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Pages 1 to 20

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Pages 1 to 20

H.—7.

1937. NEW ZEALAND.

MENTAL HOSPITALS OF THE DOMINION. (REPORT ON) FOR 1936.

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

The Director-General to the Hon. P. Eraser, Minister in Charge of the Department of Mental Hospitals. Sir, — Wellington, Ist June, 1937. 1 have the honour to present my annual report upon the work of the Department of Mental Hospitals for the year ending 31st December, 1936. There were at the close of the year 8,216 persons upon our registers, including 46 patients and boarders at Ashburn Hall Private Licensed Institution, and 631 patients and boarders who were out on probation to the care of relatives and friends. In actual residence in State institutions there were 7,539 persons, an increase of 249 over the corresponding figure for the previous year, and of this number 7,210 were the subject of a reception order, whilst 329 were voluntary boarders. The total number of first admissions, including voluntary boarders, was 1,145, as against 1,128 for last year, an increase of 17, and 267 former inmates were readmitted. We were able to discharge 719 patients and boarders during the year, or 50-92 per cent., calculated upon the admissions, but of that number only 386, or 27-34 per cent., could statutorily be entered as having recovered. The system of allowing patients and boarders to leave the institutions on probation has been considerably extended in the last few years, and this is of great advantage both to the patients and the institutions ; but this procedure has created a fallacy in regard to our recovery rate. Under the provisions of our Act a patient on probation may be discharged as recovered during his period of probation only if the Medical Superintendent receives a medical certificate testifying to the patient's recovery, but if no such certificate is forthcoming he must be discharged as " unrecovered." We frequently have up to seven hundred patients on probation, and the majority of these convalesce at home to ultimate recovery, bat relatively few send the requisite certificate, to the detriment of our statistics. It is, however, satisfactory to know that over half our admissions are able to return home. Accommodation. I am glad to report that during the year a very considerable improvement has been effected in regard to the shortage of accommodation, to which I have had to call attention in previous reports. The net increase in the number of patients and boarders on the registers was 170, but in spite of this, by the carrying-out of a very extensive building programme, the deficiency in accommodation was reduced from 935 to 514 beds. As stated in previous reports, overcrowding cannot be adequately stated in terms of bed space alone ; we must provide the ancillary services in proportion to the number to be served, and in this connection I direct attention to the numerous additions and alterations detailed in another part of this report. Many of these additions, such as the new store at Porirua, are but the first steps in an extensive programme which should make our institutions compare favourably with any in other parts of the world. The position with regard to the distribution of patients and the accommodation available is shown in the following table compiled in March, 1937 : —;

Net deficiency 514, as compared with 935 for last year.

I—H. 7.

~ " I I Number of ! Numbel , Number Hospital Accommo- Patients and i actually Deficiency. Surplus. Hospital. datl0n Boarders on p robation . residen l Registers. Auckland .. 1,187 1,410 130 1,280 93 Tvingseat .. 620 587 5 582 .. 38 Tokanui .. 637 630 51 579 .. 58 Porirua .. 1,284 1,631 126 1,505 221 Christchurch .. 1,137 1,420 151 1,269 132 Nelson .. 819 853 38 815 .. 4 Hokitika .. 478 454 7 447 .. 31 Seacliff .. 1,004 1,237 34 1,203 199 Totals .. 7,166 8,222 542 7,680 645 131

H.—7.

The Villa System. " The experience of each successive year adds to my conviction that in the villa system we have the means not only of ideal classification, but also of obviating all the objectionable features which loom so large in the public mind." At the end of another fourteen years I find no reason to modify the opinion thus expressed by me in 1923 in my annual report as Medical Superintendent of Nelson Mental Hospital. At the time this paragraph was penned we were making the first cautious advances in New Zealand towards the villa system, for which purpose we had acquired the old Stoke Orphanage property. There were not a few in the Department then who voiced grave apprehensions regarding the proposed changes, which are associated with the villa system —viz., the abolition of airing courts, the extension of parole to patients, and the nursing of male patients by female nurses. To-day we have three villa-system mental hospitals — Kingseat, Ngawhatu (at Nelson), and Hokitika —and their establishment has definitely opened a new and happier chapter in the treatment of the mentally afflicted. Even in the older institutions all additions are being made in the form of villas, and many of the villa-system methods have been adopted so far as has been! found, practicable. None of the villa mental hospitals have any enclosed spaces or airing courts, and exercise is taken by those who cannot be given parole in walking parties. lam hopeful that in time airing courts will disappear also from the old large institutions. So far as parole is concerned, I need only point out that the English Board of Control regards the position as satisfactory if 16 per cent, of the patients resident enjoy some measure of parole ; over all our hospitals our figure for parole is more than twice that and rises in our villa institutions to 45 per cent, at Ngawhatu and 86 per cent, at Kingseat. One matter which I regard as essential to the proper development of our mental hospitals is the extension of nursing by female nurses to the male divisions. I stated in the annual report of 1923, already referred to, that 90 per cent, of male admissions could be nursed by females, and further experience has certainly not led me to qualify the opinion then held. At Kingseat all but one of the twelve villas are staffed by female nurses, with the happiest results, and the same can be said of Ngawhatu. There is plenty of scope for male attendants in supervising farm and developmental work, but to ensure comfort and domestic efficiency within the ward or villa nurses are indispensable. One aspect of the villa system which is probably peculiar to New Zealand and which has proved a great success is the system of separate cooking done by each villa. Not only does this obviate the large capital cost of building and equipping a central kitchen, but we have found that the meals are better cooked and better served, and their preparation provides an interesting form of occupation for nurses and patients. Our experience in this matter has prompted an inquiry into the possibility of decentralizing the cooking in the older institutions ; there are difficulties, but no doubt these will be overcome. Programme foe Current Year. Included in the programme for the current year, are the following major works, which are either being planned or are already under construction :— Kingseat.—Hitherto the main activity at Kingseat has been the provision of villas to ease the overcrowding elsewhere, but with over six hundred patients in residence the time has arrived for the erection of the service blocks and specialized units. In this direction the store was occupied during the year, and the laundry, boiler-house, bakehouse, and butcher's shop are all well advanced. One of the most important units will be the Hospital Admission Villa, for which the plans are well forward, and its erection will be commenced before this report is published. The plans make ample provision for all the most modern forms of treatment, including massage, continuous baths, light, electricity, and X-rays, and the block also includes a laboratory, dispensary, and operating-theatre. Plans are being considered for the erection of an additional reservoir of 300,000 gallons capacity. The two next most pressing requirements at Kingseat are a Nurses' Home and an entertainment hall. Tokanui.—Extensive alterations are going on, to enable an interchange of male and female divisions to be effected. Porirua. —The new store will be completed shortly and the new kitchen boiler-house block will be commenced. The completion of these works will enable us to put in hand a much-needed remodelling of dining-hall and administrative block and to provide adequate visiting-rooms for patients' friends. Nelson.—lt is hoped to erect at least two male villas and thus allow for a reconstruction of the present main building at Ngawhatu to provide administrative offices, including stores. Hokitika.—Consideration is being given to reconstruction of the kitchen-stores block, which is now quite inadequate for the increased number of patients. It is intended during the year to erect two new villas to house fifty patients of each sex. Christchurch.—Considerable improvements are to be effected in connection with water-supply. Seacliff. —Additions to the Nurses' Home are under consideration, and a hospital-admission unit is necessary. Alterations, Additions, and Improvements carried out Last Year. Capital expenditure on new buildings, additions, and improvements effected during the year amounted to £142,108 19s. lid., and the following summary shows the principal items making up the total: — Auckland (£841). A new refrigerator was installed and additions to the Nurses' Home commenced.

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H.—7.

