MENTAL HOSPITALS OF THE DOMINION (REPORT ON) FOR 1937.

Appendix to the Journals of the House of Representatives, 1938 Session I, H-07

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1938. NEW ZEA L A N I).

MENTAL HOSPITALS OF THE DOMINION (REPORT ON) FOR 1937.

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. Fraser, Minister in Charge of the Department of Mental Hospitals. Sir, —• Wellington, Ist June, 1938. I have the honour to present my annual report upon the work of the Department of Mental Hospitals for the year ended 31st December, 1937. There were 8,234 names of persons upon the registers at the end of the year, including 46 patients and boarders at Ashburn Hall, which is the only licensed institution in the Dominion, and 638 patients and boarders who were on probation in the care of friends and relatives. In actual residence in State hospitals there were 7,552 persons, an increase of 13 over the previous year, and of this number 7,242 were the subject of a reception order, whilst 310 were voluntary boarders. There was a decrease of 22 in the number of patients and boarders admitted for the first time, the relative figures being 1,123 for this year and 1,145 for last year, and 304 former inmates returned to the hospitals. We were able to discharge 875 patients and boarders, or 61-32 per cent, calculated upon the admissions, but not more than 502, or 35-18 per cent., could be regarded as recovered. Having regard to the large number of those admitted whose mental disorder is due to congenital causes, to the degenerative changes of old age, and to incurable organic disease of the nervous system, the percentage of discharges must be regarded as satisfactory. Accommodation. The position in regard to accommodation and the distribution of patients is shown in the following table compiled in March, 1938

The net deficiency of accommodation is 569, as compared with 514 last year, but the difference is accounted for by the necessity which occurred during the year to evacuate part of the female side at Seacliff, with accommodation for 65 women, as the buildings had become unsafe, due to the unstable ground. In discussing the matter of accommodation it is necessary to bear in mind that this does not consist merely of the quarters which the patients occupy in the daytime and those in which they sleep and dine. Simultaneously with or preferably ahead of the erection of these quarters, provision has to be made for the proportionate Nurses' Homes, stores and other administrative needs, laundries, medical staff, &c., and during the past year we have carried out a large programme with a view to entirely wiping out the deficiency of accommodation at an early date.

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a 0 j Number Number T ... Accommo- Patients and , ,, .. . c , . rfosp.tal. d ion> Boarders on „ ,°" actually Deficiency. Surplus. Registers Probation. .Resident. I [ Auckland .. 1.205 1,408 125 1,283 78 Kingseat .. 620 591 5 586 .. 34 Tokanui .. 633 676 25 651 18 Porirua .. 1,284 1,620 101 . 1,519 235 Nelson .. 820 842 42 800 .. 20 Hokitika .. 471 460 7 453 .. 18 Christchurch .. 1,188 1,453 134 1,319 131 Seacliff .. 956 1,161 26 1,135 179 Totals .. 7,177 8,211 465 7,746 641 72

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Additions, Alterations, and Improvements. Capital expenditure incurred upon new buildings, additions, and improvements during the year amounted to £102,457 13s. 7d., and the following summary shows the major items making up the total: — Auckland (£5,657). Considerable additions were made to the Nurses' Home to provide for the increased staff necessitated by the shortened hours. Cold-storage accommodation, which is very necessary in this climate, was installed. The laundry equipment was brought up to date. Kingseat (£52,144). The butchery, bakery, boiler-house, and laundry were completed, and the equipment will be installed very soon. The central hospital block is nearing completion, after which Kingseat will be able to take direct admissions. Four new villas have been erected and occupied, and another one is about to be commenced. The Medical Superintendent's residence and that of the Engineer are well under way, and the preliminary drawings for the Nurses' Home and workshops are being done. Tokanui (£2,855). A considerable amount of minor alterations to sanitary annexes was involved in the change over of the male side to the female, and vice versa, but the change has been of great advantage. The addition of a large veranda to a ward on the female side has provided a good admission block. A cottage has been provided for an Assistant Medical Officer. A new mortuary has been erected. Porirua (£20,501). There are many problems to solve at Porirua, and these are mainly dependent upon each other. A considerable step was achieved towards their solution by the completion of the new store, and a further stage will be reached when the boiler-house and workshops block, now being erected, are completed. Nelson and Ngawhatu (£2,234.) The roads leading to the villas at Yorks Valley and the main road have all been tar-sealed. Considerable improvements have been made to the water-supply available for fire-fighting purposes. A commencement has been made with the new Nurses' Home at Ngawhatu, and drawings are in hand for three new villas. Hokitika (£2,096). Major alterations have been made at Aorangi Villa, and repairs carried out in connection with the damage from a fire at Kiwi Ward. New piggeries have been erected. Ghristchurch (£6,061). Extensive additions have been carried out in connection with the fire-alarm system. Additional conveniences have been installed in the sanitary annexes. The main drives have been tar-sealed, and new poultry-house provided. Templeton Farm Colony (£10,335). The new laundry and boiler-house have been erected, and will be equipped as soon as the machinery comes to hand. Seacliff (£570). Milking-machines were installed at the byres. A kitchenette was erected at D Ward. The old chimney-stack and several portions of old buildings were demolished. Programme for Current Year. Auckland.—Our experience of decentralized cooking at the villa mental hospitals has been so favourable that we have decided to follow so far as possible the same principle at the older institutions. To this end we are constructing kitchens in female wards 7 and 2 and in male 3 ward. Female ward 7, with very little additional alteration, will form a very excellent admission ward. Kingseat.—The erection of the Nurses' Home will be commenced during the year, and its completion will help to free a number of rooms in the villas for occupation by patients. The hospital admission villa is nearing completion. Plans are being prepared for another villa. It is intended as soon as possible to erect two single-storied villas for aged and infirm patients. Porirua. —The new store is in occupation, and the boiler-house - workshop block is approaching completion. The next stage in the large programme at Porirua will be the rebuilding of the front block at the institution to provide adequate visiting-rooms, administrative offices, and possibly staff dining-rooms.

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Bound up in these alterations is the matter of enlarging the entertainment-hall and improving the facilities for the cooking and serving of meals. In this connection plans are well forward for the erection of several small kitchens to serve separate groups of wards, thus following so far as may be possible the system which we have found so advantageous in the villa hospitals. All these changes take time, and one part of the programme has to await until another has been completed, but each year sees marked progress. Nelson- The new Nurses' Home has been started, and should be in occupation early in 1939. Hokitika.—lt is hoped to erect two new villas during the year. Christchvrch.— The results of the occupational classes have been most encouraging, and a separate block for this work will be erected at an early date. Seacilff.— It is proposed to make several improvements to the buildings, both at SeaclifE and Waitati. Proposed New Mental Hospital. Towards the close of the year a property was acquired in the Marton area for the purpose of establishing a new mental hospital which will serve the needs of the northern part of the Wellington Province and Taranaki and so relieve the pressure upon the accommodation at Porirua. The estate is approximately 541 acres in extent, is well watered, has a good northern aspect, and is generally well adapted to the erection of a new institution on the villa system. It is situated about midway between Bulls and Marton, and is sufficiently secluded, but has a good access to the main north, road to Taranaki. In the meantime the contours are being prepared and other necessary preliminary work is being carried out. Insulin Treatment. Considerable interest has been aroused during the year by well-accredited reports upon the treatment of schizophrenia by repeated doses of insulin. As schizophrenia is the form of mental disorder which accounts for about 16 per cent, of our admissions and is the psychosis from which at least 60 per cent, of our chronic mental patients were suffering upon admission, any well-authenticated reports as to treatment and cure demand serious investigation. Unfortunately, some of the accounts of the treatment which have appeared in the lay press have not come from authoritative or well-informed sources, and have given rise to hopes which cannot be realized, and must cause disappointment. Briefly stated, the treatment consists of the injection of insulin in increasing doses until the patient goe§ into a state of deep coma. The " shock dose," once ascertained, is given almost daily for about two months. The treatment is not without its dangers, and the patient requires constant and immediate medical and nursing supervision. It is evident that a considerable amount of improvement occurs in many cases during the course of treatment, but it would be altogether premature at this stage to regard the results as being permanent or to refer to them as " cures." It is in the early cases that the treatment appears to produce results, but it is also in those early cases that remission of symptoms not infrequently occurs, even without insulin treatment. The real test of the treatment is the premanency of the result, and that cannot yet be determined. Occupational Therapy. During the year a considerable extension has been achieved in the organization of occupational classes, and I hope the day is not far distant when every patient will have some form of occupation, however elementary its nature. Many wards in institutions overseas have lost their title to the term " refractory " through the introduction of the patients to the pleasure of doing arts and handicrafts, and the effect is very striking. On the other hand, our farms and gardens are much more extensive than those attached to British hospitals, and our patients engage in larger numbers in outside work, but there are still many patients whose mental or physical state renders such occupations impossible or undesirable, and for these the classes provide a valuable outlet for their energies. Occupational therapy is being already carried out in the following hospitals to the extent indicated :— Auckland. —Mrs. Ohms and Mrs. Morrison hold classes for poker-work and brass beating once weekly during the winter. Mrs Wigg teaches weaving and spinning weekly during the winter. Miss Johnson conducts classes for fancy dancing. I was present at an exhibition held at the hospital of the products of these classes, and was very pleased with the really high standard achieved. Kingseat.—Mrs Waugh has held classes in arts and handicraft, and many useful articles have been made. Porirua.—We have a paid instructor on the male side, who teaches basket and cane work, and a lady instructress for weaving. Hokitika. —One of the charge nurses has undertaken the work here, which is mainly fancywork, rugs, baskets, and trays. Arrangements are in hand to train other nurses. Christchurch. — Miss Bowron has made an excellent start with a wide variety of handicrafts, and I have had some most encouraging reports upon individual cases benefited. It is intended to erect a special block at Sunnyside for occupational work. Several nurses are being trained so as to carry the work into the wards to certain patients who cannot in the meantime attend the classes.

