the institution and have been very concerned with the welfare of the inmates. To them and to the clergymen of all denominations I tender my thanks for their attention. I also desire to accord my thanks to Drs. Brown, Lewis, and Bellringer for the help they have given me in the work of the institution. When Dr. Drown was transferred to Seacliff in May a very considerable amount of extra work was placed on the other medical officers, who carried it out without complaint. Mr. Thomas and the office staff, the Matrons, Head Attendants, and other heads of Departments have given very loyal and efficient service, and I thank them and the staff as a whole for the satisfactory manner in which the work of the hospital has been carried out. I should also like to place on record my appreciation of the services rendered to us by Mr. Holder and Mr. Wells, of Head Office, who have retired on superannuation ; and would like you to assure them of the good wishes of the staff here on their retirement.

SEACLIFF MENTAL HOSPITAL. Dr. Hayes reports : — I have the honour to present my annual report for the year ended 31st December, 1934. On the Ist January, 1934, there were 1,245 patients on the register (667 male, 578 female), while at the end of the year there were 1,218 patients (684 male, 534 female), relief from overcrowding in the female division having been obtained by the transfer of 50 patients to Hokitika in December. During the year 131 patients were admitted, of whom 105 (52 male, 53 female) were admitted for the first time. There were 41 patients discharged, of whom 24 were recovered, 7 relieved, and 10 unimproved. The health of the patients has been satisfactory, and deaths numbered 59 (28 male, 31 female), the commonest assigned cause being senile decay. Thirty-six voluntary boarders were admitted, of whom 6 were readmissions. Of the total number of voluntary boarders under treatment during the year (68) 24 were discharged, 2 committed, and 1 died. There were 5 cases admitted under section 8, all of whom were subsequently committed. Overcrowding is still a problem. Though the transfer of female patients to Hokitika has reduced the overcrowding from 112 to 72, on the other hand the overcrowding on the male side has increased from 130 to 137. The patients in F. 1 are still obliged to have their meals in the corridor of that ward and to sleep in F. 2, but some relief will be afforded this coming year by the completion of the new wing to the Nurses' Home. This will allow the F. 1 patients to occupy the old dining-room vacated by the nurses. The new boiler-house and Engineer's workshops have been completed and the transference of practically all machinery effected by the end of the year. A new wing, which is to comprise diningroom and charge nurses' dining and sitting rooms and twenty-one bedrooms, is in course of erection at the Nurses' Home, and is about half completed. New waste-water drains were put in at Waitati for three of the villas, effecting considerable improvement in the sewage and drainage of these wards. Radiators in F. 1 Waitati were raised above floor-level, and the hot-water service renewed. The Medical Superintendent's residence was levelled and renovated. The concert hall is in course of renovation. New hot-water service throughout the main building at Seacliff is nearly completed.

2—H. 7.

9

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The clinic at the Dunedin Public Hospital is visited bi-weekly. During the year 132 new cases were seen, of which 69 were in the wards and the remainder as out-patients ; 23 of the latter were recommended by practitioners. Of the total clinic figures, 22 were committed, 15 admitted as voluntary boarders, and 31 discharged ; 48 were reported upon and 8 were under treatment at the end of the year. The Invercargill Clinic was visited monthly by Dr. Hunter, and later by Dr. Brown. Forty-two cases were seen, of which 3 were referred by the Borstal, and of the others, 3 were subsequently committed and 3 admitted as voluntary boarders. Concerts have been provided during the year by various parties, but the most welcomed event was the installation of a talkie plant donated by the citizens of Dunedin, through the efforts of Mr. Cummings and the Patients' and Prisoners' Aid Society. To Mr. Stevens, the Chaplain and agent of this society, I have to record my thanks for regular weekly visits on behalf of the patients and also for assistance from time to time, both materially and by supervision, in placing patients without friends on probation. Mr. Cummings, the patients' friend, visits every week and displays his usual keen interest in the hospital and patients, and to the visiting Ministers I wish to tender thanks for their visits and services which are much appreciated. My thanks are due to Dr. Hunter, Dr. Brown, and Dr. Bowell for their assistance during the year, for most of which we have been short-staffed. In conclusion, I wish to thank the various executive officers, Matrons, and Head Attendants, and the staff generally for their good work during the year.

STATISTICAL. The patients on the register at the end of the year numbered 7,433 (m. 4,133, f. 3,300), or 151 (m, 68, f. 83) more than at the beginning ; and the daily average under treatment during the year was 6,938 (m. 3,899, f. 3,039), or 197 (m. 90, f. 107) more than in the previous year ; while the total under care was 8,265. Patients belonging to the Native race numbered 122 (m. 68, f. 54) at the end of the year. The admissions numbered 983 (m. 479, f. 504), or 134 less than in the previous year. Of these 155 had been previously under care, making the proportion of readmissions 15-8 per cent., and 828 patients were admitted for the first time. The ratio to population of all admissions (exclusive of Maoris) was 6-44 (m. 6-14, f. 6-75) to 10,000, and of first admissions 5-45 (m. 5-21, f. 5-69), so that 1,551 persons in the general population contributed one patient, and 1,835 contributed a patient admitted for the first time. The discharges (excluding transfers) numbered 396, or 23 more than in 1933. 136 (or 24 more) harmless unrecovered persons were returned to the care of friends ; and 260 (m. 114, f. 146) recovered 1 less than last year —representing a percentage of 26-45 (m. 23-80, f. 28-97) on the total admitted. With voluntary boarders added the percentage rises to 31-53. Altogether, 50 per cent, of the inmates admitted were able to leave institutional care. Of a total of 8,265 patients under care, 436 (m. 233, f. 203) died, or 6-28 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 V, and the following is the percentage of causes mainly contributing : Senile decay, 29-13 ; diseases of the brain and nervous system group, 22-02; heart-disease, 19-03 ; tuberculosis, 6-42. In Table VI 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 .. .. .. .. 6-89 8-53 7-74 Congenital .. .. .. .. .. 19-00 15-48 17-19 Predisposed by previous attack .. .. 13-36 12-30 12-82 Critical periods .. .. .. .. 22-55 31-35 27-06 Child-bearing (puerperal, non-septic, and lactation) .. 4-76 2-44 Mental stress .. .. .. .. 1.7-54 18-65 18-11 Toxic, including— m. f. Syphilis .. .. .. 4-17 0-40"! „ n_n Alcohol .. .. .. 3-97 1-39/ 2-58 5-4:9 Traumatic .. .. .. . . .. 0-41 .. 0-20 Disorder of nervous system, including— m. f. Epilepsy .. .. .. 5-22 2-78 6-68 4-17 5-39 Other bodily affections .. .. .. 5-01 2-18 3-56 No definite cause a.ssigned 100-00 100-00 100-00

10

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Voluntary Boarders.

It will be noted that there were 311 voluntary admissions in the year under review, that 251 were discharged, and that 18 boarders, representing 5-78 per cent, of the admissions, had to be transferred to the register of patients (having shown mental disorder in degree sufficiently pronounced and sustained to render it improper for them to be continued as voluntary boarders), while the proportion of deaths on average number resident was 4-41 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 1934 was 363.