Kingseat (£65,191). Four villas were completed and occupied during the year. The new store has been erected and equipped. A commencement has been made with the new laundry, boiler-house, bakehouse, and butcher's shop. Roadmaking, sewerage-construction, lighting, and drainage have all been carried forward. / Tokanui (£18,839). Two villas for male patients have been completed and occupied. Alterations have been made to the store accommodation. Roading and sewerage works have been carried out. Porirua (£6,510). Erection of a new store has been commenced, and alterations to " Vailima " carried out. Ngawhatu (£16,218). Three new villas have been equipped. A new telephone system has been installed. A new refrigerator has been installed. New coal-bunkers have been built. Roading has been improved and extended. Hokitika (£7,579). One new villa has been completed and equipped. Extensions have been made to the laundry. A residence for the clerk has been erected. Christchurch (£2.3,971). A new bakehouse has been erected. Additions have been made to the female dining-room. The water-supply has been improved. At Templeton Farm Colony the erection of a new laundry has been commenced. Two villas have been completed at Jenkins' Farm for male patients. A workshops block for vocational training of boys has been erected. Seacliff (£2,958). The dining-room accommodation at D Ward has been improved. A new bath and shower room for male patients has been completed. A new dairy has been erected. Shortening or Nursing Staff Working-hours. At the conference of Medical Superintendents last year a discussion took place as to the best means of reducing the working-hours of our nursing staffs, in conformity with the general Government policy of reducing working-hours. Those present were unanimously of opinion that a substantial reduction was desirable from the fifty-three hours then being worked, but it was stressed that any amelioration of working-conditions should be accompanied by a corresponding benefit to the patients. With your concurrence, a committee, consisting of Mr. Ellwood, Head Attendant at Christchurch, and Mr. Millar, Secretary of the Public Service Association, was set up to report upon the matter, and after consideration the recommendations of this committee were adopted and the scheme came into operation as from Ist September. In addition to a reduction of hours from fifty-three to approximately forty-two per week, the scheme provided for an extra shift to cover the evening hours, so that a larger number of patients are now enabled to sit up to a reasonably late hour at nights. In spite of the fact that the change-over involved the engagement of 270 new officers and the provision of their accommodation its inauguration took place with remarkably little inconvenience or disturbance of the institutional routine. The innovation is of too recent date for me to report adequately upon its general effect on the hospitals, but the reports which I have so far received are favourable. The only adverse comments are in regard to a lack of continuity of supervision by the higher officers, but certain proposals to deal with this are now being discussed with the Public Service Commissioners, and in any event the position will improve as the new junior staff get to know the work. So far as nursing staff is concerned, the reports are to the effect that there is a definitely increased keenness in the work. To the credit of the nurses I would like to record that two Medical Superintendents have reported that there is a marked increase in the number of nurses who take patients out for the day of their own accord, in their own time, and at their private expense. A considerably increased number of patients now retire to rest at a later and more reasonable hour than was formerly possible, and there is a heightened interest in recreations. Occupational Therapy. I was very deeply impressed on my visit to Great Britain two years ago with the enormous progress made in the provision of suitable occupation for all classes of patients in mental hospitals and with the obivious benefits to the patients and the institutions. In New Zealand a large percentage of our patients have always been employed on the necessary work of the institutions —the men on the farms and gardens, the women in the laundries, kitchens, &c. —but many patients are unwilling or unable from various reasons, mental and physical, to do institution work. For these people we have lately introduced the teaching of handicrafts, and the results are most encouraging. To begin with we have had classes for the more recent and recoverable types who benefit by some such congenial way of passing the time, but I am hopeful of extending the classes to the more chronic cases, and I have no doubt that the tranquillising effect of useful occupation which I have seen elsewhere will soon become apparent in our own institutions.

3

H.—7.

The work has been done so far in New Zealand, partly by outside voluntary effort and to some extent by part-time paid instructors, but the experience in other countries leads to the expectation that occupational therapy will develop to an extent which will necessitate the employment of regular whole-time officers. Changes in Medical Staff. It is with great regret that I record the death on 30th December of Dr. H. M. Prins, Medical Superintendent of Tokanui Mental Hospital. Dr. Prins was a man of generous and kindly nature, and during his twenty years of service in the Department he had earned the respect and affection of the patients and his fellow-officers. Dr. James Dewar Hunter was promoted to be Medical Superintendent at Kingseat Mental Hospital last August. Dr. Hunter has had special experience of the villa system both in Scotland and in New Zealand and is therefore well qualified to be the first Medical Superintendent of our leading villa mental hospital. Dr. Gilbert Mortimer Tothill was promoted to the position of Medical Superintendent of Tokanui Mental Hospital in January in succession to the late Dr. Prins. Dr. Tothill had several years' experience in psychiatry in England before joining our service nine years ago. His promotion is well earned. Appreciation. I am always glad of the opportunity to include in this report my sincere appreciation of the generous loyalty and support given to me at all times by my colleagues Dr. John Russell and all the Medical Superintendents and by the other officers of the service. I am extremely fortunate in my Head Office staff, and to Mr. Sinclair, Chief Clerk, and the other officers I tender my thanks for valuable work well done throughout the year.

AUCKLAND MENTAL HOSPITAL. Dr. Buchanan reports : — I have the honour to present my annual report for the year ended 31st December, 1936. The total number of cases under care during the year was 1,592, with a weekly average of 1,185. The admissions numbered 303 (147 males, 156 females). Of this number, 242 were admitted for the first time. . Under section 8 of the Mental Defectives Amendment Act, 169 patients were admitted. Eighty-four voluntary boarders were admitted during the year, making a total of 193 under care, and of these, 70 were discharged. At the end of the year 157 patients were on probation, 104 on full parole, and 159 on limited parole. Deaths totalled 113 (50 males, 63 females). Generally, the health of the patients has been good. However, we were unfortunate in having an epidemic of dysentry, which broke out in March, came to a peak in June, and became quiescent in October. It is now over, though occasional sporadic cases still occur. This outbreak presented many difficulties. Our accommodation was already very limited, and the necessity of providing adequate isolation taxed our ingenuity. This experience has prompted me to include the cost of building an isolation block in my annual estimates. The work of the nurses who were in charge of the epidemic was admirable, and deserves praise. On the 15th September we were honoured by a visit from the Minister of Mental Hospitals, the Hon. Peter Fraser. A fairly comprehensive programme of maintenance and new work has been effected. In this list the main items are general painting, outside and inside ; tarring and sanding roads and airing courts ; alterations to the water service to provide a more efficient fire-fighting supply ; a new veranda built on to the Wolfe Home ; a sun-shelter shed in M. 3 ; preparations for the installation of a cool storage in the main kitchen ; introduction of a vegetable-peeling machine, also in the main kitchen ; and the addition of ventilating skylights to M. 3. Many other small, but none the less important, works were also carried out. The library has proved a great success. It now possesses a great number of books of excellent quality. The increasing number of books, and the enlarging number of patients who take advantage of the amenities this club provides, will probably necessitate building-extension. During the year we have lost the services of two old members of the staff, one having reached retiring-age and the other on account of impaired health. I refer to Mr. White, who has been our Chief Engineer since Ist May, 1928, and Mr. Myers, our Storeman since 27th December, 1923. The former was a valuable colleague and sincere friend. His wide knowledge of engineering, and his broad practical common-sense in everyday matters, was of very great use and importance. The latter was a devoted, loyal, and conscientious member of our staff. Entertainments have been good. In this connection I wish to thank specially Mr. Neville Carlson for his consistent entertainment and amusement of our patients, and the Amateur Magician Society for giving a most entertaining and thoroughly appreciated performance. The Official Visitors continue to take a useful and regular interest in the welfare of the patients. On the 15th August I handed over the charge of the Kingseat Mental Hospital to Dr. Hunter, who was appointed Medical Superintendent. In spite of relief from the extra work entailed in looking after this growing hospital, it was with regret that I partially severed my connection with it. The supervising of buildings embodying new ideas in the nursing of mental cases was always interesting and congenial. 1 tender to Dr. Hunter my congratulations on his appointment and best wishes for his future at Kingseat.

4

H.—7.

The introduction of the forty-hour week at first, caused some inconvenience, but I am glad to state that the new regime now runs smoothly and happily. Naturally, there is some resultant congestion in staffing accommodation, but this will be overcome if the proposed alterations and additions to the Nurses' Home are made. The Psychiatric Clinic continues to function well. On the appointment of Dr. Hunter to the Kingseat Mental Hospital he took over the clinic on Thursday mornings, which hitherto had been conducted by Dr. Short. In severing my clinical relationship with Dr. Short I wish to record my thanks for his co-operation. The relative figures of the clinic are : — Thursdays Tuesdays. (Dr. Short and Total. Dr. Hunter). (1) Number of separate persons seen .. M. 283 83 366 F. 23 34 57 306 117 423 (2) Number of — (a) First visits .. .. .. .. 256 105 361 (b) Subsequent consultations .. .. 563 589 1,152 819 694 1,513 (3) Sources of reference — Tuesdays. Thursdays. Pensions Department .. .. .. 207 36 243 Medical practitioners .. .... 26 64 90 Voluntary calls .. .. ..27 17 44 Prisons Department .. .. 20 .. ' 20 Psychological Clinic .. .. I .. 1 Porirua Mental Hospital .. 1 .. 1 Police Department .. .. 5 . . 5 287 117 404 Monthly visits have been made by Dr. G. M. Tot-hill and myself to the Inebriates' Home on Rotoroa and Pakatoa Islands. An increasing number of prisoners has been seen in Mount Eden Prison and reported upon. In conclusion, I wish to record my thanks to the Medical Officers, the matrons, head attendant, clerk, and staff for their helpful co-operation during the year. The work of the medical officers is becoming increasingly onerous, and there is not any doubt but that we now require additional help. It says much for the keenness and strong sense of duty of these officers that they have carried on their added obligations conscientiously and without complaint.

KINGSEAT MENTAL HOSPITAL. Dr. Hunter, reports : — I have the honour to submit my annual report for the year ending 31st December, 1936. The total number of cases under care during the year was 610 (311 males and 299 females), with a weekly average of 443 cases. Three, male voluntary boarders were admitted during the year. At the end of the year 9 patients (5 males and 4 females) were on probation, and 10 patients (5 males and 5 females) were finally discharged. Deaths totalled 11 (6 males and 5 females). With the increasing size of the hospital it has been necessary to appoint a resident Medical Superintendent and a Clerk. This was done as soon as the two residences and the store, which were in the course of construction, were completed. Kingseat, although a separate hospital, had been administered in conjunction with the Auckland Mental Hospital, with Dr. Buchanan as Medical Superintendent of both hospitals, and I would like to record my appreciation of the work which he has done in connection with Kingseat. On my taking over in August of this year Kingseat began to function as a separate unit. The hospital consists of twelve separate villas, six for men and six for women, each villa being self-contained, including its own cooking facilities, this being appreciated very much by the patients and staff. Eleven of the villas are in charge of nurses, the remaining one being in charge of men, with a nurse assisting. During the year four new villas have been completed, two for men and two for women. These are occupied by the transfer from Porirua of 47 men and 50 women, and from Auckland of 8 men and 38 women, the remaining beds being occupied by the transference of our own patients from the Earm Ward and the camp. The camp and the Farm Ward were closed, and necessary alterations were made to the latter for the accommodation of additional male attendant staff. The completion and opening of the new store, along with the appointment of additional clerical staff, has done much to facilitate the working of the hospital. The contract for the erection of the engine-room, laundry, bakery and butcher's shop, and coal-store was let early in December, and the foundations of these buildings have been commenced. The introduction of the forty-two-hour week for our nursing, artisan, and farm staff, along with the appointment of extra staff for the opening of the new villas, has resulted in our nursing staff being increased from 29 nurses and 16 attendants to 60 and 29 respectively, with the result that a Nurses' Home seems to be the only satisfactory solution for the shortage of staff accommodation.