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Templeton. —We have a full-time instructor, who teaches the boys upholstery and carpentry and the making of canvas covers for stock. Seacliff. —Miss Miller conducts classes twice a week, and the work includes macrame-twine work, cane-work, suede-work, and pewter-work. It is proposed to include weaving in the near future, and I hope at no distant date that we may provide special accommodation for this work. Several of the ladies mentioned are giving their services free of all cost to the Department, and I desire to record my sincere appreciation of the valuable help they are giving to the patients and to the Department. Honours. Amongst the Coronation honours, two of our matrons, Miss Miriam Mayze, of Auckland, and Miss McLaren, of Seacliff, were decorated with the M.8.E., and this recognition of the Department and of two officers who have given long and faithful service gave considerable pleasure and satisfaction to us all. Promotions. Dr. Malcolm Brown was appointed Medical Superintendent at Seacliff, to succeed the late Dr. Hayes. Dr. Brown has served the Department well for ten years, and his promotion has been well earned. Drs. Hay, Macky, Lewis, and BelJringer have all been promoted to the newly created positions of Deputy Medical Superintendents. The Late Dr. H. D. Hayes. It is with the deepest regret that I have to record the death, on 31st October, 1937, of Dr. Henry Douglas Hayes, Medical Superintendent of Seacliff Mental Hospital. Dr. Hayes joined our Department in 1928, bringing with him from his former colleagues in the London County and Maudsley Hospitals a very high reputation for his personal and professional qualifications, and during his ten years of service with us he enhanced that reputation with all his colleagues, who came to regard him with respect and affection. Hayes was the soul of honour —a .man whose work was inspired by an unswerving loyalty to the highest and worthiest ideals of his profession. His untimely death was a great loss to the Department and a source of sincere sorrow to those of us who were privileged to enjoy his friendship. Appreciation. In conclusion, it is a pleasure to acknowledge the loyalty and support which I can always count upon receiving from, my colleagues, Dr. John Russell and all the Medical Superintendents. I have an excellent staff at Head Office, and to Mr. Sinclair, Chief Clerk, and all the other officers I give my thanks" for good 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, 1937. The total number of cases under care during the year was 1,582, with a weekly average of 1,179. The admissions numbered 302 (138 males, 164 females). Of this number, 245 were admitted for the first time. Under section Bof the Mental Defectives Amendment Act, 200 patients were admitted. Seventy-seven voluntary boarders were admitted during the year, making a total of 186 under care, and, of these, 92 were discharged. At the end of the year 173 patients were on probation, 135 on full parole, and 196 on limited parole. Deaths totalled 100 (54 males, 46 females). In general the health of the patients has been good throughout the past year. Fortunately, there has not been a recrudescence of a dysentry epidemic as in last year, though sporadic cases still arise. Routine maintenance has been kept up well, and several new works have been carried out. the most important of which are — (1) Completion of new cool store in the main kitchen. (2) Additions to the Nurses' Home to provide quarters for the increase in staff necessitated by the new hours of working. These include substantial extensions to the existing day- and dining-rooms, the building of a room for the charge nurses, improvements to the kitchen, and accommodation for the Sister in charge of the Home. (3) Glassing-in of the veranda attached to Ward F. 6. This provides a sun-porch and weather protection for the old ladies who dwell there. (4) Erection of a new poultry-house. (5) Building a new dutch barn in place of the one which was destroyed by fire. We, like all other hospitals, have suffered from under-staffing of the female personnel. It is difficult to get to the root of this trouble and to remedy the situation. The result has been that overtime has, of necessity, been worked by many members of the staff. It is a matter of congratulation that we have a loyal team who have gamely accepted the extra responsibility entailed and faced the unfortunate position in an uncomplaining manner.

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We are gradually extending the scheme whereby as many wards as possible will be provided with their own kitchens. So far this system is a great success, in that better and more varied menus are provided for the patients concerned. The social interests of the patients have been well and generously catered for bv outside organizations. The Mental Hospital Branch of the Auckland Hospital Auxiliary has been of the greatest assistance. It provides a monthly sum of money for the Recreation Fund, and also donated a substantial bonus for the purchase of Christmas extras. Station IZB supplied fifteen loud-speakers and 150 sets of head-phones, which were installed throughout the main building. The Returned Soldiers' Association installed sets in the other wards, and also gave us, on perpetual loan, the use of a public-address outfit. This latter has proved a great boon, especially at entertainments in the main hall. Weaving and wood-working classes have been held during the year by Mesdames Wigg and Ohms. These arts have stimulated great interest among the patients, and remarkably fine results have been, obtained. Many of the finished articles were sold at a fair which Matron, with the help of many willing friends, conducted towards the end of the year. In spite of inclement Weather, this bazaar was well attended, and resulted in the sum of £72 being added to the patients' Recreation Fund. Mr. Neville Carlsen has continued to provide periodic concert parties during the year. To all those persons and organizations mentioned, and to many others not mentioned, I feel I owe a very deep debt of gratitude for the help given. The annual picnic established itself, among the patients, with the usual reputation of being " the best held yet." Dr. Macky and myself have paid monthly visits to the Inebriates Homes on Rotoroa and Pakatoa Islands in company with Mr. F. K. Hunt, S.M. I append figures relative to the psychiatric clinics held by Dr. Hunter and myself at the Auckland Public Hospital. The figures actually are an understatement, due to the fact that my clinical notes covering a certain period were stolen and destroyed when my car was stolen :— Tuesdays. Thursdays Total. (Dr. Hunter). (1) Number of separate persons seen .. M. 290 58 348 F. 25 20 45 315 78 393 (2) Number of— (a) First visits .. .. .. .. 275 78 353 (b) Subsequent consultations .. .. 487 302 789 762 380 1,142 (3) Sources of reference — Tuesdays. Thursdays. Pensions Department .. .. .. 254 55 309 Medical practitioners . . . . 27 19 46 Voluntary calls . . . . . . 13 3 16 Prisons Department .. .. 14 1 15 Nelson Mental Hospital . . .. 1 .. 1 Seacliff Mental Hospital . . . . 1 .. 1 Police Department .. .. 2 .. 2 Minister of Crown .. .. 1 .. 1 Salvation Army .. .. .. 1 .. 1 Public Trustee .. .. .. 1 .. 1 315 78 393 During the year our Matron, Miss Mayze, received from His Majesty the decoration of M.B.E. This recognition of long and meritorious service was extremely popular with staff and patients, and I desire to put on record my own congratulations and my appreciation of the honour conferred upon a most worthy officer. In concluding, I must express my gratitude to the medical officers, matron, head attendant, clerk, and all other members of the staff for the help and encouragement given me during the year.

KINGSEAT MENTAL HOSPITAL. Dr. Hunter reports : — I have the honour to submit my annual report for the year ended 31st December, 1937. The total number of patients under care during the year was 605 (310 males and 295 females), with a weekly average of -576. Patients admitted by transfer were 22 (13 males and 9 females). Transfers to other hospitals numbered 5 (2 males and 3 females). There were 5 patients (3 males and 2 females) discharged, and there were 11 deaths (8 males and 3 females). Voluntary boarders numbered 6 (3 males and 3 females) throughout the year, there being no admissions, discharges, or deaths.

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The general health of the patients and staff has been excellent, there being little serious sickness. The patients' deaths occurred among mostly the elderly patients. During December, 1936, the erection of the new laundry, Engineer's block, fuel-store butchery, and bakery was commenced, and has now been completed.' The installation of the necessary machinery is in progress, but the non-arrival of the boilers and other equipment will prevent until late m 1938 the full benefit being obtained from this modern and up-to-date equipment. The new laundry will be greatly appreciated as the amount of laundry-work required with the growing hospital has outgrown the capacity of the old one. Early in September, 1937, the erection of the admission and hospital block was commenced and good progress has been made up to the end of the year. This villa is situated on a slight overlooking the recreation-ground, with a sunny and bright outlook. The completion and equipment of this building will allow of the hospital functioning as a complete unit, enabling the direct admission of patients. The amenities of the new unit, coupled with the advantages of the modern villa system with its homelike atmosphere, and the freedom from irksome restraint should, do much towards the successful treatment of our nervous and mental sick. The opening of the new unit and the increasing number of patients, will necessitate the appointment of an Assistant Medical Officer. The villa system type of mental hospital has been commented upon favourably from overseas. The Victorian Government, Australia, which is remodelling its -mental-hospitals system, sent two representatives, the Hon. Mr. Bailey, Minister in Charge of Mental Hospitals of Victoria, and Dr. Catarinich, Director of Mental Hospitals for Victoria, to inspect and investigate the villa system as carried out at Kingseat, and they were impressed with the possibilities, remarking on the absence of the so-called " mental hospitals " atmosphere. The Hon. P. Fraser, Minister in Charge of Mental Hospitals, visited the hospital in July, and the two Public Service Commissioners visited in June with regard to staffing problems. A contract lias been let for the erection of a residence for the Engineer, and it is anticipated that this work will be commenced early in the New Year. A temporary internal telephone system was installed early in the year, but, with the completion of the new unit and the building of further new villas, an automatic system is required. The authority for this has been granted, but the necessary equipment has not come to hand as yet. The canteen and library, which has been reorganized and centralized, is proving a popular and much appreciated amenity by both patients and staff. During the year clubs for tennis, cricket, rugby football, and basketball have been established, and all members of the hospital are eligible to play in these teams. Numerous enjoyable and friendly games have been played with visiting teams. All sports fixtures are arranged by invitation, thus fostering the spirit of the game rather than the result. The bowling-green, which is in the course of construction, will provide another avenue of recreation for all. One of _ our most urgent needs is a recreation hall with cinema facilities, as the weekly d-ances require three rooms of a villa, causing much inconvenience and congestion, at the same time limiting the number who can attend. The erection of the Nurses' Home will give extra attendant-staff accommodation, by releasing the staff quarters in the male villas ; but extra accommodation will be required for artisans engaged at the engine-room, &c. the growth of the hospital and the increasing amount of maintenance-work required, the erection of workshops and the appointment of the necessary artisan staff is becoming increasingly urgent. During the year, painting of the downstairs rooms in Villas 1, 2, 3, and 4 has been completed, also the painting of farm buildings and the metal fire-escapes has been carried out. A weekly handicraft class conducted by Mrs. Waugh, under the auspices of the Auckland Women s Auxiliary, Mental Hospitals Branch, has been instituted, and affords a welcome change from hospital routine. The appointment of an extra matron and head attendant, both Class " C," and a tutor sister should do much to help and ecnourage our nursing staff, at the same time making the work more instructive and interesting. The patients on the whole are happy and contented, and appreciative of the extra privileges, to which they are reacting satisfactorily. They are fully occupied with constructive work on the farm, in the grounds, gardening, laundry, and sewing, and their amusements have not been neglected. A weekly clinic is conducted at the Auckland Public Hospital, where 78 new cases were treated, while there were 380 attendances. The new cases were referred by- Pensions, 55; hospital, 3 ; Prisons, 1 ; and medical practitioners, 19. I am most grateful to those who have helped to provide entertainment, and for the gifts of reading-material; to the several local branches of the Returned Soldiers' Association ° for looking after the ex-soldier patients ; the Pukekohe Returned Soldiers and their assistants for concerts and entertainments; the Women's Division of the Farmers' Union and the women's institutes for their interest in the activities of the hospital; the Auckland Women's Auxiliary for regular donations for the benefit of the patients ; and the members of the clergy who have conducted church services throughout the year. Finally, ] wish to thank Mr. Tibbie and his staff, matron, head attendant, and all members of the staff for their very helpful and encouraging services for the benefit of the patients and m forwarding the interests of the hospital.