MENTAL NURSES. In December the usual examination was held for the registration of mental nurses, when the following passed : — • Passed top for Dominion : Nurses H. M. Dutton (Auckland), and S. E. Phillips (Hokitika), (equal). Auckland : Attendants —W. J. Belton, W. H. Carroll, S. T. Goodwin, W. M. Leitch, W. J. Pready.* Nurses —S. A. Bell, S. Chester, A. E. Clotworthy, C. M. Creamer, H. M. Dutton,* E. R. Hanrahan, M. E. Hirtzel, M. E. McKean, J. E. Pittams, D. E. Russell, L. B. Scott, P. M. Sherrifl, M. J. Tooman. Te Awamutu : Nurses —I. C. Shepherd, A. Stewart.* Porirua : Attendant —T. Morrow. Nurses —W. M. Bennie, M. L. Campbell, A. M. Dorset,* E. Entwistle, J. H. Lindsay,* E. Wright. Nelson : Nurses —E. M. Comerford, E. M. Duff,* A. E. M. Duncan, A. J. Hawkins,* 0. I. Kerr, L. McKay, B. R. McNamara, M. A. Phillips, L. M. Prince, D. S. Sheldon,* L. M. Toms.* Hokitika : Nurses —E. M. A. Howard, S. E. Phillips,* M. H. Prendergast, M. K. Towers. Christchurch : Attendants —G. B. Kean, W. H. Oliver. Nurses —G. E. A. Bunn, E. I. Lynn,* M. E. McMurray,* E. A. McNeill, V. M. O'Boyle, I. D. Sutherland. Seacliff: Attendant —G. Connor. Nurses —C. L. Beasley, P. Botting, M. M. Gray,* S. Livingstone, T. F. Milne, E. M. Moore, A. W. Paul, D. I. Smaill, E. L. Smith.

* Passed with distinction.

11

Firat, Nht, TPirat, Tnt.nl Transferred Bemaining Year - Admission Admission AdmMons to Agister Died. Discharged. on i Admission. Admission. Admissions. of Patlents , 81st December. M. F. T. M. F. T. M. F. T. M. F. T. M. F. T. M. F. T. M. F. T. 1912 .. .. 6 17 23 0 0 0 6 17 23 1 3 4 0 0 0 4 3 7 1 11 12 1913 .. 18 19 37 0 2 2 18 21 39 2 5 7 0 1 1 12 12 24 5 14 19 1914 .. .. 17 19 36 3 2 5 20 21 41 7 5 12 1 1 2 11 15 26 6 14 20 1915 .. .. 15 17 32 1 2 3 16 19 35 3 4 7 0 1 1 8 14 22 11 14 25 1916 .. .. 13 23 36 5 8 13 18 31 49 4 4 8' 1 2 3 14 14 28 10 15 25 1917 .. .. 14 21 35 1 13 14 15 34 49 6 6 12 0 1 1 10 23 33 9 19 28 1918 .. .. 23 38 61 5 11 16 28 49 77 1 4 5 2 2 4 15 30 45 19 32 51 1919 .. .. 31 39 70 5 19 24 36 58 94 3 3 6 0 2 2 26 42 68 26 43 69 1920 .. .. 26 38 64 16 12 28 42 50 92 3 4 7 1 2 3 33 33 66 31 54 85 1921 .. .. 39 39 78 11 15 26 50 54 104 2 3 5 5 1 6 38 41 79 36 63 99 1922 .. .. 47 38 85 10 16 26 57 54 111 6 5 11 4 4 8 40 48 88 43 60 103 1923 .. .. 44 50 94 15 21 36 59 71 130 3 6 9 3 3 6 47 47 94 49 75 124 1924 .. .. 38 44 82 16 20 36 54 64 118 4 8 12 6 3 9 39 48 87 54 80 134 1925 .. .. 64 59 123 15 34 49 79 93 172 10 15 25 6 3 9 60 63 123 57 92 149 1926 .. .. 71 60 131 11 29 40 82 89 171 10 11 21 7 2 9 49 71 120 73 97 170 1927 .. .. 70 70 140 25 32 57 95 102 197 8 6 14 5 12 17 75 58 133 80 123 203 1928 .. .. 120 94 214 37 39 76 157 133 290 8 10 18 10 8 18 102 97 199 117 141 258 1929 .. .. 102 63 165 50 43 93 152 106 258 11 3 14 9 9 18 119 110 229 130 125 255 1930 .. .. 152 84 236 41 35 76 193 119 312 15 9 24 8 6 14 130 79 209 170 150 320 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 1933 .. ..112 109 221 53 52 85 165 141 306 11 14 25 5 4 9 121 107 228 198 157 355 1934 .. .. 132 90 221 56 33 89 188 123 311 7 11 18 10 6 16 152 99 251 217 164 381

H.—7

APPENDIX.

Table I.—Showing the Admissions, Readmissions, Discharges, and Deaths in Mental Hospitals during the Year 1934.

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 1934.

12

M. F. T. M. F. T. In mental hospitals, 1st January, 1934 .. .. .. .. 4,065 3,217 7,282 Admitted for the first time .. .. .. .. 405 423 828 \ _ n . „„„ Readmitted 74 81 155 > 479 ° 04 983 Total under care during the year .. .. .. 4,544 3,721 8,265 Discharged and died — Recovered .. .. .. .. .. .. 114 146 260 Notlmproved !! !! !! " !! } 64 72 136 Died .. .. .. .. .. .. 233 203 436 411 421 832 (Not including transfers —Males, 220 ; females, 148.) Remaining in mental hospitals, 31st December, 1934 .. .. 4,133 3,300 7,433 Increase over 31st December, 1933 .. .. .. .. 68 83 151 Average number resident during the year .. .. .. .. 3,899 3,039 6,938