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H.—7.

The increased time for recreation now enjoyed by our staff is very much appreciated, and is reflected in the carrying-out of their duties. In September a weekly out-patient clinic was started at the Auckland Public Hospital, working in conjunction with Dr. Buchanan, of Auckland Mental Hospital. Consultations and attendances for treatment numbered 68, and of these, 21 were new cases. The year has been one of continuous activity, consisting of excavations for new buildings ; the laying-out and improving the grounds around the new villas and residences ; the sowing of 4f acres of lawn around villas 12 and 13 ; the planting of shelter-belts, hedges, ornamental trees, and shrubs ; the excavating for the underground cables for electrical power; and the removal of overhead power-lines. The time has come, I think, for the appointment of a full-time artisan, capable of attending promptly to the many small requirements of maintenance, &c., which would be more economically dealt with in the beginning rather than allow them to be costly replacements at a later date. The increasing size of the institution and the fact that the older buildings are requiring more items of maintenance would provide sufficient work to keep him fully occupied. The farm continues to be a useful adjunct to the hospital, and its many outlets for occupational therapy have proved very beneficial to our patients. The patients, on the whole, are happy and contented, and the new transfers soon respond to the environment. They are given as much parole within the boundaries of the hospital property as possible, consistent with their mental conditions, and this privilege, together with that of being allowed to sit up until 10 p.m., is much sought after and is appreciated very much, as it allows of the patients enjoying to the full the benefits associated with radio, each villa having its owr. set. The patients are fully occupied with constructive works in the grounds, gardening, laundry, and sewing-room, some having their own gardening plots. Their amusements have not been neglected, football, cricket, tennis, and croquet being provided. During the winter months weekly dances are held, but we are handicapped by the lack of a recreation hall, preferably one with cinema facilities, which would be appreciated by patients and staff. Up to the present a day-room in one of the villas has been used, although not suitable for dancing, but the arrival of 150 patients on transfer will necessitate new arrangements for the coming winter. The Hon. P. Fraser, Minister in Charge of Mental Hospitals, visited us on the 17th December, and spent the morning inspecting the villas and the hospital generally. Mr. McFarlane, of the Public Works Department, continues to show his keen interest in the growth of Kingseat, and his many helpful suggestions are appreciated. I am most grateful to the following, who have done much for the entertainment and welfare of the patients : — The Official Visitor, the Rev. Mr. Wood, Mr. Hooker, The members of the various women's institutes, The Auckland Hospital Auxiliary, Mental Hospitals Branch, Several local branches of the Returned Soldiers' Association, and also to the many people throughout the Auckland Province who have sent us newspapers and reading-matter. Finally, I wish to thank the clerk, matron, head attendant, and all the staff for their very helpful and encouraging services throughout the past year.

TOKANUI MENTAL HOSPITAL. Br. Tothill reports : — I have the honour to submit the annual report for the year ending 31st December, 1936. At the end of December Dr. Prins, who had been Medical Superintendent for the past eight years, died. In spite of failing health the welfare of his patients and staff was always his first consideration. He was greatly esteemed in the district, and our deepest sympathy is extended to his widow and two sons. The total number of patients under care was 692, with a weekly average of 567. Admissions numbered 80 (40 males and 40 females), 67 being admitted for the first time. There were 21 voluntary boarders under treatment, 9 being new admissions. During the year 8 voluntary boarders and 48 patients under certificate were discharged, 49 had sufficiently recovered to be allowed home on trial, and 4 were transferred to other institutions. There were 29 deaths. Two modern male villas were erected, and are much appreciated by the patients. A new Medical Superintendent's house is now in occupation. The sewerage system and digester was completed and is functioning satisfactorily. Part of the water-main from Te Awamutu has been renewed, the water-main to the Nurses' Home replaced, and a new reticulation water-supply to the staff houses introduced. An outside dormitory was converted into a main store and a bowser-pump installed. Model concrete piggeries have been built on the Farm. Painting, road-construction, planning of gardens, and general maintenance have been carried out. Alterations in the main buildings, in anticipation of a change-over of patients, are in progress, and the telephone system, is being overhauled. The usual recreations and entertainments have been held, the talking pictures proving most popular. The performance of the Te Awamutu Band and the concert parties provided by Mr. Findlay, the Official Visitor, have been greatly appreciated. In conclusion, thanks are due to all members of the staff for their loyal co-operation and also to visitors for their interest in the welfare of the institution.

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PORIRUA MENTAL HOSPITAL. Dr. Hart reports : — I have the honour to submit my report for the year ending 31st December, 1936. The total number of cases under care during the year was 2,085, of whom 1,866 were committed patients, 209 voluntary boarders, and 10 sent to the hospital on remand. Admissions numbered 419 : 316 under certification, 94 as voluntary boarders, and 9 were admitted for observation. Of the cases admitted for observation, 6 were discharged at the expiration of the periods of remand. During the year 70 voluntary boarders and 106 committed patients were discharged and an additional 89 patients were sufficiently improved mentally to be able to go on probation to the care of relatives or friends. Deaths numbered 109, and 165 patients were transferred to other Mental Hospitals. Apart from the care and treatment of cases resident and already enumerated, I have to refer to the Psychiatric Clinic and the Psychiatric Ward for Women at the Wellington Public Hospital; the inauguration of the latter being "the first step made in this direction in New Zealand. By active co-operation between the Wellington Hospital Board and this Department a ward has been set apart for the observation and treatment of ea-rly cases of psychoses and psychoneuroses. The ward is staffed by trained mental nurses seconded for duty there from this mental hospital. It is not intended that the ward should become a subsidiary mental hospital, as all well-defined cases of psychoses will continue to be sent as early as possible to the mental hospital, which alone can fully provide the specialized experience and therapeutic resources necessary for the active and successful treatment of such cases. At the same time I believe, and statistics will support my opinion, that successful early treatment can be provided in such a ward for mild cases of psychoses and psychoneuroses. Rest in such a ward, psychotherapy, temporary alleviation, and later adjustments of environmental and domestic stress have enabled certain cases to become once again socially adapted members of the community. I feel confident that treatment in the Psychiatric Ward has, in certain cases, prevented in the individual an extension of mental and nervous symptoms, and it is reasonable to believe that in several cases admission to a mental hospital has been avoided. The Hospital Almoner and the Social Worker of the Mental Hospital Department have been associated with the work of the ward in assisting in the rehabilitation into 'the community of the cases we have been able to discharge. The Psychiatric Ward has only been in operation since June last (a period of six months) and some 47 women have been under treatment, of which number 31 were discharged and 16 admitted to the mental hospital (7 as voluntary boarders and 9 under certification). The fact that all cases exhibited some mental and nervous symptoms and that it was possible to discharge 31 of 47 eases I think in itself more than justifies the existence of such a ward. A similar ward for men is under consideration and should prove an equally useful unit. The bi-weekly Out-patient Clinic at the Wellington Public Hospital continues as formerly, visits totalling 567, of which number 136 were new cases. In May of this year a monthly Out-patient Clinic was inaugurated at the Palmerston North Hospital, and 49 cases were referred for advice and treatment. The numbers and sources of reference of new extra mural cases dealt with during the year are as follows : — Psychiatric Clinic .. .. .. .. .. .. 136 In-patients Wellington Public Hospital .. .. .. .. .. 118 Palmerston North Hospital Clinic .. .. .. .. 49 Prisons Department . . .. .. .. .. .. 21 Total new cases .. .. .. .. , . 324 The transfer of 165 patients during the year to Kingseat and Nelson Mental Hospitals has reduced the overcrowding, which on scheduled accommodation still exists to the extent of 143 males and 56 females. Owing to the reduced hours of work and the resultant increase in nursing staff the staff accommodation is now inadequate, and additional accommodation for nurses will have to be provided for. As an addition to other avenues ot occupational therapy an instructor in cane-work and coir-mat making has been appointed. Classes only commenced some weeks ago and it is too early to look for results, but it is anticipated that this work and work in the allied " simple crafts " will prove of value both therapeutically and in the production of useful articles. The artisan staff in all its branches has been fully occupied on general maintenance-work and, in addition to contract work, three staff and a party of patients have been constantly employed at interior painting and renovations. Under this heading the complete interior painting of Wards M. 3, M. 5, M. 6, F, and D was carried out during the year, whilst portion of M. 7, E, Rauta, office block, certain staff residences, &c., were painted and renovated. Alterations and additions to existing buildings carried out during the year have been as follows :— The erection of a new dairy and alterations to the male bathroom in the main building, with the erection of a dressing-room. The provision and equipment of a kitchenette for Male 1, and the extension of the building with the provision of extra bathing accommodation at Yalima. Additional wash-hand basins were installed in E ward, and bathroom and lavatory additions in Male 5, lavatory and urinal additions in Male 3, and improvements to the ventilation in the corridors of the main building. Extensions were made of the hot-water service to the wash-hand basins in the villas Kaumatua, Weymouth, Somerset, Montrose, and Nairn. The malthoid roofing of the poultry-house wa« replaced by corrugated iron, and fairly extensive repairs carried out to the slate roofs of the main building. Of new equipment a new Ideal boiler was installed at the lower buildings, and plate-warmers provided for the main dining-hall, M. 1 and M. 6.