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TOKANUI MENTAL HOSPITAL. Dr. Tothill reports : — I have the honour to present my annual report for the year ending 31st December, 1937. The total number of patients under care during the year was 768 (378 males and 390 females), with a weekly average of 585. Admissions numbered 173, of whom 76 were transferred from other institutions and 16 were voluntary boarders. The discharges were 63 committed patients, 12 voluntary boarders, and 5 transferred. There were 37 deaths, senile decay accounting for more than 25 per cent. At the end of the year 680 patients, including 36 on probation and 17 voluntary boarders, remained on the register. Several examinations and reports have been made on inmates at Waikeria at the request of the Justice Department. Considerable work has been carried out in renovating the wards of the older part of the hospital. F. 7 Ward has been completely repainted and various improvements made. Bright colour schemes have been introduced to produce a more homely atmosphere. Wards P. 1 and P. 3 are at present in the process of being overhauled. The change over of sides was effected smoothly and expeditiously. It has resulted in more efficient classification and easier administration. Alterations to the new store and telephone cables were completed. The kitchen chimney was rebuilt, a Public Works overseer's store and office constructed, and the bathroom in P. 3 modernized. Following the annual survey, staff houses on the estate were repaired and renovated. Staff mess-rooms are at present receiving attention. A housing scheme which will meet the requirements of our married staff is still under consideration. The new mortuary is now nearing completion. At the camp, stables and a grain and manure-shed was erected. Various farm buildings have been repainted, and improvements and repairs made in the blacksmith's shop. Draining, fencing, and breaking in new land has been carried out. Sanction has been obtained to build a veranda on to the female admission ward and to convert F. 2 Ward into an independent unit with all domestic facilities. It is hoped during the New Year to have independent cooking and bathing in all the older female wards, conditions which will approximate to those in modern villas. An Assistant Medical Officer's house will be erected in the near future. The institution has outgrown its domestic facilities, and it has been proposed that a new block comprising a laundry, engine-room, bakery, and butcher's shop be constructed. Our present means for treating new patients is not satisfactory owing to the admission wards being in immediate proximity to the chronic wards. It is undesirable that recent admissions should be in contact with chronics, and serious consideration will have to be given to the erection of a modern admission block away from the main hospital and independently situated in its own grounds. Lawns have been laid down round the new male villas, and a nursery garden is now able to supply all wards with cut flowers. The park-like feature of the grounds is being extended, and the policy of maximum parole with safety has reacted to the benefit of the patients. During the year Dr. Corban was transferred to Hokitika, his place being taken by Dr. Couston, from Sunnyside, for whose help I am grateful. In July the Hon. F. Praser, Minister in Charge of Mental Hospitals, visited various parts of the institution. Mr. Broadfoot was present at our annual Fancy Dress Ball, and I was pleased to welcome Mr. McCombs and Mr. Hultquist when they called at the hospital. The usual recreations and entertainments have been held, and in the near future a broadcaster for dance music will be installed. A rugby team was formed, the games providing enjoyment for both staff and patients. Monthly staff dances were organized throughout the winter. Performances by the Te Awamutu Band and a gymnastic display by the Y.M.C.A. of Hamilton were greatly appreciated. Our Official Visitor, Mr. Findlay, has been untiring in his efforts to provide extra comforts and entertainments. His sincere and deep interest in the hospital has been a great help to me. The generous gifts of the R.S.A. of Otorohanga and Auckland brought much happiness to the returned-soldier patients at Christmas. The various devotional services have been conducted throughout the year. Mr. Brookes, the Public Works Department overseer, has been always ready to give his valuable assistance in proposed works, and I am. indebted to the Clerk, Matrons, Head Attendants, and Staff generally for their support and helpful services during the year.

PORIRUA MENTAL HOSPITAL. Dr. Hart reports : — I have the honour to submit my report for the year ending the 31st December, 1937. The total number of cases under care in this hospital during the year was 2,044-, of whom 1,817 were committed patients, 219 were voluntary boarders, and the balance were cases remanded for observation. Admissions numbered 431, under certification 326, as voluntary boarders 97, and on remand 8. During the year 239 persons (152 committed patients and 87 voluntary boarders) were discharged, whilst a further number were sufficiently recovered mentally to be able to leave hospital and go on probation to the care of relatives or friends. Deaths numbered 142, and 66 patients were transferred to other hospitals.

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In comparison with the figures of the previous year, increases will be noted in the figures for admissions, discharges, and deaths. I think it is worthy of note that over 22 per cent, of all admissions for the year entered hospital as voluntary boarders. The nature of the great majority of mental disorders precludes the possibility of such cases being admitted voluntarily. The great majority of these cases lack volition, lack insight, and are incapable of seeing the necessity for making a written application for such admission. I think that under these circumstances the percentage of admissions who have voluntarily applied for treatment and have been admitted at least indicates that there is a growing section of the public which has an appreciation of the possibilities of the early treatment of nervous and mental disorders and a confidence in the facilities which the Department has available for such cases. An extension of the principle of psychiatric wards in general hospitals has been carried out by the opening in May last of a small ward in the Wellington Public Hospital for male patients, so that there is now available in the Wellington Public Hospital, under our supervision, male and female psychiatric wards for the observation and, where possible, early treatment of cases exhibiting some mental or nervous symptoms. Statistics show that the organization of these units and the work in these wards has been well worth while. Even those cases whose psychosis or psychoneurosis necessitated eventually their admission to the mental hospital, during their period in the psychiatric ward the complete technical organization of the hospital, such as laboratory tests, X-rays, &c., has been conveniently available for the investigation of the physical aspects, if any, of their mental illnesses. The psychiatric out-patient clinics at the Wellington Public Hospital and the Palmerston North Hospital have continued as formerly. The numbers of individual cases dealt with during the year are as follows : — (1) Cases in male and female psychiatric wards, Wellington Public Hospital .. 138 (2) Bi-weekly out-patients clinic, Wellington Public Hospital . . .. 194 (3) Palmerston North Hospital Clinic . . . . . . . . 96 Separate persons seen . . . . . • • ■ • • 428 The most important building completed during the year was the new stores block, which is now in use and allows of efficient storage and issuing of stores. The adjoining boiler-house, engineering, and artisans block is nearing completion and when in occupation should facilitate a more efficient working in these sub-departments, and, in the case of the new boiler-house, overcome certain technical difficulties existing with the present plant. A new bakehouse and butchers' shop, especially the former, are amongst out most urgent needs. It is hoped during the year to obtain money to make structural alterations to the administration block, in providing visiting-rooms and additional medical and clerical offices. When the present engineering block is evacuated it is hoped to convert same into an attendants' mess and recreation-room and have the ground floor fitted up as an occupation centre for basket-making, weaving, handicrafts, &c. Plans have been drawn up for an extension of the main hall, reequipment of the kitchen in the main building, with some decentralization by the addition of four small kitchens in the main female block. During the year the artisan staff has been fully occupied in repairing and renovating existing buildings, and a certain amount of this work has been carried out by contract. The interior of the Nurses' Home has been painted and papered. The dormitories, corridors, day-rooms, &c., of the female wards A, B, C, E, and H, and the male wards 1 and 8, have been renovated throughout. At present the exterior of the male wards 6, 7, 8, H. cottage, and certain staff residences are being renovated. Additional poultry-houses were erected during the year, and extensive repairs were made to the upper and lower reservoirs. In the five villas, supporting piles were replaced, and improvements made to the ventilation. Flooring was renewed in wards M. 6 and M. 7, whilst alterations were made in the bathroom of the lower building block by the addition of showers, and a considerable portion of the malthoid roofing of the same block was renewed with galvanized iron. Hot-water extensions were made at Rauta and the staff quarters in M. 7. A staffing innovation made during the year was the appointment of a full-time hairdresser. The facilities made available by this appointment have been much appreciated by a large section of our patients, more especially "those in the female admission and convalescent wards. The therapeutic value of useful employment has been constantly kept in mind during the year, and wherever possible patients have been encouraged to interest themselves in useful work on the farm, in the gardens, artisans' shops, sewing-rooms, and in domestic tasks about the villas and wards. Instruction in cane-work by the occupation officer during the year has been extended, more especially to those cases who, for various reasons, have not participated in other forms of occupation. The recent appointment to the nursing staff of a nurse qualified to teach weaving and simple handicrafts has enabled us to commence with weaving. On the whole, the health of the patients during the year has been reasonably good, the only unusual feature was that we had, during the year, seven cases of typhoid, one of whom died. These cases were confined to a ward housing the more difficult patients and in a ward where the prospects of " contact infection '" were at its greatest. Fortunately, early active measures of isolation and preventative innoculation limited the outbreak to seven cases. Despite the active co-operation of the Health Department and considerable investigation by my Assistant Medical Officers on staff and patients, we were unable to trace the carrier or source of entry of the bacillus to the hospital. The mode of infection was proved to be by direct contact and not due to the general water, milk, or food supply to the hospital. Prior to these cases there is no record of typhoid at Porirua for over fifteen vears.