In Mental Hos- Admissions in 1934. Total Number Mental Hospitals. I pitals on —r— «.«Li,,, 1st January, 1934. Admitted for the Not First m - Patients First Time. Admission. ; Transfers. under Care. M. P. T. M. F. T. M. F. T. M. F. T. M. K. T Auckland .. .. 722 624 1,346 93 106 199 16 15 31 19 6 25 850 751 1,601 Kingseat .. 192 50 242 .. . . 63 50 113 255 100 355 Tokanui ,. .. 318 276 594 32 29 61 4 2 6 4 0 4 358 307 665 Porirua .. .. 869 679 1,548 106 104 210 29 33 62 4 4 8 1,008 820 1,828 Nelson .. .. 380 171 551 34 25 59 6 4 10 103 26 129 523 226 749 Hokitika .. .. 235 146 381 11 7 18 0 1 1 4 50 54 250 204 454 Christchurch .. .. 668 671 1,339 74 93 167 11 17 28 15 7 22 768 788 1,556 Seacliff .. .. 667 578 1,245 52 53 105 8 8 16 6 4 10 733 643 1,376 Ash burn Hall (private 14 22 36 3 6 9 0 1 1 2 1 3 19 30 49 mental hospital) Totals .. 4,0653,217 7,282 405 423 828 74 81 155 220 148 368 4,764 3,869 8,633 Patients discharged, transferred, and died. T , , ,, In Mental HosMental Hospitals. D i so i, are ed Discharged ' Total discharged, 31 st P December, Recovered not retired. Transferred. ■ Died. 1934. M. F. T. M. F. T. M. F. T. M. F. T. M. F. T. M. F. T. Auckland .. .. 22 41 63 26 20 46 68 52 120 55 44 99 171 157 328 679 594 1,273 Kingseat .. .. .. •• 11 1 12 5 0 5 16 1 17 239 99 338 Tokanui .. 14 6 20 3 6 9 2 2 4 16 10 26 35 24 59 323 283 606 Porirua .. .. 36 45 81 10 8 18 61 5 66 71 60 131 178 118 296 830 702 1,532 Nelson .. .. 13 7 20 3 5 8 5 4 9 12 10 22 33 26 59 490 200 690 Hokitika .. .. 0 3 3 4 4 8 3 0 3 7 6 13 14 13 27 236 191 427 Christchurch .. 21 25 46 10 19 29 62 31 93 37 41 78 130 116 246 638 672 1,310 Seacliff .. .. 7 17 24 8 9 17 6 52 58 28 31 59 49 109 158 684 534 1,218 Ashburn Hall (private 1 2 3 0 1 1 2 1 3 2 1 3 5 5 10 14 25 39 mental hospital) Totals .. 114 146 260 64 72 136 220 148 368 233 203 436 631 569 1,200 4,133 3,300 7,433 Avnr»M Nmnhev Percentage Percentage of Mental Hospitals. "SSSs™ N^mbeTresIden? during the Year. during the Year. M. F. T. M. F. T. M. F. T. Auckland .. .. .. .. .. 647 564 1,211 20-18 33-88 27-39 8-50 7-80 8-17 Kingseat .. .. .. .. ..219 69 288 .. 2-28 0-00 1-74 Tokanui .. .. .. .. .. 306 264 570 38-88 19-35 29-85 5-23 3-79 4-56 Porirua .. .. .. .. .. 789 636 1,425 26-66 32-85 29-78 9-00 9-43 9-19 Nelson .. .. .. .. .. . . 410 170 580 32-50 24-14 28-99 2-93 5-88 3-79 Hokitika .. .. .. .. .. 233 155 388 00-00 37-50 15-79 3-00 3-86 3-35 Christchurch .. .. .. .. .. 618 622 1,240 24-71 22-73 23-59 5-99 6-59 6-29 Seacliff.. .. .. .. .. .. 663 544 1,207 11-66 27-87 19-83 4-22 5-70 4-89 Ashburn Hall (private mental hospital) . . .. 14 15 29 33-33 28-57 30-00 14-29 6-66 10-34 Totals .. .. .. .. 3,899 3,039 6,938 23-80 28-97 26-45 5-98 6-68 6-28

H.—7.

Table III.— Native Countries.

Table IV.—Length of Residence of Patients discharged "Recovered" during 1934.

13

Countries. Auckland. Kingseat. Tokanui. Porirua. Nelson. Hokitika. Christchurch. Seacliff. (Pr ivat 0. Total. M. F. T. M. F. T. M. F. T. M. F. T. M. F. T. M. F. T. M. F. T. M. F. T. M. F. T. M. F. T. England and Wales .. 104 80 184 40 25 65 53 36 89 143 102 245 54 16 70 37 16 53 64 63 127 70 44 114 3 2 5 568 384 952 Scotland .. .. 19 15 34 13 1 14 15 7 22 32 23 55 25 8 33 10 5 15 17 15 32 46 32 78 3 1 4 180 107 287 Ireland .. 33 26 59 12 7 19 21 14 35 40 31 71 16 2 18 16 9 25 17 22 39 27 33 60 1 0 1 183 144 327 New Zealand.. .. 395 394 789 114 56 170 188 180 368 516 5031,019 351 158 509 133 124 257 525 5451,070 492 386 878 6 20 26 2,720 2,366 5,086 Australian States .. 31 24 55 11 2 13 12 15 27 32 17 49 7 6 13 14 9 23 9 13 22 16 22 38 1 2 3 133 110 243 France .... 0 1 1 .. 10 1 .. .. •• •• •• •• * i J Germany .. ..303 101 314 134 101 101 134 303 .. 14 7 -,1 Austria .. 25 4 29 7 0 7 3 0 3 2 0 2 2 0 2 .. 0 2 2 1 01 .. 40 6 46 Norway .. ..101303101112 .. 101 .. .. lino Sweden .. .. .. 112011314101101101202 .. 9 3 12 Denmark .. ..101101202426303101 .. 213 .. 14 3 17 Italy .. ..213 .. 101202011404 .. .. .. China .. ..2 0 2 .. 1 0 1 5 1 6 .. .. .. 1 0 1 .. £ W Maoris .. 11 21 32 4 1 5 12 13 25 30 15 45 8 2 10 1 1 2 2 1 3 .. .. 68 54 122 Other countries 21 10 31 15 1 16 10 16 26 19 3 22 7 1 8 4 0 4 2 8 10 6 5 11 .. 84 44 128 Unknown .. .. 31 18 49 17 5 22 .. .. 15 6 21 13 27 40 .. 18 11 29 •• 94 67 161 Totals .. 679 5941,273 239 99 338 323 283 606 830 7021,532 490 200 690 236 191 427 638 672 1,310 684 534 1,218 14 25 39 4,133 3,300 7,433

Length of Besidence. Auckland. Kmgseat. Tokanui. Porirua. Nelson. Hokitika. Christohuroh. Seacliff. (Private M.Fi.). Total. M. F. T. M. F. T. M. F. T. M. F. T. M. F. T. M. F. T. M. F. T. M. F. T. M. F. T. M. F. T. Under 1 month .. .. .. .. •• •• 2 J o i Oil 02 2 From 1 to 3 months .. 044 .. 112 202 202 .. -02 J J J nil ,? 9(1 „ 3 6 „ .. 235 .. 101 47 11 213 022 279 055 011 11 26 37 6 9 .. 37 10 .. 437 77 14 112 .. 246 235 .. 19 25 44 C) 12 . 3 9 12 .. 1 0 1 6 13 19 3 1 4 .. 3 3 6 4 2 6 1 0 1 21 28 49 1 " 2 year." .. 12 12 24 .. 6 1 7 8 13 21 5 3 8 .. 7 9 16 1 4 5 .. 39 42 81 23 „ .. 224 .. 112 516 .. 011 202 011 .. 10 6 16 ;; 3 ;; s „ ..022 .. .. 033 .. .. 213 .. .. o«o 57, .. .. .. .. 101 .. .. 101 .. .. 202 ;; 7 „ 10 „ ..011 .. .. 112 .. .. .. 011 .. 1 3 4 „ 10 „ 12 „ ..Oil .. .. 101 .. .. ■ ■ • • • • 112 j> 12 15 j, .. •• •• •• •• 1 * ** iio Over 15 years .. .. .. •• •• 101 011 Totals .. 22 41 63 .. 14 6 20 36 45 81 13 7 20 0 3 3 21 25 46 7 17 24 1 2 3 114 146 260 I , ■■

H.-7

Table V. —Causes of Death, 1934.