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The following works were commenced during the year and are at present progressing : — New store block, extensions of hot-water service in Male Wards 5, 7, and 8, reroofing of wards Male 4 and B, and the removal of towers which have become structually unsafe. Under contract the complete painting of five villas, roofs of lower buildings, and the wards Valima and Tiro-Moana is now progressing. It is hoped that as soon as possible the new boiler-house and kitchen for the main building will be commenced so as to overcome at as early a date as possible the cooking, laundry, and central heating difficulties existing at present in that portion of the hospital. I still believe that when arrears in patient accommodation throughout our hospitals have been overcome that the now desirable provision of a modern laboratory at Porirua will then become very definitely a justifiable and necessary expenditure. There is at present unsatisfactory and inadequate accommodation for a portion of the medical staff, and an additional residence for a married assistant medical officer is required. The office accommodation for assistant medical officers and clerical staff is hopelessly inadequate, and it is desired that monetary provision be made in the current year for a reconstruction of the administrative block, which will be made possible when the new store is completed. Activities on the farm, in the orchard, and gardens have continued as formerly. The fact that too great a proportion of our acreage consists of sheep country means that there is insufficient area for herd pasturage. Due to the good grass season milk returns were higher than the previous year, but during certain months of the year we had to purchase milk from an outside source. Patients' recreations were well provided for in the way of golf, tennis, bowls, concerts, fortnightly dances, weekly cinema, and picnics to the beach. The library activities have been extended, and we are very grateful to Mr. Hooker for his continued interest in this phase of patients' recreation. I am indebted to many individuals and societies for their donations of goods and money towards patients' recreation, and, although it would be impossible to name all, I desire particularly to thank the Rev. Mr. Harding, Mrs. Heard, Mrs. Gordon Glassford, concert parties, the Commercial Travellers Association, the Women's National Reserve, Women's Service Guild, Women's Institute, and the Women's Division of the Farmers' Union. The various Ministers of religion have held their services at the hospital at regular intervals. The hospital was honoured by a visit from the Governor-General on 15th May, 1936. I regret to have to record the sudden deaths of Dr. Lang and charge attendant Stewart, which occurred during the year. Both were efficient and conscientious officers, and their deaths were deeply regretted by all members of the staff. Drs. Hunter and Marshall were transferred to Kingseat and Waitati respectively, and replaced by Drs. Lewis and Bowell. In conclusion, I must thank all members of the staff for their assistance in the work of the year.

NELSON MENTAL HOSPITAL. Dr. Williams reports I have the honour to present my annual report for the year ending 31st December, 1936. During the year 936 persons were under care, of whom 34 were voluntary boarders. The admissions totalled 212, of whom 154 were transferred from other mental hospitals. Twelve patients were discharged, 9 were transferred to other institutions, and 35 died. Twenty-four patients were admitted under section 8 of the Mental Defectives Amendment Act, 1928. Eleven voluntary boarders were admitted and 16 were discharged " recovered," while the mental state of 4 necessitated certification. It is interesting to note that of the 846 patients resident at the end of the year, 649 were born in New Zealand. This preponderance is, of course, largely due to the fact that the old Nelson Mental Hospital is now reserved for the reception of cases suffering from congenital mental defectiveness. Speaking more generally, the year has been in some degree an eventful one, though, on the whole, pleasantly so. Firstly, three new female villas have been opened and occupied by patients transferred from Sunnyside and Porirua. To me, who knew many of these previously, and undoubtedly also to others, it has been a tribute to the villa system generally to have noted the altered and happier outlook and consequent more rational conduct of even the most difficult patients since their transfer to surroundings where conditions are so much less irksome and where restraint is practically non-existent. The staff too have benefited by a radically reduced working-week, and without doubt this improved state of affairs will be reflected in the greater well-being of the patients, notwithstanding perhaps that the continuity of care and the consequent knowledge and understanding of the individual patient is not so complete as formerly. As for myself, I had the opportunity of attending a Superintendents' Conference in Wellington. This enabled me, and no doubt the others attending, to gain a fuller understanding of mental hospitals affairs generally, and it is an innovation I consider which might with continued benefit be repeated at intervals. Maintenance-work has gone on as usual, as have also the various activities associated with the farm and gardens and in opening up new areas generally. In the latter respects we have been handicapped considerably by a paucity of good and able workers, but progress has been very satisfactory in the circumstances. Farm receipts have continued to show a pleasing buoyancy.

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A good deal of road-work has been done, and tenders have been called for colfixing the main road. A destructor has been erected and is now in operation. Coal and coke bunkers have also been' erected, as has also a cool store. Improvements have been made to the swimming-baths, and two new tennis-courts have been laid down. Repairs and painting of the farm buildings at Ngawhatu are under way. A number of other minor works have also been completed, perhaps the most noteworthy of these being the efforts of the " painting " party. The patients have been reasonably well catered for in the matter of amusements and recreation, and in this respect my thanks are due to many individuals, business firms, and societies in Nelson for their continued support and for donations of money and goods. Miss Cooksey and party have been particularly good in providing outings for the children. The Sunshine Fund organized by Mrs. Scantlebury for provision also of picnics for the children has been very successful and the results much appreciated. To the Official Visitor, to the visiting Ministers of religion, to my colleague Dr. Crawshaw, and to the staff generally, for assistance and co-operation, I wish also to express my thanks.

HOKITIKA MENTAL HOSPITAL. Dr. Childs reports : — I have the honour to submit my report for the year ending 1936. At the commencement of the year the patients on the register numbered 418. The admissions proper were 18, while 3 male and 52 female patients were received on transfer. The discharges numbered 15, transfers to other hospitals 3, and deaths 15. The total number under treatment was 491, and the number remaining on the register at the end of the year 458. There were 3 voluntary boarders on the register at the beginning of the year, and during the year 5 were admitted and 6 discharged. The health of the patients generally has been good, the majority of the deaths occurring amongst the senile patients. A new modern villa accommodating 50 female patients was opened and occupied in December. This villa is an open one, and is occupied mostly by patients transferred from Seacliff. A modern residence is in the course of erection for the Chief Clerk, and should be finished shortly. Aorangi and Sefton wards are at present being remodelled, and when finished will be used as an open villa for the better type of elderly patient. The laundry has been enlarged, a new verandah added to Wio Villa, and necessary repairs effected to Moana ward and to the Superintendent's cottage. The usual routine of farming operations has been carried out, 9 acres of swamp land have been cleared, drained, and left fallow, while 14 acres left fallow last year have been sown in grass. A commencement has also been made to put in a deep drain running the full length of the west boundary fence. The grounds around the new villa " Weka " are in the process of being drained and levelled, preparatory to lawns and gardens being laid down. The painting gang has been continuously employed during the year, and the usual maintenancework carried on. A monthly clinic has been held at Greymouth, and occasional visits paid to the Westland Hospital. . The usual games and recreations have been carried out, and the playing-field has been improved. The Hokitika Band has again been very generous in its visits to the hospital, and has supplied music for a number of dances. Thanks are also due to those who have provided entertainments during the year, these being invariably of a high standard. Thanks are also due to those who made gifts to the hospital during the Christmas Season. The clergy have made frequent visits, and I would also thank the Official Visitor for his co-operation. I wish to thank the staff for their assistance during the year.

CHRISTCHURCH MENTAL HOSPITAL. Dr. MoKillop reports : — I have the honour to forward my report for the year ending 31st December, 1936. On the Ist January, 1936, there were 1,411 patients on the register. During the year 232 patients were admitted, 96 were discharged, and 112 were transferred to other institutions. The total number under care during the year was 1,64-3. In addition, 116 voluntary boarders (59 men and 57 women) received treatment during the year, 55 being still in residence. 2—H. 7.

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The health of the patients has been very good ; there were 69 deaths, the chief cause being senile decay. Professor Hercus and the staff of the Bacteriological Department have given valued assistance in research work, more particularly with reference to general paralysis and to goitre. There were again only two deaths associated with general paralysis. In 1930 a complete survey of the number of goitres was made, and the figures were as follows : — Females .. .. .. 214, goitres out of 468 patients, 45-7 per cent. Males .. .. .. 122, goitres out of 391 patients, 31-2 per cent. In November, 1936, a further survey was made, and 93 males and 128 females were found to have goitre, the female percentage being 27 per cent, and the male 17.6 per cent. This reduction is due to the use of iodized salt for all purposes. It can definitely be said that none of our patients have developed goitre since the use of iodized salt. It is interesting to note that when the first survey was made, the largest percentage of goitres was in the chronic wards, but the reverse is now the case. Two villas are almost ready for occupation at Jenkin's Farm, Templet.on ; the workshop block is completed, and several lads are being taught useful trades there. The water-supply at Templet.on is not working as satisfactorily as was expected, and it may be necessary to build storage tanks as has been done at Sunnyside. The alterations and extensions to the female dining-room at Sunnyside have been completed and have added materially to the comfort of the patients. Other works of importance completed during the year have been the erection of a vegetable-house and alterations to the kitchen yards. A new bakehouse is well under way. We have had a very successful year on the farm, and the prospects for the harvest are very good. Many concerts and dance parties have visited the institution and have been a source of enjoyment to the patients. I have to thank them and the companies who provided the picture programmes weekly throughout the year. Mr. Acland, District Inspector, and the Official visitors—Mrs. Williams and Mr. Hanna—have regularly visited the institutions and have taken a keen interest in the welfare of the patients. The transfer of Dr. Lewis to Porirua was a distinct loss both to Sunnyside and Templeton. I have to thank him for his valued help during the past few years, and also Drs. Bellringer and Couston for their assistance. As we are short of a medical officer, much extra work has been placed upon them. I have to thank Mr. Thomas and the office staff, the matrons, head attendants, and other heads of departments for their very efficient service, and the staff as a whole for the way the work of the institution has been carried out.