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The activities on the farm, in the orchard, and in the vegetable and flower gardens has continued as formerly. Patients recreation has been well provided for during the year in the way of golf, tennis, bowls, concerts, fortnightly dances, weekly cinemas, and picnics to the beach. By the donation of books and purchases from the Recreation Fund many new volumes have been added to the library. The use made of the lending portion of the library is well shown by the figures for six months, during which 4,860 books were issued. lam indebted to Mr. Hooker for his continued interest in supplying weeklies and magazines for the library reading-room. I am indebted to many individuals and societies for their donation of goods, reading-matter, and money towards patients recreation, and, although it would be impossible to name all, I desire particularly to thank the Rev. Mr. Harding, the Commercial Travellers' Association, the Smith Family, the Women's National Reserve, Women's Service Guild, New Zealand Returned Soldiers' Association, Women's Institute, and the Women's Division of the Farmers' Union. I must thank the ministers of religion who have held religious services at the hospital at regular intervals. The District Inspector and Official Visitors have frequently visited the hospital during the year, and I must thank them for their helpful co-operation. There were numerous changes in the medical staff during the year. Drs. Boyd-Wilson and Campbell left to go abroad, Dr. Bowell to take an appointment at the Auckland Public Hospital, and Dr. Clay to go into practice. The greatest difficulty and real handicap in the administration of the hospital during the year has been the unavoidable shortage and changing of medical staff. In conclusion, I must thank members of the staff for their assistance in the work of the year, and more especially the Assistant Medical Officers, who, for the greater part of the year, ungrudgingly carried the extra and unreasonable burden of work occasioned by the shortage of colleagues.

NELSON MENTAL HOSPITAL. Dr. Williams reports : — I have the honour to present my annual report for the year ending 31st December, 1937. The total number of persons under care during the year was 926—24 of these were voluntary boarders. Fifty-six patients (42 males and 14 females) were admitted during the year —22 of these were transfers. Nineteen patients (11 males and 8 females) were discharged, seven (4 males and 3 females) were transferred elsewhere, and forty (25 males and 15 females) died. Seventeen patients were admitted under section 8 of the 1928 amendment to the Act. Ten voluntary boarders (7 males and 3 females) were admitted for treatment, eleven (7 males and 4 females) were discharged recovered. Not much building of a major order has been carried out during the year, but a good deal of maintenance and minor works have been done. At Ngawhatu the main drive was prepared and tar-sealing completed ; this was done also around the laundry and boiler-house. Preparation for road-sealing in Yorks Valley has also been in train, and a road to the site of the new piggeries is in course of construction. The male villas and Stoke Ward have been considerably refurbished and paiiyted, and the results are very satisfactory. The farm buildings were repaired and painted, and the laying-down of two hard tennis-courts in Yorks Valley was completed. A certain amount of developmental-work has gone on, but activities of this nature have been slowed up because of shortage of adequate working parties and the temporary transference of many of those available to urgent works elsewhere. At Nelson a pipe-line has been laid and hydrants fixed in order to provide more adequate fire protection. Fire-breaks have been made in the pine plantation, and the hillside adjacent has been prepared for further tree-planting in the autumn. Four extra breeding-pens have been constructed in pursuance of an altered policy with regard to pigs. A new lavatory was built in the boys' park, repairs were done about the kitchen, and surface draining completed about Braemar. For 1938 the tentative programme is somewhat more comprehensive, and it is hoped to begin with the building of the new Nurses' Home very shortly. The erection of further male villas to absorb the patients from Stoke Ward is also in view, and I am looking forward to this, as not only will the erection of a new stores and administration block, with its attendant advantages, then become feasible, but also will become possible better classification and more satisfactory treatment conditions for male patients. I am looking forward, also, to the provision of a small hospital and admission block, with operating-theatre and up-to-date therapeutic department attached. I am afraid that, as it is, facilities for the surgical treatment of a population of this size are hardly adequate; and, although in some cases, of course, treatment in public hospital is preferable, there are nevertheless many conditions we deal with ourselves, but in the management of which we should be considerably aided by the extension of nursing facilities. Another aspect of this matter of a separate hospital block is, I think, worth mentioning, and that is the good effect a leavening of such general work has in stimulating the interest of the staff generally. Purely mental-work,

2—H, 7.

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notwithstanding its importance, is frequently tardy in and sometimes devoid of tangible result, and the acquirement of knowledge in other branches of nursing by actual experience is useful not only in itself, but because of the greater interest it often gives to the whole course of mental nursing ; and, after all, mental nursing and general nursing are complementary, and that this is your view also is evidenced by the appointment of tutor sisters. This latter is a move that will be appreciated by every one, and it cannot but be a success. We have, for a variety of reasons, and in common with other hospitals, I understand, been greatly hampered for some time now by shortage of suitable staff, but I have found definitely that the introduction into the syllabus of lectures from the subject direct on the physical as' well as on the mental side has created genuine interest, and it has resulted, too, in many probationers remaining more eager to go on with their course of training than to accept one of the apparently more tempting positions which are so freely offering nowadays. The tutor sisters will be of great aid in providing this wider knowledge. I would like to refer to the necessity that must soon arise for rebuilding at Nelson; on renovation or repair alone would not be justified. Transfer of the residents to Ngawhatu is neither desirable nor feasible, but it has sometimes been suggested that it would be better to shift this centre for mental defectives nearer to one of the main cities because of difficulty of access to Nelson itself. Points against this, however, if I may mention them, are : We an excellent site; air services have greatly improved access, and the climate' is, I should think, without equal for children and adults alike. Reverting to the activities for the past year, sufficient discussion has been made, no doubt, to the subject of shorter hours. One aspect that might be mentioned, however, is that the greater opportunity for recreation so offered has resulted in the formation at our hospital of new sports and athletic clubs. In addition to the cricket club, we now have rugby, football, badminton, basketball, and tennis. Much success has been achieved in each, and with a minimum of interference with routine duties, but probably the most gratifying part has been the active and successful participation in these clubs by many of the patients. . A canteen was started in a small way during the early part of the year, available to patients and staff alike ; it has been very popular, and at the end of the year a profit of over £37 had resulted, this to go to the patients' Recreation Fund. A library has been run in conjunction with the canteen. The swimming-bath has been generally popular and well patronized, and regular fortnightly dances lately instituted have also been successful. Nevertheless, we are, possibly because of our situation, still perhaps not quite so well provided with entertainment as some of the metropolitan hospitals, though this disparity will be lessened greatly when the erection of a talking-machine at Ngawhatu becomes possible. Many individuals, business firms, and societies in Nelson have been very good to us in the matter of donations of cash and goods, and their kindness and continued support have been much appreciated ; my thanks are due also to Miss Cooksey and her party in providing outings for the children; to Mrs Scantlebury and to the visiting ministers of religion, particularly the Reverend Hay and Father Cullen. To the staff generally, for their loyal assistance and co-operation, I wish also to express my sincere thanks.

HOKITIKA MENTAL HOSPITAL. Dr. Childs reports : — I have the honour to submit my report for the year ending 1937. At the commencement of the year the patients on the register numbered 458. The admissions proper were 19, while 6 male and 23 female patients were received on transfer. The discharges numbered 15, transfers to other institutions 17, and deaths 12. The total number under treatment was 506, and the number remaining on the register at the end of the year 462. There were two voluntary boarders on the register at the beginning of the year, 5 were admitted, and 4 discharged. The general health of the patients has been very satisfactory, most of the deaths occurring amon» the older patients. A fire occurred in " Kiwi " male admission ward on the night of 20th July, 1937, and half the ward was extensively damaged. The patients were all removed safely and accommodated in other wards. The staff did excellent work during and after the fire, and I would also like to thank the Hokitika Fire Brigade for their prompt and timely assistance. The renovating and repairing of the damaged portion is now almost completed, and the ward will soon be fully occupied. A modern residence for the Chief Clerk has now been completed. The remodelling of " Sefton " and " Aorangi " wards was completed on 17th May, 1937, and the improvement effected is considerable. They are now used as open wards for elderly patients. A new tennis-court has been completed, necessary repairs effected to " Moana " and " Taupo " wards, and the inside of " Egmont " ward has been painted and papered. A modern piggery is in the course of erection. The usual routine of farming and gardening operations has been carried out ; 5 acres of swamp land have been cleared, drained, and left fallow, while 9 acres left fallow last year have been sown in grass.

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The painting gang has been continuously employed during the year, and the usual maintenancework carried on. The Hokitika Band, as usual, has visited the hospital on many occasions, and supplied music for the dances. A monthly clinic has been held at Greymouth, and visits made to the Westland Hospital when requested. Recreation and games have played an important part, more so than in former years. Thanks are due to those who have provided entertainment during the year and to those who made gifts to the hospital during the Christmas season. The clergy have made frequent visits, and are taking an increasing interest in the institution. The Official Visitor, who has been on an extended tour of Europe, visited the hospital before leaving and on his return. I wish to thank the staff for the material assistance they have given during the year.