14

j I 'i w Cause «- I ! I 4 ā I ! a I ? a'.alJsi'iss 5 M r° „° S fl 8 3 O I. General Diseases. Tuberculosis— M. J. m. e. m. f. m. p. m. e. m. e. m. e. m. e. m. e. ! M. E. General .. . • •• ..01 .. .. 01 .. .. 11 .. .. 13 Of lungs .. .. ..34 .. 102511 .. 1101 .. 8 12 Of intestines .. .. .. •• •• 04 .. .. 04 Cancer .. .. .. ..24 .. 11 13200141 12 .. 11 12 Toxaemia .. .. .. •• •• •• 1020 .. 0102 .. 33 Diabetes .. .. •• •• •• •• •• 10 .. .. 0101 .. 12 Pernicious anaemia .. .. ..20 .. .. .. .. .. 0101 .. 22 Goitre .. .. •• •• •• •• •• •• •• 01 .. 01 Ludwig's angina .. .. ..10 .. .. .. .. .. .. .. .. 10 Asthenia .. .. .. •• •• •• •• 02 .. .. .. .. .. 02 II. Diseases oe the Nervous System. Mania, exhaustion from .. .. .. .. .. II .. .. 10 .. .. 21 Melancholia, exhaustion from ..01 .. .. 43 .. .. 31 .. .. 7 5 Confusional insanity, exhaustion from .. .. .. 01 .. .. .. .. .. .. 01 General paralysis of insane .. ..41 .. .. 112 .. 0150 10 .. 21 4 Encephalitis .. .. .. •• •• •• 10 .. .. .. .. 10 Epilepsy . . .. .. ..1 2 .. 1 1 5 5 0 1 .. 1 5 2 2 .. 10 16 Cerebral haemorrhage .. ..01 .. 012602201310 .. 6 13 Cerebral thrombosis .. .. ..30 .. .. .. .. .. .. .. .. 30 Cerebral syphilis .. .. .. •• •• •• •• 10 .. 10 Amyotrophic lateral sclerosis .. ..01 .. .. .. .. .. .. .. .. 01 Subacute combined degeneration of cord .. .. .. .. .. .. 10 .. .. 10 Cerebral tumour .. .. ..01 .. .. 10 .. .. .. .. .. 11 Huntingdon's chorea .. .. .. .. .. 10 .. .. .. .. .. 10 III. Diseases oe the Respibatoby System. Pneumonia .. .. •• 12 .. 014402 .. 4412 .. 10 15 Influenzal broncho-pneumonia .. .. 10 .. .. .. 10 .. .. .. 20 Bronchitis .. .. .. .. •• 10 .. 10 .. .. .. .. .. 20 Acute pharyngitis .. .. ..01 .. .. .. .. .. .. .. .. 01 IV. Diseases oe the Circulatory System. Heart-disease .. .. .. 18 15 10339722034326 .. 39 39 Arterio-sclerosis .. .. .. •• •• 30 .. .. .. .. .. 1040 Pulmonary infarct .. .. ..01 .. .. .. .. .. .. .. .. 01 V. Diseases oe the Digestive System. Acute intestinal obstruction .. ..10 .. .. .. .. .. .. .. .. 10 Bacillary dysentery .. .. ..01 .. .. .. .. .. .. .. .. 01 Exhaustion from severe diarrhoea .. .. .. 20 .. .. .. .. .. .. 20 Pancreatic hemorrhage .. ..10 .. .. .. .. .. .. .. .. 10 Perforation of oesophagus .. .. .. 10 .. .. .. .. .. .. .. 10 Perforated duodenal ulcer .. .. 10 .. .. .. .. .. .. .. .. 10 VI. Diseases of the Genito-urinary System. Nephritis .. .. .. ..01 .. .. 12 .. .. .. 11 .. 24 Eclampsia .. .. •• •• •• •• 01 .. .. 01 VII. Old Age. Senile decay .. .. .. 14 6 .. 5 2 21 15 3 2 4 1 11 14 17 10 1 1 76 51 VIII. External Causes. Asphyxia .. .. •• •• •• •• •• 01 .. .. .. .. .. 01 Suicide .. .. .. •• •• 10 .. .. .. .. .. 10 IX. DIED WHILE on Trial .. ..3110 .. 4310 .. .. 12 .. 10 6 Totals .. .. .. 55 44 5 0 | 16 10 71 60 12 10 7 6 37 41 28 31 2 1 233 203

H.—7

Table VI.—Principal Assigned Causes of Insanity, 1934.

15

PViviaf Ashburn Causes. Auckland. Kingseat. Tokanui. Porirua. Nelson. Hokitika. 5" Seacliff. Hall Total cnurcn ' (P.M.H.). r M. F. M. F. M. F. M. F. M. F. M. F. M. F. M. F. M. F. M. F Alcohol .. ..53 .. .. 2220 3 062 10 .. 19 7 Arterio-sclerosis 10 1 .. 2230 .. .. 1001 .. 16 4 Climacteric .. 0 18 .. 0 3 0 9 0 2 .. 0 10 0 10 .. 0 52 Congenital .. 15 16 .. 2 1 22 15 18 8 0 1 14 31 20 6 .. 91 78 Constitutional .. .. .. .. 11 .. .. .. ., _ 11 Encephalitis ..01 .. 10 .. .. .. .. 01 .. 12 Epilepsy .. ..61 .. 314442 .. 632 3 .. 25 14 Gross brain lesion .. .. .. .. .. 10 .. .. .. .. 10 Heredity .. ..3 9 .. 1 5 1 2 2 3 3 3 16 14 6 3 1 4 33 43 Infantile paralysis .. .. .. .. .. 10 .. .. .. .. 10 Influenza .. .. .. .. .. 10 .. .. .. .. .. 10 Ill-health .. ..10 .. 5203 .. .. .. 01 .. 66 Involution .. ..11 .. .. .. 03112304 .. 4 12 Mental stress 26 40 .. 12 7 30 30 4 2 2 2 5 6 5 7 .. 84 94 Organic brain-disease 11 .. .. 20 .. .. 14 .. .. 45 Previous attack 16 8 .. 4 3 29 33 5 3 .. 2 7 8 6 0 2 64 62 Puberty or adolescence 6 7 .. 4 3 3 10 1 2 .. 16 6 2 3 .. 32 31 Puerperal .. ..05 .. 0207 .. .. 0802 .. 0 24 Senility .. .. 13 10 .. 1 1 27 20 1 4 2 0 14 15 12 13 2 0 72 63 Syphilis .. ..50 .. 1091 1001 2020 .. 20 2 Toxic .. .. .. .. 01 .. .. .. .. 220124 Traumatic .. ..10 .. .. 10 .. .. .. .. .. 20 Transfers .. 19 6 63 50 4 0 4 4 103 26 4 50 15 7 6 4 2 1 220 148 Totals .. 128 127 63 50 40 31 139 141 143 55 15 58 100 117 66 65 5 8 699 652

H,— 7

Table VII.—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.