SEACLIFF MENTAL HOSPITAL. Dr. Hayes reports : — I have the honour to present my annual report for the year ended 31st- December, 1936. The total number of patients under care during the year was 1,382. There were 146 admissions, of which 127 were first admissions, 14 readmissions, and five transfers. Discharges numbered 55, of which 32 were recovered. Voluntary boarders under care were 60 in number, of whom 29 were admitted during the year ; 21 were discharged and 8 committed. Deaths were 87, the principal causes being senile decay and heart-disease. At the beginning of the year there were 1,236 patients and 31 boarders, while at the end there were 1,184 patients and 30 boarders. The reduction in population of 53 was due to the transfer of 51 patients (female) to Hokitika in December. This reduction in the female population has rendered the overcrowding in that division negligible (6), but the male side is still seriously overcrowded (148). The proposed additions to Clifton House should help both the overcrowding and classification problems, and I regret that to date it has not been started. During the year the following more important public works have been completed. The new male shower-bath room is in operation. A new dining-room has been added to D. ward, and this is a welcome addition, as the degraded type of patient had hitherto to use the main dining hall. The female cottage was improved by enlarging the dormitory and reconstructing the lavatory accommodation. The evacuated female wing (F. 1) was demolished and the building closed to conform with the original design. It will be a matter for consideration later to evacuate the remaining female wing (F. 2 and F. 3). The morgue was renovated and suitably equipped. In addition, renovation has been carried out in many parts of the institution and general painting maintained. A new entrance-gate and drive has been constructed to permit of the proposed enlargement to Clifton House, and is also an improvement upon the former one. The farm has progressed and there has been a decided improvement in our dairy herds with increase of milk-production. A new egg-store has been built at the poultry-farm and should improve our conditions for preserving. A start has been made on tree-planting from our own seed. In September the shorter hours for the nursing staff led to an increase in our establishment of 26 nurses and 27 attendants. The increase in the effective staff available through the newly created special shift has already resulted in improvement in conditions. A considerable number of patients of both sexes now are able to sit up until 10 p.m. The benefit resulting from this is already reflected in better sleeping in the dormitories concerned.

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The Dunedin Clinic dealt with 158 new cases during the year, in the earlier part of which I was appointed to the honorary staff of the Dunedin Hospital. The details concerning these cases are as follows: — Diagnosis. Senile dementia.. .. .. 23 Childish psychiatry .. .. 6 Congenital mental defect.. .. 17 War neuroses .. .. .. 5 Anxiety states .. .. 16 Epilepsy .. .. 4 Hysteria .. .. 16 Reactive depression . . .. 3 Alcoholism .. .. ..11 Post-traumatic states .. .. 2 Schizophrenia .. .. ..11 Obsessional states .. .. 2 Involutional melancholia. . .. 9 Neurasthenia .. .. .. 1 Paranoid states . . .. 9 Secondary dementia .. . . ] Manic-depre,ssive insanity . . 7 General paralysis of the insane .. I Toxic-exhaustive states .. .. 6 Constitutional emotional instability 1 Organic dementia and cerebral arterio- Normal .. .. .. 1 sclerosis .. .. .. 6 Total .. ..158 Source. Disposal. Hospital wards .. 69 Discharged recovered .. .. 8 Practitioners .. .. .. 61 Discharged relieved .. .. 28 Child Welfare Department .. 10 Discharged unrecovered .. 10 Spontaneous . . .. 10 Left against advice .. .. 3 Pensions Department .. .. 6 Voluntary boarders .. .. 11 Magistrates' Court . . .. 1 Committed .. .. 34 School Medical Officer .. .. 1 Advice or report supplied .. 47 Referred to other hospitals or institutions .. . . 8 Died .. .. .. 3 Under treatment at end of year .. 6 158 158 The clinic at Invercargill has been conducted by Dr. Brown, who reports 28 new cases, of whom 15 were at the Southland Hospital and 6 referred Joy practitioners, 2 each by the Pensions Department, Child Welfare Department, and parents ; one spontaneous case. With regard, to disposal, 5 were committed and 2 voluntary boarders. We have been particularly fortunate this year in the interest taken in the patients by various Dunedin organizations. The Patients and Prisoners Aid Society has maintained its constant activities in promoting the patients' recreation and conducting religious services. The services of the society's agent and chaplain, Mr. A. Stevens, have been much appreciated, and towards the end of the year he conducted an appeal for the installation of radios in the seven remaining wards which were not so equipped. His appeal was immediately successful, and our thanks are due both to the society and the subscribers. The Dunedin Branch of the Women's National Council now visit the hospital and take an active part in the recreation and occupation of the female patients. They have been teaching handicrafts, &c., and also bring many useful gifts, as well as taking a personal interest in many cases. Miss Miller, the vocational instructress to the Red Cross Society, commenced teaching handicrafts to several of the returned soldiers, and has extended her work to other cases interested in her activities and likely to benefit by them. We are indebted to her and to the Rev. Brian King for initiating this work. Several concert parties have come out and entertained the patients, and I extend my thanks to them. The Royal Male Choir and Justices of the Peace Association have been chiefly responsible for these parties. We have also to thank the Returned Soldiers' Association for their continued interests in returned-soldier patients, and their numerous gifts to them, particularly at Christmas-time. In March Mr. F. G. Cummings retired from the position of Patients' Friend after over thirty years association with the hospital in his capacity as agent and chaplain to the Patients and Prisoners Aid Society. At a suitable meeting a presentation was made to him expressing our deep regret at his retirement and appreciating the valuable years of assistance he rendered both patients and hospital. I have to thank the visiting clergy for conducting services, and Mr. J. Louclen, Official Visitor, for his services. At the beginning of the year Dr. McLachlan commenced duties, as also did Mr. Thomas in place of Mr. Riordan, who was transferred to Poriraa. During the year Dr. Bowell was transferred to Porirua Mental Hospital, Dr. Marshall coming to Waitati. To my colleagues and to the staff generally I wish to tender my thanks for loyal support and work done throughout the year.

STATISTICAL. The patients on the register at the end of the year numbered 7,860 (m. 4,357, f. 3,503), or 173 (m. 75, f. 98) more than at the beginning ; and the daily average under treatment during the year was 7,288 (m. 4,093, f. 3,195), or 174 (m. 90, f. 84) more than in the previous year ; while the total under care was 8,796. Patients belonging to the Native race numbered 141 (m. 82, f. 59) at the end of. the year.

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The admissions numbered 1,109 (in. 553, f. 556), or 40 more than in the previous year. Of these, 161 had been previously under care, mating the proportion of readmissions 14-52 per cent., and 948 patients were admitted for the first time. The ratio to population of all admissions (exclusive of Maoris) was 7-07 (m. 7-34, f. 7-20) to 10,000, and of first admissions 6-17 (m. 6-19, f. 6-14), so that 1,388 persons in the general population contributed one patient, and 1,620 contributed a patient admitted for the first time. The discharges (excluding transfers) numbered 471, or 91 more than in 1935. 201 (or 74 more) harmless unrecovered persons were returned to the care of friends ; and 270 (m. 121, f. 149) recovered —17 more than last year —representing a percentage of 24-34 (m. 21-88, f. 26-80) on the total admitted. With voluntary boarders added the percentage rises to 27-34. Altogether, 50-92 per cent, of the inmates admitted were able to leave institutional care. Of a total of 8,796 patients under care, 465 (m. 252, f. 213) died, or 6-38 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 VI, and the following is the percentage of causes mainly contributing : Senile decay, 18-71 ; diseases of the brain and nervous system group, 23-01 ; heart-disease, 19-57 ; tuberculosis, 6-45. In Table VII 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 assignment causations in the table referred to are grouped and shown in their relative proportions :— Males. Females. Total. Heredity .. .. .. .. .. 8-68 6-83 7-76 Congenital .. .. .. .. .. 19-89 12-41 16-14 Predisposed by previous attack .. .. 12-12 18-70 15-42 Critical periods .. .. .. .. 6-87 14-21 10-55 Child-bearing (puerperal, non-septic, and lactation) .. 1-99 0-99 Mental stress .. .. .. .. 18-44 20-32 19-39 Toxic, including — M. p. Syphilis .. .. .. 4-88 1-441 ~ . .. Alcohol 3-61 0-72/ 9 ' 95 3 ' 06 6 " 49 Traumatic .. .. .. .. .. 0-54 .. 0-27 Disorder of nervous system, including— m. f. Epilepsy .. .. .. 2-89 2'52 5-06 3-78 4-42 Other bodily affections .. .. .. 8-50 6-65 7-57 Senility .. .. .. .. .. 9-95 12-05 11-00 100-00 100-00 100-00

Voluntary Boarders.

It will be noted that there were 303 voluntary admissions in the year under review, that 248 were discharged, and that 41 boarders, representing 13-53 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 of resident was 4-72 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 1936 was 360.