CHRISTCHURCH MENTAL HOSPITAL. Db. McKillop reports : — I have tie honour to forward my report for the year ending 31st .December, 1937. On the Ist January, 1937, there were 1,366 patients (752 males, 614 females) on the register. During the year 240 patients were admitted and 57 were transferred from other institutions ; 152 patients were discharged and 38 were transferred to other institutions. The total number under care during the year was 1,663. During the year 106 voluntary boarders (59 men, 47 women) received treatment, 48 being resident on the 31st December. The number of deaths was 79, the principal cause of death being senile decay. We were fortunate in being able to avail ourselves of treatment by malaria, and many general paralytics, post-encephalitics, and cases of dementia prsecox benefited by this treatment. During 1937 many works of major importance have been carried out : Two new tanks for an efficient water-supply for all purposes have been completed, and the pumping-machinery is at present being installed. The new bakehouse will be in use in the course of a few days. It is intended to utilize the area occupied by the old bakehouse as extra store accommodation, as this is urgently required. At Templeton two new villas are in occupation ; the laundry has been completed, but the equipment is not yet to hand. The grounds have been carefully laid out, and visitors have frequently complimented us on the excellent lawns and gardens. The results of the occupational therapy classes both at Sunnyside and Templeton have been most encouraging, and it is pleasing to note that the provision of new workrooms and equipment for the extension of this has been approved. The clinic at the Christchurch Hospital has been well attended, with an average of twelve consultations weekly. In January 1937, it was decided to start a monthly clinic at the Timaru Hospital, and many ex-patients and others have come for advice ; on my last visit there were twelve consultations, including five new patients. The farm has had a very successful year, and, in addition to supplying our own wants and supplementing the requirements of other institutions, quite a quantity of cereals was sold at satisfactory prices. The new poultry-houses are nearly completed —they are of the latest design, and will enable us to carry on this branch of farming under the best possible conditions. The removal of the old houses and runs will greatly improve the amenities of the male villa and north house. The question of laying down hard tennis-courts for the staff on the site vacated will be discussed with you later. The entertainment-of the patients has been carried out on the usual lines. I have to thank the many concert parties and the companies who provided the picture programmes. These have been a source of great enjoyment to the patients and staff. Mr. H. D. Acland, K.C., District Inspector, and the Official Visitors, Mrs. Williams and Mr. Hanna, have paid many visits to the institution and are keenly interested in the welfare of the patients. During the whole year the medical staff has worked short-handed : Dr. Couston was transferred to Tokanui, and I was very sorry to lose the services of such a capable and efficient officer. I have to record my appreciation of the services of Dr. Bellringer, who has had so much extra work placed on him. I have also to thank Mr. Thomas and the office staff, the Matron, head attendants, and the staff as a whole for the wonderful work they have done during the year.

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SEACLIFF MENTAL HOSPITAL. Dr. Brown reports :— I have the honour to submit the annual report for the year ending 31st December, 1937. At the end of October, Dr. Henry Douglas Hayes, who had been the Medical Superintendent for the past five years, died. Still a young man, his ideals of duty and service were of the highest and he gave unsparingly of himself. The welfare of his hospital was ever his foremost thought. He was much esteemed in the community, and his loss is felt there as well as in Seacliff. All of us who worked with him extend our deepest sympathy to his widow and children. On the Ist January, 1937, there were 1,184 patients on the register. During the year 153 patients were admitted, 59 were discharged, and 64 were transferred to other institutions. A total number of 1,337 patients were under care during the year. There were 69 voluntary boarders under care, and 36 of these are still in residence. There were 81 deaths, the principal causes being senile decay and heart-disease. At the end of the year there were 1,133 patients and 36 boarders. Towards the end of the year it was found necessary to abandon as dangerous another female wing, F. 3, and, while patients were transferred to Christchurch and Tokanui, this nevertheless accentuated the overcrowding problem. The male side is overcrowded to the number of 109 and the female side to 82. New admission units are an urgent necessity. Various replacements and improvements have been made to the institution during the year. A new kitchen and scullery in the male hospital have improved the facilities there. An open-air veranda has been added to D Ward for the treatment of pulmonary cases, and a new kitchen with a range and hot-water boilers has improved the food-service there. The kitchen and scullery in F. 5 were modernized, and provision for keeping food warm provided. In F. 4 the bathroom and lavatory were remodelled. The Retreat at Waitati was overhauled, more lavatory and bathroom facilities were provided, and the building was papered and painted. General maintenance of the buildings has been going on, including the renewal and repair of the chimney-tops. Both at Seacliff and Waitati a great deal of external painting has been done. The water-main from Double Hill Reservoir has, due to the slipping ground through which it passes, required a great deal of maintenance. A new and modern dairy has been built at the farm. The farm-work has progressed satisfactorily. The garden has been well tended, and a plentiful supply of fresh vegetables has been provided at all seasons of the year. Miss Miller, of the Red Cross Society, who has been teaching handicrafts to the male patients, extended her activities to the female side, with excellent results. She has also been instructing attendants and nurses with a view to later introducing this work to the chronic wards. Various members of the Dunedin Branch of the Women's National Council have visited regularly and taken part in the occupational-work. The various handicrafts have, at present, to be done in the sittingrooms of the wards, and I think that the time has come when the erection of a small pavilion for use as an occupational centre should be considered. Your appointment of an officer to supervise the kitchen services has resulted in improved methods of food-distribution and an improvement in the meals in general. The provision of more equipment in the kitchen is a matter in hand, and this should show further beneficial effects. Various organizations have done much for us in the way of entertainments. The Patients' and Prisoners' Aid Society has shown its continued interest, and Mr. Steven, the society's agent and chaplain, has conducted religious services and promoted many concerts. The society provided the transport which allowed a large party of patients to attend the circus, and the proprietor of the latter gave free admission. lam grateful to the Otago Agricultural and Pastoral Association for allowing a number of patients free admission to their summer show in November. The Dunedin Royal Male Voice Choir and the Justices of the Peace Association provided concerts, as in former years. Band concerts were given by the Dunedin Highland Pipe Band, the Palmerston Pipe Band, the Kaikorai Band, the Tramways Band, and the Salvation Army Band; and the Dunedin Burns Club and Toe H gave concerts at Seacliff and Waitati. I wish to express my thanks to them and to the companies who provide our weekly picture programmes also to the Returned Soldiers' Association for tobacco, &c., supplied to our soldier patients. I desire to thank various local firms for supplies of novels and periodicals. The psychiatric clinic at Dunedin Public Hospital is held twice a week, and during the year 173 new cases were seen. The Invercargill Public Hospital was visited monthly either by Dr. Hay or myself, and 26 new cases were seen there. During the year a clinic was inaugurated at the Oamaru Public Hospital, and I visit there once a month. During the year Mrs. McLaren, the matron, was made a Member of the Order of the British Empire and was invested by His Excellency the Governor-General. It is gratifying that her many years of faithful and efficient service should be so recognized, and I would tender her my congratulations. I wish to thank the clergy of the various denominations who have conducted services and visited the patients. I have to thank the matrons, the head attendants, and their respective nursing staffs for their loyal support and efficient work. I have also to thank Mr. Thomas, the Chief Clerk, and the various other heads of departments for their services. I wish to pay tribute to the loyal support of my medical colleagues. The illness and death of Dr. Hayes, and the necessity of lending a medical officer to the Christchurch Mental Hospital at various times, placed on them much extra work, which was well and ungrudgingly done.

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STATISTICAL. The patients on the register at the end of the year numbered 7,897 (m. 4,352, f. 3,545), or 37 more (in. 5 fewer and f. 42 more) than at the beginning ; the daily average under treatment during the year was 7,384 (m. 4,112, f. 3,272), or 96 (m. 19, f. 77) more than in the previous year; while the total under care was 8,984. Patients belonging to the Native race numbered 147 (m. 78, f. 69) at the end of the year. The admissions numbered 1,124 (m. 557, f. 567), or 15 more than in the previous year. Of these 195 had been previously under care, making the proportion of readmissions 17-35 per cent., and 929 patients were admitted for the first time. The ratio to population of all admissions (exclusive of Maoris) was 7-25 (m. 7-09, f. 7-42) to 10,000, and of first admissions 6-00 (m. 5-92, f. 6-09), so that 1,378 persons in the general population contributed one patient and 1,664 contributed a patient admitted for the first time. The discharges (excluding transfers) numbered 590, or 119 more than in 1936. Harmless unrecovered persons numbering 231 (or 30 more) were returned to the care of friends ; and 359 (m. 180, f. 179) recovered —89 more than last year —representing a percentage of 31-94 (m. 32-31, f. 31-57) on the total admitted. With voluntary boarders added the percentage rises to 35-18. Altogether, 61 •32 per cent, of the inmates admitted were able to leave institutional care. Of a total of 8,984 patients under care, 497 (m. 261, f. 236) died, or 6-73 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, 21-73; diseases of the brain and nervous system group, 22-13; heart-disease, 18-31; tuberculosis, 6-23. In Table YII 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 .. .. .. .. .. 7-36 9-17 8-27 Congenital .. .. .. .. .. 18-49 11-47 14-95 Predisposed by previous attack .. .. 16-70 19-23 17-97 Critical periods .. .. .. .. 5-39 13-93 9-70 Child-bearing (puerperal, non-septic, and lactation) .. 1-77 0-89 Mental stress .. .. .. .. 17-41 16-56 17-00 Toxic, including— m. f. Km :: :: :: til !:«} 10 - 23 M 0 8 -° 9 Traumatic .. .. .. .. .. 0-18 0-18 0-18 Disorder of nervous system, including — m. f. Epilepsy .. .. •• 4-31 2-12 5-39 2-82 4-09 Other bodily affections .. .. .. 7-00 8-29 7-65 Senility .. .. .. .. .. 11-85 10-58 11-21 100-00 100-00 100-00

Voluntary Boarders.

13

v„, First ! Not First Total i ! tv ,, tv *, ,, I Semaining Year - ; Admission. Admission. Admissions. *° I D,ed ' Discharged. on I of Patients, ; | 31st December. M. If. T. M. F. T. M. r. T. M. F. T. M. J?. T. M. P. 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 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 1937 .. .. ,103 91 194 64 45 109 167 136 303 14 7 21 6 10 16 163 122 285 178 159 337

H.—7,

It will be noted that there were 303 voluntary admissions in the year under review, that 285 were discharged, and that 21 boarders, representing 6-93 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 4-62 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 1937 was 346. MENTAL NURSES. In December the usual examination was held for the registration of mental nurses, when the following passed : — Passed top for Dominion : Nurse G. M. Brown (Seacliff). Auckland : Attendants—A. J. K. Baxter, N. 0. Fairlie, 1). J. Hill, H. M. Ross, F. E. Watt. Nurses —A. M. Goodall, M. I. G. Inkpen, J. G. Johnston, N. E. I. Mills, E. M. Randall, V. K. Sheahan. Kingseat: Attendant —11. D. Simpson. Nurses —L. C. R. Roswell, K. M. Johnstone, N. M. Quigley. Tokanui: Attendant —G. D. Thompson. Nurses —M. Casey, D. Cran, J. A. Elmsley,* M. E. Fordham. Porirua : Attendants —A. C. Lassen, J. P. Duncan, J. J. Clark. Nurses —J. A. Baucke, M. B. Duncan, M. A. Pohl, E. T. Wholey, E. Willetts. Nelson : Attendants —J. J. R. Cussen, A. A. McLean, R. L. D. Powrie. Nurses —N. I. Carter, M. R. Duffy, L. A. Kelly, M. A. Sowman.* Hokitika : Nurse —J. Ward. Christchurch: Attendants —G. J. Howell,* G. N. Newton. Nurses —N. Adam, N. I. Cameron, M. M. E. Clarke, M. M. Davidson, A. P. Gow, M. V. Hallins,* M. M. Nelson, N. W. Pounsford, M. Roberts, M. F. Sim, I. J. Woods. Institution Officers : Templeton Farm —G. B. Grose, A. L. M. Anderson, M. K. Dwyer,* A. C. M. Murphy, A. R. Marshall. Seacliff: Nurses —G. M. Brown,* U. M. Charteris, T. E. Corkin, W. M. Edwards, J. W. R. Haywood, L. M. King, J. M. E. P. Madell, R. M. Millar, N. M. M. Townsend, M. I. Tully.