16

DlSCharged - Remaining, Averase Numbers Percentage ! Percentage of Deaths Year. Admitted. Died. 31st December in of Recoveries on on Average Numbers Recovered. Relieved. Not Improved. each Year. e. uenu. Admissions. resident. _ M. F. T. M. F. T. M. F. T. M. F. T. M. F. T. M. F. T. M. F. T. M. F. T. M. F. T. 1875 ! 482 254| 736 j .. 1876 .. 221 117 338 129 79 208 17 8 25 2 8 10 36 12 48 519 264! 783 491 257 748 54-53 66-01 57-56 8-21 3-58 6-70 1877 .. 250 112 362 123 57 180 20 5 25 3 2 5 42 21 ! 63 ! 581 29l[ 872 541 277 818 49-20 50-80 49-72 7-76 7-58 7-70 1878 .. 247 131 378 121 68 189 14 14 28 4 4 8 51 17 68 ! 638 319; 957 601 303 904 48-98 51-90 50-00 8-48 5-61 7-52 1879 .. 248 151 399 112 76 188 15 13 28 9 4 13 55 16 71 ! 695 361 1,056 666 337 1,003 45-16 50-33 47-11 8-25 4-74 7-07 1880 .. 229 149 378 100 67 167 36 25 61 5 2 7 54 20 74 729 396 1,125 703 371 1,074 43-66 44-96 44-17 7-68 5-39 6-89 1881 .. 232 127 359 93 65 158 41 36 77 9 2 11 49 14 63 769 406 1,175 747 388 1,135 40-08 51-10 44-01 6-29 3-60 5-55 1882 .. 267 152 419 95 59 ! 154 1 49 32 81 5 6 11 60 19 79 ! 827 442! 1,269 796 421 1,217 35-58 38-81 36-75 7-53 4-51 6-49 1883 .. 255 166 421 102 78 1 180 j 13 20 33 10 9 19 65 18 83 j 892 483 1,375 860 475 1,335 40-00 46-98 42-75 7-55 3-78 6-21 1884 .. 238 153 391 89 77 166 17 9 26 18 12 30 68 24 92 I 938 514 1,452 911 497 1,408 37-39 50-32 42-45 7-46 4-82 6-53 1885 .. 246 133 379 95 76 171 10 5 15 25 2 27 73 22 95 ! 981 542 1,523 965 528 1,493 38-62 57-14 45-12 7-56 4-16 6-36 1886 .. 207 165 372 99 60 159 ! 11 17 28 12 7 19 57 19 76 i 1,009 604 1,613 984 559 1,543 47-82 36-36 42-74 5-79 3-39 4-91 1887 .. 255 161 416 103 78 181 ! 34 17 51 74 27 101 1,053 643! 1,696 1,034 613 1,647 40-39 48-75 43-61 7-15 4-40 6-13 1888 .. 215 146 361 116 92 208 31 28 59 2 3 5 78 26 104 1,041 640: 1,681 1,045 641 1,686 53-95 63-01 57-62 7-56 4-05 6-16 1889 .. 230 161 391 93 53 146 31 30 61 3 1 4 70 30 100 1,074 687i 1,761 1,046 660 1,707 40-43 32-92 37-34 6-69 4-54 5-86 1890 .. 230 160 390 98 88 186 23 17 40 12 5 17 76 35 111 1,095 702 1,797 1,078 685 1,763 42-61 55-00 47-69 7-05 5-11 6-29 1891 .. 234 171 405 88 74 162 33 24 57 14 .. 14 79 41 120 1,115 734 1,849 1,089 699 1,789 37-61 43-27 40-00 7-25 5-86 6-71 1892 .. 231 158 389 89 i 76 165 21 17 38 8 2 10 74 34 108 1,154 763 1,917 1,125 714 1,839 38-53 48-10 42-42 6-58 4-76 5-87 1893 .. 281 179 460 101 ! 89 190 17 12 29 10 8 18 78 23 101 1,229 810; 2,039 1,172 758 1,930 35-94 49-72 41-30 6-66 3-03 5-23 1894 .. 270 176 446 107 76 183 15 11 26 5 4 9 64 35 99 1,308 860! 2,168 1,241 812 1 2,053 39-63 43-13 41-03 5-16 4-31 4-82 1895 .. 252 165 417 105 77 182 24 19 43 1 2 3 101 42 143 1,329 885 2,214 1,313 849 ! 2,162 41-67 46-66 43-64 7-69 4-94 6-61 1896 278 159 437 104 70 174 25 16 41 2 1 3 86 32 118 1,390 925! 2,315 1,347 882 2,229 37-41 44-02 39-13 6-38 3-63 5-29 1897 .. 284 193 477 102 73 175 17 12 29 10 .. 10 105 43 148 1,440 990j 2,430 1,411 944 2,355 35-92 37-82 36-69 7-44 4-55 6-28 1898 .. 254 212 466 114 110 224 13 23 36 7 1 8 88 60 148 1,472 1,008 2,480 1,438 973 2,411 44-88 51-89 48-07 6-12 6-17 6-14 1899 .. 259 199 458 88 99 187 15 19 34 2 1 3 114 43 157 1,512 1,045 2,557 1,487 1,004 2,491 33-98 49-49 40-83 7-67 4-28 6-30 1900 .. 300 202 502 103 96 199 29 10 39 4 4 99 46 145 1,581 1,091 2,672 1,534 1,049 2,583 34-33 47-54 39-64 6-45 4-38 5-61 1901 .. 320 223 543 125 104 229 20 17 37 2 2 102 72 174 1,654 1,119 2,773 1,622 1,094 2,716 39-06 46-64 42-17 6-29 6-58 6-41 1902 .. 352 192 544 135 99 234 26 15 41 10 9 19 120 55 175 1,715 1,133 2,848 1,671 1,114 2,785 38-35 51-56 43-01 7-18 4-94 6-28 1903 .. 355 226 581 144 101 245 26 24 50 2 2 129 44 173 1,771 1,188 2,959 1,741 1,160! 2,901 40-56 44-69 42-17 7-41 3-79 5-96 1904 .. 332 236 568 157 106 263 24 11 35 1 1 120 70 190 1,801 1,237 3,038 1,780 1,198; 2,978 47-59 44-91 46-30 6-74 5-84 6-38 1905 .. 360 251 611 149 121 270 29 24 53 147 67 214 1,836 1,276 3,112 1,796 1,232 3,028 41-39 48-21 44-19 8-18 5-44 7-07 1906 .. 395 264 659 157 126 283 28 22 50 1 1 146 85 231 1,900 1,306 3,206 1,823 X,265 3,088 39-75 47-73 42-94 8-01 6-71 7-48 1907 .. 359 241 600 160 139 299 22 13 35 168 64 232 1,909 1,331 3,240 1,851 1,285! 3,136 44-29 57-68 49-84 9-08 4-98 7-39 1908 .. 426 318 744 180 146 326 9 12 21 1 1 148 74 222 1,997 1,417 3,414 1,894 1,346 3,240 42-25 45-91 43-82 7-81 5-50 6-85 1909 .. 419 297 716 179 170 349 17 11 28 1 1 136 68 204 2,083 1,465 3,548 1,970 1,404 3,374 42-72 57-24 48-74 6-90 4-84 6-00 1910 .. 474 314 788 182 145 327 29 27 56 186 97 283 2,160 1,510 3,670 2,028 1,445' 3,473 38-40 46-18 41-50 9-17 6-71 8-15 1911 .. 448 317 765 163 168 331 23 16 39 4 2 6 198 105 303 2,220 1,536 3,756 2,105 1,496 3,601 36-38 53-00 43-27 9-41 7-02 8-41 1912 .. 458 381 839 184 141 325 17 44 61 11 5 16 193 87 280 2,273 1,640 3,913 2,146 1,551 3,697 40-17 37-01 38-74 8-99 5-61 7-57 1913 .. 466 318 784 175 162 337 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 .. 509 359 868 207 162 369 27 29 56 6 9 15 193 88 281 2,408 1,703 4,111 2,309 1,641 3,950 40-67 45-12 42-51 8-36 5-36 7-11 1915 .. 450 361 811 202 157 359 26 32 58 10 11 21 172 112 284 2,448 1.752 4,200 2,391 1,703 4,094 44-89 43-21 44-88 7-19 6-58 6-94 1916 .. 518 361 879 160 171 331 35 34 69 7 8 15 1 209 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