12

y par ' First Not First j Total ?„ ra gl'S e i ™ tv , Remaining Year ' : Admission. Admission. ! Admissions. % » e » st . er D,eii - Discharged. on of Patients. 31st 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 39 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 4-3 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 16] 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 32 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 1935 .. ..130 87 217 40 55 95 170 142 312 18 20 38 19 10 29 151 116 267 199 160 359 1936 .. .. 98 99 197 62 44 106 160 143 303 21 20 41 7 10 17 137 111 248 194 162 356

H.—7.

MENTAL NURSES. In December the usual examination was held for the registration of mental nurses, when the following passed :— Passed top for Dominion : M. C. Mcßae (Te Awamutu). Auckland: Nurses —I. Carter,* 0. B. Erlandson, A. D. King, M. E. Noble, E. A. Norris, B. G. Mackie, M. W. MacKay. Papakura: Nurses —K. L. Clotworthy, V. Norton. Te Awamutu: Attendants—J. G. Casey, E. E. Condon, D. Graham, H. E. McAlpine,* J. K. Mills, L. G. Norton,* K. J. P. Quinlan, A. R. Theobald. Nurses —I. E. Bradley, I. G. Dowman, M. C. Mcßae,* J. A. Tylee. Vorirua : Attendants —W. R. Briggs, P. Philip, G. H. Stanbridge, W. S. Thomas, G. Todd. Nurses —M. M. E. Browne, R. A. Connor, M. A. McDonald, R. Morgan. Nelson : Attendants—F. Rogers. Nurses —C. E. Hall, I. M. Hermansen, C. M. MacMillan, C. E. Mac.Rae,* A. J. McMillan,* S. E. Thorn, P. B. Wilkinson. Hokitika : Attendants —J. P. Atkinson, L. F. C. Fleming, W. L. Morresy. Nurses —M. E. C. Hanrahan. Christchurch : Attendants —P. A. Hart, R. J. Masters. Nurses —M. H. Clarke, M. F. Dowling, R. C. Jarvis,* E. M. Logan,* J. C. Mclnroe, E. D. L. H. McKay, M. A. McMahon, E. M. Walker, E. L. Wallis,* M. E. Wylie. Institution Officers, Templeton Farm— I. E. W. Belcher,* E. M. Hughes, C. M. Kennedy, H. J. Stalker. SeaclijJ: Nurses —L. I. Annan, V. Cain, H. M. Cronin, M. E. Pett, T. E. Smith, M. J. E. Strachan, E. M. Whitehead.

* Passed with distinction.

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APPENDIX.

Table I. —Showing the Admissions, Readmissions, Discharges, and Deaths in Mental Hospitals during the Year 1936.

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 1936.

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M. *. T. M. F. T. In mental hospitals, 1st January, 1936 .. .. .. .. 4,282 3,405 7,687 Admitted for the first time .. .. .. .. 483 465 948 \ Kr „ KK „ , , „„ Readmitted 70 91 161 / ōo3 55b J,U)J Total under care during the year .. .. .. 4,835 3,961 8,796 Discharged and died — Recovered .. .. .. . • . ■ .. 121 149 270 Not recovered .. .. .. .. .. 105 96 201 Died .. . . .. .. .. .. 252 213 465 — 478 458 936 (Not including transfers —Males, 107 ; females, 324.) Remaining in mental hospitals, 31st December, 1936 .. .. 4,357 3,503 7,860 Increase over 31st December, 1935 .. .. .. .. 75 98 173 Average number resident during the year .. .. .. .. 4,093 3,195 7,288

Admissions in 1936. tw„i AT „™i In Mental Hospitals ' rotal umber Mental Hospitals, 011 1 1st January, 1936. Admitted for the i Not First Transfers mX Care First Time. Admissions. iransiers. under uire. M. F. T. M. F. T. M. F. T. M. F. T. ■ M. F. T. Auckland .. .. 702 587 1,289 113 129 242 19 21 40 15 6 21 84!) 743 1,592 Kingseat . . .. 248 197 445 .. 1 1 2 62 101 163 311 299 610 Tokanui .. . . 329 283 612 34 33 67 5 4 9 1 3 4 369 323 692 Porirua .. .. 870 680 1,550 128 118 246 23 35 58 8 4 12 1,029 837 1,866 Nelson .. .. 484 206 690 26 29 55 2 2 4 5 150 155 517 387 904 Hokitika .. 228 190 418 7 6 13 2 3 5 3 52 55 240 251 491 Christchurch .. .. 711 700 1,411 110 79 189 13 14 27 8 8 16 842 801 1,643 Seacliff .. .. 697 539 1,236 62 65 127 5 9 14 5 0 5 769 613 1,382 Ashburn Hall (private 13 23 36 3 6 9 0 2 2 .. 16 31 47 mental hospital) — — — Totals .. 4,282 3,405 7,687 483 465 948 70 91 161 107 324 431 4,942 4,285 9,227 Patients discharged, transferred, and died. _ _ _ In Mental Hospitals Mental Hospitals. I j i Tr)t „, on Discharged I Discharged Transferred I Died transferred 31st December, 1936. recovered. J not recovered. ! " an8terre(l . , Died. tranaerred, M. F. T. M. F. T. M. F. T. M. F. T. M. F. T. M. F. T. Auckland .. .. 32 32 64 29 32 61 17 57 74 50 63 113 128 184 312 721 559 1,280 Kingseat .. .. 2 0 2 3 5 8 3 3 6 6 5 11 14 13 27 297 286 583 Tokanui .. .. 16 12 28 12 8 20 4 0 4 10 19 29 42 39 81 327 284 611 Porirua .. .. 32 39 71 24 11 35 61 104 165 73 31 104 190 185 375 839 652 1.491 Nelson .. .. 4 4 8 4 0 4 6 5 11 21 14 35 35 23 58 482 364 846 Hokitika .. .. 5 6 11 3 1 4 2 1 3 9 6 15 19 14 33 221 237 458 Christchurch .. 21 31 52 19 25 44 10 102 112 40 29 69 90 187 277 752 614 1,366 Seacliff .. .. 8 24 32 11 12 23 4 52 56 42 45 87 65 133 198 704 480 1,184 Ashburn Hall (private 112 022 .. 112 246 14 27 41 mental hospital) — Totals .. 121 149 270 105 96 201 107 324 431 252 213 465 585 782 1,367 4,357 3,503 7,860 1™,.™ Wnmhpr Percentages Percentages of ur <- 1 i„ SKri™ of Recoveries on Deaths on Average Mental Hospitals. resident during Admissions Number resident during the Year. during the Year. M. F. T. M. F. T. M. F. T. Auckland .. .. .. •• 649 536 1,185 24-24 21-33 22-70 7-70 11-75 9-54 Kingseat .. .. .. -- 243 200 443 .. 2-47 2-50 2-48 Tokanui .. -- •• 307 260 567 41-03 32-43 36-84 3-26 7-31 5-11 Porirua .. .. -- 835 652 1,487 21-19 25-49 23-35 8-74 4-75 6-99 Nelson .. .. •• 464 241 705 14-28 12-90 13-56 4-53 5-81 4-96 Hokitika .. .. -. - - 220 187 407 55-55 66-66 61-11 4-09 3-21 3-69 Christchurch .. .. .. •• 674 588 1,262 17-07 33-33 24-07 5-93 4-93 5-47 Seacliff .. - - •• •• 687 507 1,194 11-94 32-43 22-69 6-11 8-88 7-29 Ashburn Hall (private mental hospital) .. 14 24 38 33-33 12-50 18-18 7-14 4-17 5-26 Totals.. .. .. •• 4,093 3,195 7,288 21-88 26-80 24-34 6-15 6-66 6-38

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Table III.— Native Countries.

15

Ashburn Hall I Countries. Auckland. Kingseat. Tokanui. Porirua. Nelson. Hokitika. Christchurch. Seaeliff. (Private Mental > Total. Hospital). ! , I | - M. F. T. M. F. T. M. F. T. M. F. T. M. F. T. M. F. T. M. F. T. M. F. T. j M. F. T. M. F. T.\ England and Wales .. 113 76 191 53 50 103 52 38 90 140 88 228 49 34 83 j 29 18 47 60 57 117 63 32 95 : 4 1 5 565 394 959 Scotland . . .. 23 13 36 12 6 18 15 8 23 35 18 53 23 12 35 ! 5 7 12 24 16 40 43 30 73 , 3 2 5 183 112 295 Ireland .. .. 24 17 41 17 19 36 20 15 35 35 22 57 15 7 22 16 11 27 22 19 41 26 22 48 1 0 1 176 132 308 New Zealand.. .. 427 375 802 ! 141 158 299 193 187 380 525 466 991 354 285 639 131 153 284 628 499 1,127 526 368 894 5 22 27 2,930 2,513.5,443 Australian States .. 33 23 56 16 12 28 10 15 25 32 16 48 7 8 15 15 8 23 9 15 24 17 17 34 1 2 3 140 116 256 France .. ..011, .. 101 .. .. •• •• •• 112 Germany .. 101(202 314 156 1 1 2 -1 0 ill 1 2:4 0 4 .. 14 8 22 Austria .. 14 1 15 17 0 7 3 0 3 .. 202 .. .. 101 .. 27 Norway .. ..1 0 1404 202 1 1 2 .. 101 .. .. 9 1 10 Sweden .. .. .. 123 011 202 101 101 101 202 .. 8 3 11 Denmark .. ..101:10 1 213325303101 .. 101 .. 12 3 15 Italy .. .. 2 0 2 0 1 1 1 0 1 2 0 2 0 1 1 4 0 4 ... .. • - 9 2 11 China . . 516)101101415» .. .. .. 10 1 . . 12 2 14 Maoris .. 15 20 35 I 5 0 5 13 13 26 37 22 59 8 2 10 1 1 2 I 3 1 4 .. .. 82 59 141 Other countries 35 18 53 I 16 9 25 11 5 16 22 11 33 7 2 9 4 0 4 4 6 10 6 4 10 .. 105 55 160 Unknown . . .. 25 14 39 ; 21 29 50 .. . . 12 12 24 12 39 51 .. 14 7 21 .. 1 84 101 185 Totals .. | 721 559 1,280 : 297 286 583 327 284 611 839 652 1,491,482 364 846 221 237 458 J 752 614 1,366 704 480 1,184 14 27 41 4,357 3,503 7,860

H,— 7

Table IV.—Ages of Patients on 31st December, 1936.