* Passed with distinction.

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APPENDIX.

Table I.—Showing the Admissions, Readmissions, Discharges, and Deaths in Mental Hospitals during the Year 1937.

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 1937.

15

M. F. T. M. F. T. In mental hospitals, 1st January, 1937 .. .. .. .. 4,357 3,503 7,860 Admitted for the first time .. .. .. .. 464 465 929 \ ___ „„„ , in . Readmitted 93 102 195 / 557 ° 6 ' ] ' 124 Total under care during the year .. .. .. 4,914 4,070 8,984 Discharged and died— Recovered .. .. .. .. .. .. 180 179 359 Not recovered .. .. .. .. .. 121 110 231 Died .. .. .. .. .. .. 261 236 497 — 562 . 525 1,087 (Not including transfers —Males, 90 ; females, 155.) Remaining in mental hospitals, 31st December, 1937 .. .. 4,352 3,545 7,897 Increase over 31st December, 1936 .. .. .. .. 5* 42 37 Average number resident during the year .. .. .. .. 4,112 3,272 7,384 * Decrease.

Admissions in 1937. tw«i M , ltvlU , ; In Mental Hospitals lotal Number Mental Hospitals. on I x> ?• + 1st January, 1937. Admitted for the Not First ! Transfprs iimferfW First Time. Admissions. j iransters. under Care. M. F. T. M. F. T. M. F. T. M. F. T. M. F. T. Auckland .. .. 721 559 1,280 112 133 245 21 25 46 5 6 11 859 723 1,582 Kingseat .. .. 297 286 583 .. . . 13 9 22 310 295 605 Tokanui .. .. 327 284 611 36 29 65 7 9 16 8 68 76 378 390 768 Poriraa .. .. 839 652 1,491 125 115 240 33 37 70 10 6 16 1,007 810 1,817 Nelson .. .. 482 364 846 19 8 27 3 4 7 20 2 22 524 378 902 Hokitika .. 221 237 458 8 8 16 1 2 3 6 23 29 236 270 506 Christchurch .. .. 752 614 1,366 105 96 201 21 17 38 20 38 58 898 765 1,663 Seacliff .. .. 704 480 1,184 57 72 129 7 8 15 7 2 9 775 562 1,337 Ashburn Hall (private 14 27 41 2 4 6 .. 1 1 2 17 32 49 mental hospital) — Totals .. 4,357 3,503 7,861 464 465 929 93 102 195 90 155 245 15,004 4,225 9,229 I ! Patients discharged, transferred, and died. I In Mental Hospitals Mental Hospitals. I _ , . , on SS noSeC | transferred. I Died. T0 S^j« d ' •. W37. and died. M. F. T. M. F. T. M. F. T. M. F. T. M. F. T. M. F. T. Auckland .. .. 35 35 70 32 21 53 26 12 38 54 46 100 147 114 261 712 609 1,321 Kingseat .. .. 3 1 4 0 1 1 2 3 5 8 3 11 13 8 21 297 287 584 Tokanui .. .. 19 13 32 17 14 31 0 5 5 20 17 37 56 49 105 322 341 663 Porirua .. .. 37 72 109 23 20 43 8 58 66 67 65 132 135 215 350 872 595 1.467 Nelson .. .. 9 7 16 3 1 4 5 3 8 25 15 40 42 26 68 482 352 834 Hokitika .. .. 4 2 6 6 3 9 12 5 17 5 7 12 27 17 44 209 253 462 Christchurch .. 48 40 88 27 37 64 13 25 38 37 42 79 125 144 269 773 621 1,394 Seacliff .. .. 25 8 33 13 13 26 22 42 64 44 37 81 104 100 204 671 462 1,133 Ashburn Hall (private 011 .. 224 134 37 10 14 25 39 mental hospital) Totals .. 180 179 359 121 110 231 90 155 245 261 235 498 652 680 1,332 4,352 3,545 7,897 4verage Number Percentages Percentages of Mental Hospitals. j "resident during oE Recoveries on Deaths on Average 1 thp Vpnr Admissions Number resident daring the Year. during the Year. M. F. T. M. F. T. M. F. T. Auckland .. .. .. .. 660 519 1,179 24-06 13-29 18-21 8-18 8-86 8-48 Kingseat .. .. .. .. 291 285 576 .. 2-75 1-05 1-91 Tokanui .. .. .. .. 301 284 585 44-19 34-21 39-50 6-64 5-98 6-32 Porirua .. .. .. .. 814 560 1,374 23-54 47-37 35-16 8-23 11-61 9-60 Nelson .. .. .. .. 455 343 798 40-91 58-33 47-06 5-49 4-37 5-01 Hokitika .. .. .. .. 210 236 446 44-44 20-00 31-58 2-38 2-96 2-69 Christchurch .. .. .. .. 692 543 1,235 38-09 35-40 36-82 5-34 7-71 6-40 Seacliff .. .. .. .. 675. 475 1,150 39-06 10-00 26-61 6-52 7-79 7-04 Ashburn Hall (private mental hospital) .. 14 27 41 .. 25-00 16-66 7-14 14-81 12-19 Totals.. .. .. .. 4,112 3,272 7,384 32-32 31-57 31-94 6-35 7-21 6-73

H.—7.

Table III.— Native Countries.

Table IV.—Ages of Patients on 31st December, 1937.

16

Ashburn Hall Countries. Auckland. Kingseat. Tokanui. Porirua. Nelson. Hokitika. Christchurch. Seacliff. (Private Mental j Total. Hospital). - - . . j . M. F. T. M. F. T. M. F. T. M. F. T. M. F. T. I M. F. T. M. F. T. M. F. T. M. F. T. 1 M. F. T. England and Wales .. 115 80 195 53 50 103 43 45 88 136 88 224 47 34 81 26 20 46 60 54 114 60 32 92 3 1 4 543 404 947 Scotland .. .. 24 18 42 13 5 18 13 6 19 37 16 53 23 13 36 6 9 15 22 11 33 1 37 31 68 3 2 5 178 111 289 Ireland .. 25 19 44 16 19 35 18 15 33 35 17 52 14 5 19 15 12 27 20 17 37 21 14 35 0 1 1 164 119 283 New Zealand.. .. 411 403 814 142 163 305 200 223 423 563 423 986 360 275 635 124 163 287 653 516 1,169 509 364 873 7 20 27 2,969 2,550 5,519 Australian States .. 34 28 62 18 12 30 II 13 24 32 17 49 7 7 14 15 9 24 10 16 26 15 9 24 1 1 2 143 112 255 Prance .. ..011 .. 101 .. .. .. .. .. .. 112 Germany .. ..101101314246112101101404 .. 14 6 20 .Austria .. ..819606404 .. 101 .. .. 101 .. 20 1 21 .Norway .. ..101404202011 .. 101 101 .. 9 1 10 Sweden .. .. .. 12 3011 101202101 101202 .. 8 3 11 Denmark .. ..101101213314404101 .. 101 .. 13 2 15 Italy .. .,202011101202011303 .. .. .. 82 10 China .. ..303101101415 .. .. j .. 101 . 10 111 Maoris .. 20 25 45 5 0 5 9 19 28 35 18 53 6 3 9 1 1 2 | 2 3 5 .. .. j 78 69 147 Other countries 43 13 56 12 9 21 14 17 31 22 9 31 5 2 7 4 0 4 4 4 8 6 4 10 .. 110 58 168 Unknown .. 24 21 45 24 26 50 .. .. 12 11 23 11 39 50 j .. 13 8 21 .. ! 84 105 189 Totals .. 712 609 1,321 297 287 584 322 341 663 872 595 1,467 482 352 834 209 253 462 1773 621 1,394 ! 671 462 1,133 14 25 39 ! 4,352 3,545~7^897 I I

I j Ashburn Hall Ages. I Auckland. Kmgseat. Tokanui. j Porirua. J Kelson. Hokitika. j Christchureh. , Seaclifl. j (Private Mental , Total. Hospital). M. F. T. M. F. T. I 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 ..1 0 1 .. . . .. 10 4 14 0 1 1 8 6 14 .. 19 11 30 „ 5 „ 10 „ .. 1 0 1 .. 1 1 2 ! 1 13 14 25 6 31 0 1 1 36 22 58 0 3 3 !! 64 46 110 „ 10 „ 15 „ .. 10 4 14 .. 7 4 11 j 2 8 10 46 16 62 0 2 2 83 50 133 1 1 2 149 85 234 „ 15 „ 20 „ 22 20 42 3 0 3 8 12 20 ! 26 17 43 51 24 75 0 2 2 119 73 192 17 10 27 1 0 1 247 158 405 „ 20 „ 30 „ .. Ill 80 191 19 20 39 51 44 95 ! 129 69 198 105 39 144 18 20 38 110 104 214 98 39 137 1 1 2 642 416 1 058 „ 30 „ 40 „ .. 135 99 234 37 41 78 47 63 110 174 105 279 46 53 99 30 26 56 114 81 195 134 55 189 3 0 3 720 1'243 „ 40 „ 50 „ .. 143 140 283 60 58 118 43 76 119 168 142 310 44 65 109 31 52 83 100 71 171 125 96 221 1 4 5 715 704 l'419 „ 50 „ 60 „ .. 138 142 280 78 78 156 81 65 146 201 123 324 50 67 117 66 76 142 117 103 220 140 113 253 1 11 12 872 778 l'650 „ 60 „ 70 „ .. 84 73 157 70 55 125 60 50 110 110 63 173 54 54 108 43 49 92 49 65 114 93 85 178 3 3 6 566 497 l'o63 „ 70 „ 80 „ .. 40 36 76 24 22 46 17 19 36 i 47 43 90 35 21 56 17 20 37 28 36 64 47 47 94 4 4 8 259 248 '507 „ 80 „ 90 „ 10 5 15 3 3 6 5 2 7 12 10 22 8 2 10 1 0 1 8 10 18 14 9 23 0 2 2 61 43 104 Upwards of 90 ,,..2 0 2 1 0 1 .. 022 .. .. 101213 6 3 9 Unknown .. 15 10 25 2 10 12 i 2 5 7 2 0 2 8 1 9 3 4 7 .. 0 3 3 " 32 33 65 Totals .. 712 609 1,321 297 287 584 . 322 341 663 872 595 1,467 482 352 834 209 253 462 773 621 1,394 671 462 1,133 ~~14 25 39 4,352 3,545 7,897 I I - | I

3—H. 7

H.—7

Table V.—Length of Residence of Patients discharged "Recovered" during 1937.