3 —H. 7

H.—7

17

1917 .. 470 374 844 171 152 323 I 32 ! 20 52 I 6 ; 5 11 205 113 318 2,611s 1,904 4,515 2,543 1,825 4,368 36-38 40-64 38-27 8-06 6-19 ; 7-28 1918 437 402 839 142 141 283 17 I 36 53 12 12 24 274 174 448 2,603 ! 1,943 4,546 2,602 1,899 4,501 32-49 35-07 33-7310-53 9-16 9-95 1919 512 371 883 190 147 337 37 44 81 9 13 22 212 130 342 2,667 1,980 4,647 2,620 1,907 4,527; 37-U 39-62 38-17 8-09 6-82 7-55 1920 .. 455 418 873 162 148 310 27 37 64 j 6 10 16 210 166 376 2,717 2,037 4,754 2,674 1,980 4,654 35-63 35-32 35-51 7-85 8-40 8-08 1921 479 402 881 178 193 371 30 21 51 15 ; 9 24 201 117 318 2,772 2,099 4,871 2,723 2,031 4,754 37-23 47-88 42-11 7-38 5-76 6-69 1922 .. 453 386 839 156 157 313 32 20 52 10 8 18 211 184 395 2,816: 2,116 4,932 2,747 2,062 4,809 34-44 40-67 37-31 7-67 8-92 j 8-21 1923 442 366 808 168 151 319 ; 42 38 80 15 5 20 194 131 325 2,839 2,157; 4,996 2,789 2,079 4,868, 38-00 41-25 39-48 6-95 6-30 ; 6-67 1924 446 377 823 152 128 280 30 42 72 9 11 20 221 95 316 2,873 2,258 5,131 2,808 2,146 4,953 34-08 33-95 34-02 7-87 4-42 : 6-37 1925 445 430 875 144 175 319 29 37 66 23 17 40 201 123 324 2,921 2,336 5,257 2,830 2,203 5,033 32-36 40-69 36-45 7-45 5-57 6-43 1926 " 508 439 947 136 145 281 27 35 62 15 25 40 207 147 354 3,044i 2,423 5,467 2,926 2,287 5,213 26-18 30-75 29-67 6-16 6-42 | 6-77 1927 531 414 945 157 128 285 40 42 82 14 9 23 217 132 349 3,147 2,526: 5,673 3,022 2,373 5,395 29-56 30-91 30-16 7-17 5-65 j 6-47 1928 " 506 450 956 115 134 249 40 40 80 17 13 30 207 161 368 3,274 2,628 5,902 3,120 2,459 5,579 22-72 29-77 26-04 6-63 6-55 | 6-59 1929 549 407 956 145 144 289 30 28 58 j 22 16 38 227 153 380 3,399 2,694 6,093 3,215 2,495 5,710 26-41 35- 37i 30-23 7-06 6-13 6-65 1930 621 474 1 095 138 128 266- 28 34 62 31 ! 23 54 251 172 423 3,572, 2,811 6,383 3,342 2,590 5,932 22-22 27-00 24-29 7-51 6-64 7-15 1931 " 587 476 l'o63 127 120 247 29 30 59 29 30 59 221 199 420 3,753; 2,908 6,661 3,503 2,696 6,199 21-64 25-21:23-37 6-31 7-39 6-76 1932 . 587 484 1 071 141 160 301 39 42 81 38 I 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 6-17 6-06 1933 563 554 1* 117 117 144 261 35 27 62 28 22 50 221 124 345 4,065 3,217: 7,282 3,809 2,932 6,741 20-78 25- 99] 23-36 5-80 4-23 5-16 1934 .. 479 504 '983 114 146 260 64 72 136 .. i .. .. 233 203 436 4,133; 3,300 7,433 3,899 3,039 6,9381 23-80 28-97 26-45 5-98 6-68 ; 6-28 21,924 16,38538, 309)7, 881 6,772 14,6532,101 |l,876 3,977 .. .. .. 8,291 4,691 12,982' ■. j I [ ! 1 1 5rv - - ' 1 Excluding transfers between institutions —2,382 males, 1,503 females.

H.—7,

Table Vlll.—Showing the Admissions, Discharges, and Deaths from Ist January, 1876, to 31st December, 1934 (excluding Transfers). M. F. T. In hospitals, 31st December, 1875 .. .. .. • - 482 254 736 Admissions .. .. .. .. .. .. 21,924 16,385 38,309 22,406 16,639 39,045 Discharged — m. f. t. Recovered .. .. 7,881 6,772 14,653 Relieved .. ..\ 2 10 1 1,876 3,977 Not improved .. • • J Died .. .. .. 8,291 4,691 12,982 — 18,273 13,339 31,612 Remaining on 31st December, 1934 .. .. .. 4,133 3,300 7,433

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

18

Males. ; Females. Both Sexes. Recovered .. .. .. .. .. 36-00 41-33 38-22 Relieved \ 9 . 5g ! U .4 5 10 .38 J\ ot improved .. .. .. .. ■■ J Died .. .. .. .. .. .. 37-82 i 28-63 33-89 Remaining .. .. .. .. .. 16-60 j 18-59 17-51 100-00 | 100-00 100-00

H.—7,

Table X.—Debits for the Financial Year, 1934-35.

4—H. 7.