16

Ages. Auckland. Kingseat. Tokanui. Porirua. Nelson. Hokitlka. Christchurch. Seacliff. (PrivateM?ntal Total. I I Hospital). M. F. T. M. F. T. M. F. T. M. F. T. M. F. T. M. F. T. . M. F. T. M. F. T. M. F T M F F From 1 to 5 years .. .. .. . . .. 10 3 13 . . 9 4 13 3 0 3 ..' 22 7 29 ' 5 „ 10 „ .. 5 3 8.1 .. 0 2 2 0 12 12 ; 22 12 34 0 1 1 35 19 54 5 1 6 .. 67 50 117 „ 10 ,, 15 „ .. 9 5 14 1 0 1 | 6 2 8 6 9 15 46 10 56 0 2 2 88 41 129 12 4 16 .. 168 73 241 „ 15 „ 20 „ .. 25 16 41 5 0 5 8 7 15 25 20 45 j 57 35 92 1 1 2 97 72 169 21 10 31 .. 239 161 400 „ 20 „ 30 „ .. 97 65 162 25 25 50 46 31 77 127 90 217 94 46 140 20 18 38 114 106 220 97 38 135 1 2 3 621 421 1 042 „■ 30 „ 40 „ .. 150 100 250 36 44 80 52 50 102 157 118 275 45 56 101 30 22 52 112 85 197 137 58 195 2 0 2 721 533 1*254 „ 40 „ 50 „ .. 150 139 289 67 57 124 44 62 106 172 163 335 47 64 111 29 52 81 108 77 185 124 101 225 3 4 7 744 719 l'463 „ 50 „ 60 „ .. 138 131 269 75 85 160 j 76 58 134 180 118 298 56 70 126 67 70 137 107 99 206 145 118 263 1 12 13 845 761 l'606 ,, 60 ,, 70 „ .. 75 64 139 64 48 112 j 66 48 114 119 70 189 58 45 103 50 46 96 52 64 116 99 80 179 3 3 6 586 468 l'o54 „ 70 „ 80 „ .. 38 20 58 18 15 33 24 17 41 40 41 81 34 17 51 19 20 39 22 39 61 47 53 100 3 5 8 245 227 '472 „ 80 „ 90 „ .. 9 4 13 3 2 5 3 4 7 12 9 21 4 5 9 2 1 3 7 8 15 12 13 25 1 1 2 53 47 100 Upwards of 90 „..2 0 2 1 0 1 .. 022 .. .. 10121 3 639 Unknown .. 23 12 35 2 10 12 2 3 5 1 0 1 9 1 10 3 4 7 .. 0 3 3 !! 40 33 73 Totals .. 721 559 1,280 297 286 583 327 284 611 839 652 1,491 482 364 846 221 237 458 752 614 1,366 704 480 1,184 14 27 41 4,357 3,503 7,860 I I 9 9 9

11. 7

Table V.—Length of Residence of Patients discharged "Recovered" during 1936.

3—H. 7

17

j Ash burn Hall. Length of Residence. Auckland. Kingseat. Tokanui. j Porirua. I Nelson. Hokitika. Christchurch. I Seacliff. | (Private Mental Total. I ! j I Hospital.) M. F. T. M. F. T. M. F. T. M. F. T. M. F. T. M. F. T. M. F. T. M. F. T. M. F. T. M. F. T. Under 1 month ..213 .. .. .. .. .. .. .. .. 213 From 1 to 3 months .. 437 .. Oil Oi l .. 202 83 11 022 Oil 14 11 25 „ 3 „ 6 „ .. 358 .. 213 325 112 Oil 4 4 8 101 101 15 14 29 „ 6 „ 9 „ .. 347 .. 415 56 11 022 Oil 2 2 4 347 .. 17 20 37 9 „ 12 .. 7 4 11 .. 4 0 4 10 8 18 .. 0 3 3 Oil 2 9 11 .. 23 25 48 1 „ 2 years .. 4 9 13 .. 2 6 8 7 14 21 Oil 1 0 1 4 14 18 1 5 6 .. 19 49 68 „2 „ 3 „ .. 527 202 213 257 .. 101 235 022 .. 14 13 27 „ 3 „ 5 „ .. Oil .. 101 426 101 101 145 .. .. 8 7 15 ,! 5 ,, 7 „ .. 404! .. 022 112 202 Oil .. 112 .. 8 5 13 7 „ 10 „ ..0 3 3; .. 101 . . . . .. .. .. .. 134 „ 10 „ 12 „ „ 12 „ 15 „ Over 15 years .. .. .. .. .. .. .. .. .. Oil .. Oil Totals .. .. j 32 32 64 2 0 2 16 12 28 32 39 71 4 4 8 5 6 11 21 31 52 8 24 32 1 1 2 121 149 270

H.—7.

Table VI.— Causes of Death, 1936.

18

■3 ■a « S ffl āi Causes - I 1 I ā § I I a Isl 1 I I ! ! 1 ! 1 ||M 1 -"J W H PM | H 6 H I. —General Diseases. Tuberculosis — m. e. m. E. m. p. m. e. m. e. m. p. m. e. m. e. m. e. m. e. General .. .. .. ..01 .. .. 10 .. .. .. .. 11 Of lungs .. .. .. ..43 10222002 .. 2250 .. 16 9 Of intestines .. .. .. .. .. .. 01 .. .. .. .. .. 01 Of Bone .. .. .. ..10 . .. .. .. .. .. .. .. 10 Of Kidneys .. .. .. .. .. .. .. .. .. 10 .. .. 10 Cancer .. .. .. .. | 0 1 1 00 2 1 1 0 2 .. 21 31 .. 78 Toxaemia .. .. .. .. | .. .. 12 .. .. .. 10 .. 22 Furunculosis .. .. . . 0 1 .. .. .. .. .. .. .. 01 Diabetes .. .. .. ..!.. .. .. 10 .. .. 10 .. 1030 Asthenia .. .. .. .. .. .. .. .. 20 .. .. .. .. 20 Typhoid .. .. .. ..01 .. .. .. .. .. 03 .. 04 Septic pharyngitis .. .. ..01 .. .. .. .. .. .. .. 01 Pernicious anaemia .. .. .. .. 11 .. 10 .. .. 01 .. .. 22 Pityriasis rubra . . . . .. .. . . .. .. .. .. 10 .. .. 10 Congenital syphilis .. .. .. .. .. .. .. .. .. .. 20 .. 20 II. Diseases oe the Nervous System. Mania, exhaustion from .. ■ .. .. . 01 .. 0 1 .. 10 .. .. 12 Melancholia, exhaustion from ..02 .. .. 2 0 0 1 0 1 2 0 0 1 .. 45 Confusional insanity, exhaustion from .. j .. .. ..11 ., .. .. 01 .. 12 General paralysis of the insane ..31 .. 01 16 0 10 .. 2020 .. 24 2 Epilepsy .. .. .. ..3 0 . . .. 3 2 3 1 0 1 4 1 3 5 . . 16 10 Cerebral haemorrhage .. ..0231018121 .. 0303 .. 13 12 Cerebral thrombosis .. .. .. 0 11 .. .. .. .. .. .. 11 .. 1 12 Cerebral tumour .. .. .. .. .. .. j .. .. 01 .. .. 01 Meningitis .. .. .. .. .. .. 1 0 .. .. .. .. ..10 III. Diseases oe the Respiratory System. I Pneumonia .. .. ..3 1 . . 3 1 0 4 0 1 .. 4 3 .. 0 1 10 if ~ Broncho-pneumonia .. .. ..0401 0131 11 .. .. 11 .. 59 Pneumoconiosis .. .. ..10 .. .. .. .. .. .. .. .. 10 Pulmonary: Embolism .. ..01 .. .. .. .. 01 .. .. 02 Bronchitis .. .. .. .. .. .. .. 01 .. .. .. .. .. 01 IV. Diseases oe the Circulatory System. Heart-disease .. .. 15 10 01 16 88 41 52 2 10 5 13 .. 40 51 Arterio-sclerosis .. .. ..32 0140 .. .. 405 1 .. 16 4 Anaemia .. .. .. ..02 . .. .. .. 10 .. .. .. 12 Cononary thrombosis .. .. .. .. .. 20 .. .. .. .. .. 20 Aneurysm .. .. .. .. .. . . .. .. ,. .. 10 .. .. 10 V. Diseases oe the Digestive System. Intestinal obstruction .. .. .. .. .. .. .. .. 10 .. 10 Bacillary dysentery .. .. ..58 .. .. .. .. .. .. .. , 58 Cholecystilis .. .. ..01 .. .. .. .. .. .. .. 01 Chronic colitis .. .. .. .. .. .. 11 01 .. .. 12 Gastric ulcer .. .. .. .. .. .. .. .. 01 .. .. 01 VI. Diseases oe the Genito-urinary System. Nephritis .. .. .. ..10 . .. 20 .. .. .. .. .. 30 Uraemia .. .. .. ..10 .. .. 10 .. .. .. .. .. 20 VII. Old Age. Senile decay .. .. ..7 6 . . 2 3 12 4 6 2 3 1 11 5 11 14 .. 52 35 VIII. External Causes. Asphyxia .. .. .. ..01 .. .. .. .. .. 10 .. .. 11 Fracture of base of skull .. .. .. .. .. 10 .. .. .. .. .. 10 Fracture of spine .. .. .. .. .. .. 01 .. .. .. .. .. 01 Suicide .. .. .. .. .. .. .. 03 .. .. .. 10 .. 13 Died while on Trial .. ..33011041 .. .. 1011 .. 10 6 Totals .. .. ... 50 63 6 5 10 19 73 31 21 14 9 6 40 29 42 45 1 1 252 213

H.—7.