17

Ash burn Hall. Length of Residence. Auckland. Kingseat. Tokanui. Porirua. Nelson. Hokitika. Christchurch. Seaclifl. (Private Mental Total. Hospital.) M. F. T. M. F. T. M. F. T. M. F. T. M. F. T. M. F. X. M. F. T. M. F. T. M. F. T. M. F. T. Under 1 month .. 527 .. .. 213 .. 101 101 .. .. 93 12 From 1 to 3 months .. 437 .. 527 066 .. •• 85 13 112 .. 18 17 35 „ 3 „ 6 „ .. 2 13 .. Oil 7 5 12 .. .. 12 9 21 5 1 6 .. 26 17 43 6 „ 9 .. 0 3 3 .. 1 0 1 7 13 20 1 1 2 1 0 1 6 6 12 5 1 6 . . 21 24 45 9 „ 12 .. 4 5 9 .. 1 2 3 11 12 23 .. .. 1 0 1 2 2 4 0 1 1 19 22 41 1 „ 2 years .. 11 11 22 .. 4 2 6 4 20 24 2 2 4 2 1 3 6 5 11 6 1 7 .. 35 42 77 2 „ 3 „ .. 4 5 9 .. 1 2 3 3 10 13 0 1 1 .. 3 4 7 3 1 4 .. 14 23 37 „ 3 „ 5 „ .. 235 213 325 134 325 .. 57 12 213 .. 18 19 37 „ 5 „ 7 „ .. 224 101 011 123 213 011 325 101 .. 10 9 19 7 ,, 10 ,, .. 101 .. 415 .. 101 .. 112 .. .. 729 „ 10 „ 12 „ .. .. .. .. .. • ■ 0 11 .. .0 11 „ 12 „ 15 „ .. .. .. .. 10 1 .. .• 10 1 .. 2 0 2 Over 15 years .. .. .. .. 101 •• . • 101 Totals .. .. 35 35 70 3 1 4 19 13 32 37 72 109 9 7 16 4 2 6 48 40 88 25 8 33 0 1 1 180 179 359

"11.-7

Table VI. —Causes of Death, 1937.

18

iS i i +3* ! gj £ g .g ! Causes. g | § 5 a g § jd §«*§< 3 gc i a E » *a .2 "3 £ cs o rs I a £ I I £ -S $ ■s-a® I «i I W | E-< fti H o 02 S H 1.—General Diseases. Tuberculosis — M. f. m. f. m. f. m. f. m. p. m. f. m. f. m. f. m. f. m. f. General .. .. .. •• •• •• • • 10 .. .. 10 .. 20 Of kidneys .. .. • • •. • • ■. . • ■ . .. 10 . . .. 10 Of lungs .. .. .... 2 5 .. 0 2 2 3 1 0 .. 1 5 2 4 .. 8 19 Of intestines .. .. .. .. . .. •• •• •• .. 10 .. 10 Cancer .. .. .. ..1 1 1 0 1 2 3 1 1 0 2 1 2 1 . . 0 1 11 7 Toxamiia .. .. .. .. . . • ■ .. 13 .. 0 1 .. . . 14 Typhoid .. .. .. .. ... •• .. 0 1 .. .. .. .. .. 0 1 Pernicious ansemia .. .. .. ... 10 .. 0 1 .. .. .. .. .. 11 Asthenia . . .. .. ..01 .. .. .. 12 .. .. .. . . 13 Congenital syphilis .. .. .. .. .. 10 10 .. .. 0 1 .. .. 21 II. —Diseases of thf. Nervous System. Mania, exhaustion from .. ..10 .. .. .. .. .. 0210 . . 22 Melancholia .. .. ..0 3.. 0 1 .. 2 0 .. 1 0 0 1.. 3 5 General paralysis of insane .. ..4 0 .. .. 6 2 ., .. 5 2 2 1 .. 17 5 Encephalitis .. .. ..01 .. .. . . . . . . II .. .. 12 Epilepsy .. .. .. ..0 1 . . 2 0 3 3 5 2 .. 3 1 8 2 .. 21 9 Cerebral haemorrhage .. ..4 2 0 1 2 0 4 2 0 1 .. 1 2 1 4 0 1 12 13 Cerebral thrombosis .. .. ..61 .. 1051 . . .. .. . . . . 12 2 Cerebral syphilis . . .. ..11 .. .. . . . . 1 .. . . 11 Hydrocephalus (internal) .. ..10 ... .. .. .. .. .. .. .. 10 Tubercular meningitis .. . . .. .. .. . . .. 10 .. . . 10 III.—Diseases of the Respiratory' System. Pneumonia .. . . 7; 9 .. 0 15 10 3 0 0 1 55 5 1 .. 25 27 Influenzal broncho-pneumonia . . . . . . 0 1 .. . . . . .. . . .. 0 1 Bronchitis .. .. .. .. 0 1 .. 01 11 .. 01 .. 11 .. 25 Chronic pulmonary fibrosis .. .. .. .. 01 .. .. .. .. .. .. 01 IV. —Diseases of the Circulatory System. Heart-disease .. .. 13 13 4 2 2 3 3 10 0 4 2 2 4 4 10 8 0 1 44 47 Arterio-sclerosis .. .. .. 5 0 1 0 10 20 .. .. 22 14 01127 V.—Diseases of the Digestive System. Acute intestinal obstruction .. .. .. .. .. .. ... .. 1 0 .. 1 0 Baeillary dysentery .. .. ..22 .. 10 .. .. .. .. .. .. 32 Cholecystilis .. .. .. .. .. .. .. .. 0 1 .. .. .. 0 1 Perforated duodenal ulcer .. .. .. .. .. .. .. .. .. 10 .. 10 Acute phlegmonous stomatitis .. .. .. 10 .. .. .. .. .. .. 10 Ulcerative colitis .. .. .. .. .. .. 0 1 .. .. .. .. .. 0 1 VI.—Diseases of the Genito-urinaky System. Nephritis .. .. .. .. .. .. .. 0 12 0 10 10 .. .. 4 1 Uraemia .. .. .. ..01 . . .. .. .. .. .. .. .. 01 Pyonephrosis .. .. ..01 .. .. .. .. .. .. .. .. 01 VII.—Old Age. Senile decay .. .. .. 1 0 1 0 6 4 23 21 3 6 .. 8 15 9 10 1 0 52 56 VIII.—External Causes. Suicide .. .. .. ..01 .. ..21 .. .. .. 01 .. 23 IX. —Died while on Trial ..62 .. 2163 .. .. 11 .. .. 15 7 Totals .. .. .. 54 46 8 3 20 17 67 65 25 15 5 7 37 42 44 37 1 4 261 236

H.—l

Table VII.—Principal assigned Causes of Insanity, 1937.

4—IT. 7.

19

_j " j ' " rG CS fl • •a | j cs I . a s a Causes. § ! S 'I 2 j a s S 5 S -§ S 1 _• fill 1 ! . ? i ! i-sl i 3 ! M H PM j | H & M H M F. M. F. M. F. M. F. M. F. M. F. M. F. M. F. M. F. M. F. Alcohol .. .. 14 4 .. 4 0 4 1 1 1 2 0 9 1 3 1 .. 37 8 Arterio-sclerosis ..68 .. 1 0 56 .. .. ® (Climacteric 0 11 . . 0 3 0 5 .. .. 0 7 0 13 0 1 0 40 Congenital I.' .. 22 7 .. 6 5 13 10 8 2 0 1 38 32 16 8 .. 103 65 Constitutional .. 0 4 .. .. 14 12 .. 10 .. . • .. 15 Drug addiction ..03 .. .. • • •• •• ," n " 20 Encephalitis .. •• •• •• 1 0 •• • • J ® . Epilepsy .. ..8 1 .. 4 1 5 0 2 3 0 1 2 3 3 3 .. 24 12 Heredity .. ..8 7.. 9 8 7 7 2 1 1 2 5 9 8 16 1 2 41 52 Huntingdon's chorea ..10 .. .. ■ • • • • ■ • • • • • • f Ill-health .. ..13 .. 3 7 .. .. .. .. Involution .. .. 3 12 . . 022222 .. 36 .. .. 10 24 Mental stress .. 23 42 .. 11 2 43 39 2 1 2 1 13 7 3 1 0 1 97 94 aaJStf-:: 21 * :: i i j" { »« «•» Puberty or adolescence 0 5 .. 02 21 11 01 93 72 1 0 20 15 Puerperal ..03 .. 0501 .. .. 01 .. .. 0 10 Sty I: .. 15 18 .. 5 2 19 13 3 0 .. 15 14 9 13 .. 66 60 Syphilis ..72 .. 01 55 .. .. 0340 .. 16 11 Toxic .. ..11.. .. 0 3.. 10 10 17.. 4 11 Tranrfers 0 !! " 5 6 13" 9 s"68 lo" 6 20 2 6 23 20 38 7 2 1 1 90 155 Totals .. 138 164 13 9 51 106 168 158 42 14 15 33 146 151 71 82 3 5 647 722

H.—7.