19

—— Auckland. j Kingseat. Tokanui. j Porirua. Nelson. Hokitika. Christclmrch. j Seaclifl. '' Head Office. ! Total. £ s. d. £ s. d. £ s. d. £ s. d. £ s. d. £ s. d. £ s. d. £ s. d. £ s. d, £ s. d. Salaries .. .. .. .. 39,492 19 0 6,784 12 1 20,982 18 10 50,163 9 5 j 22,154 0 3 15,049 4 3 42,629 2 3 47,577 5 1 6,793 19 8 251,627 10 10 Official Visitors .. .. .. 45 5 3 .. .. 24 4 9 .. .. 22 9 2 . . .. 91 19 2 Advertising, books, &c. .. .. 6 18 6 .. 3 8 7 8 0 6 3 9 6 4 12 0 9 3 3 10 7 6 41 19 5 87 19 3 Bacteriological research .. .. 26 5 0 .. .. 34 2 6 0 17 6 .. 5 17 6 .. .. 67 2 6 Bedding and clothing .. .. 3,955 6 2 1,650 19 1 2,007 14 4 5,185 17 8 2,421 0 5 1,672 1] 7 5,081 1 0 4,796 11 5 .. 26,771 1 8 Buildings, including additions, &e. .. 946 6 9 101 16 8 788 3 11 1,219 3 5 298 4 2 202 6 3 1,403 11 7 1,555 9 8 .. 6,515 2 5 Dental services .. .. .. I 4 9 8 .. 3 3 1 12 8 8 3 4 0 0 11 6 13 4 6 16 15 0 .. 53 16 5 Farms, maintenance of .. .. I 899 3 11 659 4 2 3,050 9 1 1,686 19 0 1,131 12 1 261 0 0 1,979 16 1 1,178 2 9 .. 10,846 7 1 Fencing, draining, and roading . . 61 10 5 95 19 10 229 17 9 394 4 8 141 15 8 13 17 5 231 2 5 235 5 10 .. 1,403 14 0' Freight, cartage, and transport .. 65 16 1 43 0 10 158 10 10 227 3 7 I 170 19 9 35 15 5 366 16 0 396 13 3 .. 1,464 15 9 Fuel, light, water, &c. .. .. 5,564 12 6 962 4 8 2,672 7 1 6,136 16 10 3,570 19 3 1,310 0 6 6,095 12 3 5,515 15 4 39 6 5 31,867 14 10 Funeral expenses .. .. .. 116 5 0 17 15 0 60 0 0 100 16 6 20 12 6 15 0 0 45 2 6 58 16 0 .. 434 7 6 Furniture and fittings .. .. 260 15 7 88 7 1 67 8 5 275 7 7 310 10 4 111 17 6 453 17 11 499 8 7 9 1 9 2,076 14 9 Gardens and shrubberies .. .. 52 14 3 43 16 4 23 15 9 105 4 2 1 61 3 7 25 8 3 287 11 10 19 16 6 .. 619 10 8 Laundry .. .. .. .. 256 16 9 153 15 9, 194 14 4 254 11 9 135 3 7 47 4 5 292 8 5 181 6 4 .. 1,516 1 4 "Legal and inquiry costs .. .. 14 10 6 .. .. 3 19 1 1 17 6 | .. .. 1 11 6 .. 21 18 7 Machinery, repairs, and stores . . 189 5 5 3 18 7 180 11 11 258 13 9 : 123 17 0 16 8 5 267 15 1 207 1 8 .. 1,247 11 10 Medical fees .. .. .. 573 4 1 .. 144 9 6 607 6 9 94 13 1 40 3 6 498 6 7 212 4 7 .. 2,170 8 3 Motor-vehicles — 1 | Maintenance of .. .. . . 23 2 0 2# 2 0 59 1 6 182 7 7 100 12 9 43 10 10 246 4 7 161 19 3 .. 837 0 6 Purchase of , . .. .. .. 548 0 0 .. .. .. .. .. . . .. 548 0 0 Nursing staff uniforms .. .. 201 4 8 27 16 9 j 113 7 7 180 13 1 61 17 9 95 1 8 171 7 4 208 19 9 .. 1,060 8 7 Office equipment .. .. .. 3 15 5 1 0 11 3 16 1 2 4 11 0 17 9 .. 3 1 9 .. 0 18 11 15 15 9 Patients, expenses connected with — Gratuities .. .. . . 31 10 0 .. 1 2 19 2 85 2 1 154 0 10 12 3 0 3 2 7 30 18 1 .. 319 15 9 Friends .. . .. ■ ■ i .. • ■ • • • • • ■ • • • ■ 89 16 0 .. 89 16 0 Recreation .. .. 205 6 9 481 4 6 591 14 7 999 19 7 515 13 3 384 18 11 831 12 10 888 19 9 .. 4,899 10 2 Transfers . . .. . . 1 13 16 2 10 1 0 .. 20 16 2 68 7 6 0 16 3 187 8 7 95 14 11 . . 397 0 7 Postages, telegrams, &c. .. .. 85 1 10 7 2 9 43 17 2 117 4 9 42 16 8 17 9 8 100 2 1 111 11 11 172 6 1 697 12 11 Printing and stationery .. .. 217 18 0 36 7 7 77 19 8 153 11 10 89 12 7 66 0 3 217 3 3 112 15 1 52 16 10 1,024 5 1 Rations .. .. .. .. 10,202 2 0 4,392 10 8 3,994 6 1 14,495 3 11 5,503 18 0 4,582 13 10 11,523 15 3 12,012 17 11 .. 66,707 7 8 Rents and rates .. .. .. .. 2162 .. 67721 .. 666 3 10 1,346 2 1 Stores .. .. .. .. 624 15 5 169 12 11 383 14 7 926 12 3 427 19 10 296 17 5 993 11 1 701 18 4 .. 4,525 1 10 Surgery and dispensary drugs, &c. .. 331 8 3 45 10 5 65 14 3 473 8 8 167 13 8 71 11 5 291 18 2 232 3 4 .. 1,678 18 2 Telephone services .. ., .. 63 12 9 54 1 1 63 17 3 167 12 3 65 6 1 29 17 5 120 10 5 183 3 11 116 18 5 864 19 7 Transfer and removal expenses . ■ 1 17 2 17 6 1 19 17 0 44 2 9 83 0 8 5 6 8 27 13 7 45 17 2 .. 245 1 1 Travelling-allowances .. .. 65 18 8 160 1 0 28 3 9 8 3 11 83 15 7 53 15 6 101 13 0 173 19 0 221 12 2 897 2 7 Travelling-expenses 73 6 9 6 6 4 33 9 5 77 0 7 25 17 0 10 4 7 66 10 7 113 7 5 216 17 8 623 0 4 Treatment in general hospitals— „ Patients .... .. 76 17 6 31 16 0 .. 5 0 0 62 18 6 21 7 0 72 12 6 81 11 0 .. 352 2 6 Staff .. .. .. 220 .. .. .. 3 12 0 0 10 6 7 16 6 300 .. 17 10 Contingencies and miscellaneous .. 82 15 0 .. 0 7 6 213 13 1 7 5 6 1 12 6 84 2 6 168 15 2 828 6 5 1,386 17 8 64,838 15 2 16,614 10 1 36,049 9 0 84,851 8 0 38,112 2 3 24,499 18 5 75,410 7 0 77,879 19 0 9,160 7 7 427,416 16 6

H.—7

Table Xa.—Credits for the Financial Year, 1934-35.