Table VII.—Principal assigned Causes of Insanity, 1936.

4—H. 7.

19

-*'c3 •§ rrs t -? . Jjj H Causes. S s '3 a . jj ,c . s^s B«S ■S a 3 I £ S I =3 al° -3 n ° o ® O _rj «3 >5 £ M -£ <_ * a § $ g M. F. M. F. M. F. M. F. M. F. M. F. M. F. M. F. M. F M F Alcohol .. ..81 .. .. 50 .. 0 1 41 30 .. 20 3 Arterio-sclerosis ..9 9 .. .. 17 3 .. .. 3 1 2 5 0 1 31 19 Climacteric .. 0 10 . 0602 .. .. 0804 0 30 Congenital .. .. 24 9 .. 7 2 15 14 8 8 .. 41 22 13 10 0 1 108 76 Constitutional ..01 .. .. 22 .. .. .. .. 23 Drug Addiction ..01 .. .. .. .. .. .. _ _ 01 Encephalitis .. .. .. .. 10 .. .. .. 10 20 Epilepsy .. ..31 .. 113144 .. 3 1 16 10 16 14 Heredity .. 8 16 .. 31 44 44 20 17 9 92 12 48 38 Ill-health .. ..25 .. 306 12 .. 1030 11 .. 16 18 Involution .. 9 19 .. 0 1 0 4 2 5 .. 2 0 1 0 .. 14 29 Mental stress .. 24 27 .. 12 11 42 49 5 2 1 3 16 10 2 10 0 1 102 113 Organic brain disease ..03 .. 326001 .. 11 .. 10 7 Previous attack 19 21 1 1 4 4 26 43 0 1 4 3 5 11 8 17 0 3 67 104 Puberty or adolescence 02 .. 11 2642 1087 82 .. 24 20 Puerperal .. ..02 .. 030401 .. 01 .. .. 0 11 Senility .. .. 14 17 .. 4 5 12 8 1 2 0 1 9 19 15 15 !! 55 67 Syphilis .. ..94 .. 10 10 001 .. 51 12 10 27 8 Toxic .. ..12 .. .. 01 .. 015120 .. 85 Traumatic .. ..20 .. .. .. .. .. 10 .. .. 30 Transfers .. 15 6 62 101 1 3 8 4 5 150 3 52 8 8 5 0 .. 107 324 Totals .. 147 156 63 102 40 40 159 157 33 181 12 61 131 101 72 74 3 8 660 880

H.—7.

Table VIII.— Showing the Admissions, Discharges, and Deaths, with the Mean Annual Mortality and Proportion of Recoveries per Cent. or the Admissions, for each Year since 1st January, 1876.

20

j I Discharged. Remaining, w„ m h»r<, Percentage Percentage oi Deaths ! — 1 «ve, AV « b - 0-—.- '"^ 19 : 1 M F. T. M. F. T. M. F. T. M. F. ī. M. F. T. M. F. T. M. F. T. M. F. j T. M. F. 1875 482 254 736 j „ 1876 !! 221 il7 338 129 79 208 17 8 25 2 8 10 36 12 48 519 264 783 491 257 748 54-53 66-01 37-56 8-21 3-58 6-70 1877 .. 250 112 362 123 57 180 20 5 25 3 2 5 42 21 63 581 291 872 541 277[ 818 49-20 50-80: 49-72 7-76 7-58 7-70 1878 .. 247 131 378 121 68 189 14 14 28 4 4 8 51 17 68 638 319 957 601 303 904 48-98 51 -90 50-00 8-48 5-61 7-52 1879 248 151 399 112 76 188 15 13 28 9 4 13 55 16 71 695 361 1,056 666 337 1,003 45-16 47-11 8-25 4-74 7-07 1880 .. 229 149 378 100 67 167 36 25 61 5 2 7 54 20 74 729 396 1,125 703 371 1,074 43-66 44-96, 44-17 7-68 5-39 6-89 1881 .. 232 127 359 93 65 158 41 36 77 9 2 11 49 14 63 769 406 1,175 747 388 1,135 40-08| 51 -10, 44-01 6-29 3-60 5-55 1882 .. 267 152 419 95 59 154 49 32 81 5 6 11 60 19 79 827 442 1,269 796 421 1,217 35-58; 38-81; 36-75 7-53 4-51 6-49 1883 .. 255 166 421 102 78 180 13 20 33 10 9 19 65 18 83 892 483 1,375 860 475 1,335 40-00| 46-98: 42-75 7-55 3-78 6-21 1884 .. 238 153 391 89 77 166 17 9 26 18 12 30 68 24 92 938 514 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 1,009 604 1,613 984 559 1,543 47-82 36-36 : 42-74 5-79 3-39 4-91 1887 .. 255 161 416 103 78 181 34 17 51 74 27 101 1,053 643 1,696 1,034 613 1,647 40-39 48-75 43-61 7-15 4-40 6-13 1888 .. 215 146 361 116 92 208 31 28 59 2 3 5 78 26 104 1,041 640 1,681 1,045 641 1,686 53-95 63-01 57-62 7-56 4-05 6-16 1889 .. 230 161 391 93 53 146 31 30 61 3 1 4 70 30 100 1,074 687 1,761 1,046 660; 1,707 40-43 32-92 37-34 6-69 4-54 5-86 1890 .. 230 160 390 98 88 186 23 17 40 12 5 17 76 35 111 1,095 702 1,797 1,078 685 1,763! 42-61 55-00,47-69 7-05 5-11 6-29 1891 .. 234 171 405 88 74 162 33 24 57 14 ! 14 79 41 120 1,115 734 1,849 1,089 699 1,789 37-61 43-27 40-00 7-25 5-86 6-71 1892 .. 231 158 389 89 76 165 21 17 38 8 2 10 74 34 108 1,154 763 1,917 1,125 714 1,839 38-53 48-10 ( 42-42 6-58 4-76 5-87 1893 .. 281 179 460 101 89 190 17 12 29 10 8 18 78 23 101 1,229 810 2,039 1,172 758 1,930 35-94 49-72 41-30 6-66 3-03 5-23 1894 .. 270 176 446 107 76 183 15 11 26 5 4 9 64 35 . 99 1,308 860 2,168 1,241 812 2,053 39-63 43-13, 41-03 5-16 4-31 4-82 1895 .. 252 165 417 105 77 182 24 19 43 1 2 3 101 42 143 1,329 885 2,214 1,313 849 2,162 41-67 46-66 43-64 7-69 4-94 6-61 1896 .. 278 159 437 104 70 174 25 16 41 2 1 3 86 32 118 1,390 925 2,315 1,347 882 2,229 37-41 44-02 39-13 6-38 3-63 5-29 1897 .. 284 193 477 102 73 175 17 12 29 10 10 105 43 148 1,440 990 2,430 1,411 944 2,355 35-92 37-82 36-69 7-44 4-55 6-28 1898 .. 254 212 466 114 110 224 13 23 36 7 1 8 88 60 148 1,472 1,008 2,480' 1,438 973 2,411 44-88 51-89 48-07 6-12 6-17 6-14 1899 .. 259 199 458 88 99 187 15 19 34 2 1 3 114 43 157 1,512 1,045 2,557 1,487 1,004 2,491 33-98 49-49 40-83 7-67 4-28 6-30 1900 .. 300 202 502 103 96 199 29 10 39 4 4 99 46 145 1,581 1,091 2,672 1,534 1,049 2,583 34-33, 47-54, 39-64 6-45 4-38 5-61 1901 ,, 320 223 543 125 104 229 20 17 37 2 2 102 72 174 1 T 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 1,265 3,088 39-75 47-73 42-94 8-01 6-71 7-48 1907 .. 359 241 600 160 139 299 22 13 35 168 64 232 1,909 1,331 3,240 1,851 1,285 3,136 44-29 57-68 49-84 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 15 209 80 289 2,555j 1,820 4,375 2,483 1,768: 4,251 30-89 47-37 37-66 8-42 4-52 6-80

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Bibliographic details

H-07 MENTAL HOSPITALS OF THE DOMINION. (REPORT ON) FOR 1936., Appendix to the Journals of the House of Representatives, 1 January 1937

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H-07 MENTAL HOSPITALS OF THE DOMINION. (REPORT ON) FOR 1936. Appendix to the Journals of the House of Representatives, 1 January 1937

Working