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

20

Average I ! I Mpntnl Trn»r,it»i b ? a , • Bedding Buildings Fuel, Light, Surgery ! , Total Cost | ®Xfōr other Net Cost Net 0ost Decrease Increase Mental Hospital. resident Salaries. and and Farm. Water, and Provisions. and per ?? - Re- per previous in in 0 ' Clothing. Repairs. Cleaning. Dispensary. ' Patient* tenance payments. Patient. Year. ! 1984-35. 1934-35. £ s. d. £ s. d. £ s. d. £ s. d. £ s. d. £ s. d. £ s. d. £ s. d. £ s. d. £ s. d. £ s. d. £ s. d. £ s. d. £ s. d. £ s d Auckland .. .. .. 1,311 30 2 6 3 0 4 0 14 5 0 13 8 4 4 11 7 15 8 0 5 1 2 12 3 ; 49 8 10 16 14 6 4 7 10 28 6 6 24 19 8 3 6 10 Kmgseat . . .. . . 312 21 14 11 5 5 10 0 6 6 2 2 3 3 1 8 14 1 7 0 2 11 6 9 4 j 53 5 0 16 5 0 10 0 7 26 19 5 25 10 4 .. 1 9 1 Tokanui ... .. .. 583 35 19 10 3 8 11 1 7 0 5 4 8 4 11 8 6 17 0 0 2 3 4 5 4 61 16 8 15 17 5 10 0 4 35 18 10 30 5 11 5 12 11 Porirua .. ,. .. 1,544 32 9 9 3 7 2 0 15 10 1 1 10 3 19 6 9 7 9 0 6 2 3 11 1 54 19 1 18 6 0 4 18 10 31 14 3 29 13 1 .. 2 1 2 Nelson . . .. .. 634 34 15 8 3 16 4 0 9 5 1 15 8 5 12 8 8 13 7 0 5 3 4 0 11 59 9 8 13 8 3 6 16 4 39 5 1 38 9 8 . . 0 15 5 Hokitika .. . . .. 407 36 19 6 4 2 2 0 9 11 0 12 10 3 4 4 11 5 2 0 3 6 3 6 4 i 60 3 11 9 13 7 4 16 8 45 13 7 49 7 5 3 13 10 Christchnrch . .. .. 1,297 32 17 4 3 18 4 1 1 8 1 10 6 4 14 0 8 17 8 0 4 6 4 18 9 58 2 9 19 1 6 6 11 6 32 9 10 30 15 4 .. 1 i4 6 Seaoliff . . .. .. 1,234 38 11 1 3 17 9 153 0 19 1 495 9 14 8 039 413 63 23 21 78 7 13 8 34 0 11 36 50 241 Head Office .. .. .. .. 0 18 7 .. .. .. 001 .. .. 064 150 .. .. 150126 .. 026 Totals .. .. 7,322 34 7 1 3 12 8 0 17 10 1 9 8 4 7 1 9 2 3 0 4 7 4 4 11 58 6 4 17 9 10 6 7 6 34 9 0 32 16 2 .. ! 1 12 10 / *5 ' -< ' . , J .. f , J ' ! ! * Note.— Cost does not include interest and depreciation on land, buildings, &c. 94k w L-V'tA'' iA Xjh ' uK \JcH> Lfc LA. b L ' x >

Auckland. Kingseat. Tokanui. Porirua. Nelson. Hokitika. Christchurch. Seacliff. Head Office. Total. „ . A , . £ s. d. ; £ s. d. I £ s. d. £ s. d. £ s. d. £ s. d. £ s. d. i £ s. d. | £ s. d. i £ s. d. Receipts for maintenance .. .. 21,925 Oil, 5,070 3 IX j 9,253 14 2 28,258 7 8 8,502 18 10 3,939 15 1 24,741 6 2 26,386 15 2 I .. 128,078 111 Receipts from farms .. .. 456 9 11 1,821 7 10 2,966 1 1 951 12 1 1,122 10 7 13 10 0 2,516 0 6 ! 1,762 17 1 ! 11,610 9 1 Miscellaneous .. .. .. 5,300 11 9j 1,307 12 7 2,874 12 9 6,675 3 7 3,198 13 9 1,955 6 1 6,012 18 7 7,719 11 9 12 0 5 35,056 11 3 ' 27,682 2 7 8,199 4 4 | 15,094 8 0 35,885 3 4 12,824 3 2 5,908 11 2 33,270 5 3 35,869 4 0 12 0 5 174,745 2 3

H.—7.

Table XIII.—Total Expenditure, out of Public Works Fund, for Buildings and Equipment at each Mental Hospital from 1st July, 1877, to 31st March, 1935.

Table XII.—Expenditure, out of Public Works Fund, on Mental Hospital Buildings, etc., during the Financial Year ended 31st March, 1935.

% *' / f; - Approximate Cost of Paper.—'Preparation, not given; printing (550 copies), £26 10s.

By Authority : G. H. Loney, Government Printer, Wellington.— 1935. Price 9d .]

21

I Total Mental Hospitals. 1877-1925. 1925-26. 1926-27. 1927-28. 1928-29. 1929-30. 1930-31. 1931 32. 1932-33. 1933-34. 1934-35. Expenditure 1st July, 1877, I o 31st March, 1935. £ £ £ | £ £ £ £ £ jg £ £ £ Auckland .. .. 177,656 2,073 19,988 12,213 12,461 2,279 3,372 621 676 155 2,321 233,815 Chrisichureh (Sunnyside) .. 203,981 2,901 7,229 10,164 7,777 35,291 23,993 4,650 7,960 3,481 23,489 33o!916 Dunedin (The Camp) .. 4,891 .. .. .. .. .. .. .. .. .. .. 4,891 Hokitika .. .. .. 35,729 8,034 1,745 141 401 3,064 14,764 8,381 3,107 8,753 5,629 89^748 Hornby .. .. .. 11,102 .. .. .. .. .. .. .. .. .. .. 11,102 Motuihi Island . . . . 561 . . . . .. . . .. .. .. .. . . .. 501 Napier .. .. .. 147 . . .. .. .. .. .. .. . . . . .. 147 Nelson and Stoke .. .. 45,601 13,750 3,496 753 956 33,250 26,494 3,339 2,680 12,251 28,552 171,122 Puhitahi (Kingseat) .. .. .. .. .. .. .. 16,130 16,433 10,278 35,438 29,784 108,063 Seacliff .. .. .. 192,992 4,767 17,888 9,408 27,132 34,609 8,914 3,065 414 6,618 4,888 310,695 Tokanui .. .. .. 114,829 8,097 j 1,658 2,124 19,887 32,405 27,787 7,164 2,918 6,295 3,797 226,961 Waitati .. .. .. 17,662 .. j 627 .. 853 2,170 9,557 936 516 .. .. 32,321 Wellington .. 29,641 .. .. .. . . . . . . . . .. .. .. 29,641 Wellington (Porirua) .. 234,770 38,213 16,004 16,315 27,315 9,028 3,129 1,349 207 29 170 346! 529 Totals .. .. 1,069,562 77,835 68,635 51,118 96,782 152,096 134,140 45,938 28,756 73,020 98,630 1,896,512 , I . r ; . i —

Mfint,nl Hoanitals i Net Expenditure for Tear Mental Hospitals. j ended 31st March, 1935. £ Auckland .. .. .. .. .. .. .. .. . . 2,321 Christchurch (Sunnyside) .. .. .. . . .. .. .. 23,489 Hokitika .. .. .. .. .. .. .. .. .. 5,629 Nelson and Stoke .. .. .. .. .. .. .. .. 28,552 Porirua .. .. .. .. .. .. .. .. .. 170 Kingseat .. .. .. .. .. .. . .. .. 29,784 SeaclifE.. .. .. .. .. .. .. .. .. .. 4,888 Tokanui .. .. .. .. .. .. .. .. .. 3,797 Waitati Total .. .. .. .. .. .. .. 98,630 : B|| * i : 1 i n u o «y