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

20

Discharged. Remaining, iromoe itnmhora Percentage Percentage of Deaths year. Admitted. : | Died. 31st December in rSaAent of Recoveries on on Average Numbers Recovered. | Relieved. Not Improved. each Year. " ' 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 .. ! 1876 . 221 117 338 129 79 208 17 | 8 25 2 8 10 36 12 48 1 519 264 783 491 257; 748 54-53 66-01 57-56 8-21 3-58 6-70 1877 250 112 362 123 57 180 20 5 25 3 2 5 42 21 63 | 581 291 872 541 277| 818 49-20 50-80 49-72 7-76 7-58 7-70 1878 .. 247 131 378 121 68 189 14 14 28 4 4 8 51 17 68 638 319 957 601 303, 904 48-98 51-90 50-00 8-48 5-61 7-52 1879 248 151 399 112 76 188 15 13 28 9 4 13 55 16 71 695 361 1,056 666 337! 1,003 45-16 50-33 47-11 8-25 4-74 7-07 1880 .. 229 149 378 100 67 167 36 25 61 5 2 7 54 20 74 729 396 1,125 703 371 1,074 43-66 44-96 44-17 7-68 5-39 6-89 1881 232 127 359 93 65 158 41 36 77 9 2 11 1 49 14 j 63 | 769 406 1,175 747 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 I 79 j 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 I 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 j 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 I 73 22 95 ' 981 542 1,523 965 528 1 1,493 38-62 57-14 45-12 7-56 4-16 6-36 1886 207 165 372 99 60 159 11 s 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 .. .. .. j 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 j 31 ! 28 59 2 3 5 j 78 26 104 i 1,041 j 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 j 1 "4 70 30 100 I 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 I 5 17 76 35 111 1,095 702 1,797; 1,078 685 1,763 j 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 i 17 12 29 I 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 I 183 ! 15 j 11 26 j 5 4 9 64 35 99 j 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 t 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 I 16 41 ! 2 1 3j 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 1 105 43 j 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 I 2! 2 466 114 110 224 13 23 36 | 7 1 8 ' 88 60 1 148 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 1 19 34 2 1 3 1 It 43 157 ; 1,512! 1,045 2,557 1,487 1,004 2,491 33-98 49-49 40-83' 7-67 ! 4-28 6-30 1900 . 300 i 202 | 502 103 96 199 29 : 10 39 4 I 4 99 46 i 145 j 1,581 1,091 2,672 1,534 1,049 2,583 34-33 47-54: 39-64 6-45 j 4-38 5-61 1901 ! 320 ! 223 : 543 125 104 229 20 j 17 37 .. I 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 I 6-58 6-41 1902 .. 352 192 544 135 99 i 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 1 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 j 264 659 J57 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 2.555.1,820 4,375 2,483 1,768. 4,251 30-89 47-37 37-66 8-42 4-52 6-80

H.—7

Excluding transfers between institutions— 2,673 males, 2,120 females.

21

1917 .. 470 374 844 171 152 323 32 20 52 6 5 11 205 113 318 2,611 1,904 4,515 2,543 1,825 4,368 36-38 40-64 38-27 8-06 | 6-19 | 7-2S 1918 .. 437 402 839 142 141 283 17 36 53 12 12 24 274 174 448 2,603 1.943 4,546 2,602 1,899 4,501 32-49 35-07 33-7310-53 9-16 j 9-95 1919 .. 512 371 883 190 147 337 37 44 81 9 13 22 212 130 342 2,667 1,980 4,647 2,620 1,907 4,527 37-11 39-62 38-17 8-09 6-82 7-55 1920 .. 455 418 873 162 148 310 27 37 64 6 10 16 210 166 376 2,717 2,037 4,754 2,674 1,980 4,654 35-63 35-32 35-51 7-85 8-40 8-08 1921 .. 479 402 881 178 193 371 30 21 51 15 9 24 201 117 318 2,772 2,099 4,871 2,723 2,031 4,754 37-23 47-88 42-11 7-38 5-76 6-69 1922 .. 453 386 839 156 157 313 32 20 52 10 8 18 211 184 395 2,816 2,116 4,932 2,747 2,062 4,809 34-44 40-67 37-31 7-67 8-92 8-21 1923 .. 442 366 808 168 151 319 42 38 80 15 5 20 194 131 325 2,839 2,157 4,996 2,789 2,079 4,868 38-00 41-25 39-48 6-95 6-30 6-67 1924 .. 446 377 823 152 128 280 30 42 72 9 11 20 221 95 316 2,873 2,258 5,131 2,808 2,146 4,953 34-08 33-95 34-02 7-87 4-42 6-37 1925 .. 445 430 875 144 175 319 29 37 66 23 17 40 201 123 324 2,921 2,336 5,257 2,830 2,203 5,033 32-36 40-69 36-45 7-45 5-57 6-43 1926 .. 508 439 947 136 145 281 27 35 62 15 25 40 207 147 354 3,044 2,423 5,467 2,926 2,287 5,213 26-18 30-75 29-67 6-16 6-42 6-77 1927 .. 531 414 945 157 128 285 40 42 82 14 9 23 217 132 349 3,147 2,526 5,673 3,022 2,373 5,395 29-56 30-91 30-16 7-17 5-65 6-47 1928 .. 506 450 956 115 134 249 40 40 80 17 13 30 207 161 368 3,274 2,628 5,902 3,120 2,459 5,579 22-72 29-77 26-04 6-63 6-55 6-59 1929 549 407 956 145 144 289 30 28 58 22 16 38 227 153 380 3,399 2,694 6,093 3,215 2,495 5,710 26-41 35-37 30-23 7-06 6-13 6-65 1930 .. 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 1,063 127 120 247 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 1632 .. 587 484 1,071 141 160 301 39 42 81 38 41 79 219 169 388 3,903 2,980 6,883 3,681 2,738 6,419 24-02 33-05 28-10 5-97 6-17 6-06 193S .. 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 72 136 233 203 436 4,133 3,300 7,433 3,899 3,039 6,938 23-80 28-97 26-45 5-98 6-68 6-28 1935 .. 567 502 1,069 117 136 253 72 55 127 229 206 435 4,282 3,405 7,687 4,003 3,111 7,114 20-63 27-09 23-67 5-72 6-62 6-11 1936 .. 553 556 1,109 121 149 270 105 96 201 252 213 465 4,357 3,503 7,860 4,093 3,195 7,288 21-88 26-80 26-76 6-18 6-66 6-38 1937 .. 557 567 1,124 180 179 359 121 110 231 261 236 497 4,352 3,545 7,897 4,112 3,272 7,384 32-32 31-57 31-94 6-35 7-21 6-73 „ i i ; 23,601 18,010 41,611 8,299 7,236 15,535 399 2,137 4,536 9,033 5,345 14,378 , | ■■ I ••

H.—7

Table IX. —Showing the Admissions, Discharges, and Deaths from Ist January, 1876, to 31st December, 1937 (excluding Transfers). M. P. T. In hospitals, 31st December, 1875 .. .. .. .. 482 254 736 Admissions .. .. .. .. .. .. .. 23,601 18,010 41,611 24,083 18,264 42,347 Discharged— M. t. Recovered .. .. 8,299 7,236 15,535 Not recovered .. .. .. 2,399 2,137 4,536 Died .. .. .. .. 9,033 5,346 14,379 —19,731 14,719 34,450 Remaining on 31st December, 1937.. .. .. .. 4,352 3,545 7,897

Table X.— Summary of Total Admissions: Percentages of Cases since the Year 1876.

22

Males. j Females. j Both Sexes. Recovered .. .. .. •» •. 34 • 46 39 • 62 36 • 69 Not recovered .. .. .. .. •• 9*96 11*70 10*71 Died .. .. .. .. .. .. 37*51 29*27 33*95 Remaining •• .. •• .. .. J8*07 19*41 18*65 100*00 100*00 100*00

H—7.

Table XI.—Debits for the Financial Year, 1937-38.

23

Auckland. Kingseat. Tokanui. Porirua. | Nelson. Hokitika. Christchurch. Seacliff. Head Office. Total. £ s. d. £ s. d. £ s. d. £ s. d. £ s. d. £ s. d. £ s. d. £ s. d. £ s. d. £ s. d. Salaries .. .. .. .. 54,600 15 2 18,648 5 11 34,709,10 10 70,069 13 11 34,302 12 8 23,308 12 2 66,270 19 3 69,992 8 2 9,909 13 10 381 >812 11 11 Official Visitors .. .. .. 50 8 0 .. .. 25 0 0 .. •• 25 4 0 •• no'in a 1Q3 0 7 Advertising, books, &c 14 19 9 14 5 2 13 12 3 22 18 0 8 0 9 11 13 0 14 6 0 29 15 0 63 10 8 193 « 1 Bacteriological research .. .. 66 6 2 0 15 6 .. 5 13 0 .. • • 1 1 y •• •• ~ Bedding and clothing .. .. 5,835 8 7 2,160 4 3 3,061 19 8 7,180 6 9 3,143 8 1 2,500 14 9 6,320 16 0 o,400 0 1 .. 3o,602 18 2 Buildings, including additions, &c. .. 911 15 11 22 13 5 480 11 9 484 19 6 254 16 9 197 5 7 1,075 14 2 903 8 11 .. 4,331 6 0 Dental services .. .. .. 1 13 3 1 19 7 2 0 9 7 19 8 19 17 6 13 19 0 14 0 8 6 •• ,, Farms, maintenance of .. .. 1,278 6 9 946 16 0 5,012 5 8 1,432 6 10 1,269 18 1 412 18 8 1.492 14 6 7,658 0 5 .. 19,o03 6 11 Fencing, draining, and roading .. 44 10 3 147 16 8 76 8 1 63 14 4 56 3 10 22 5 3 82 16 3 89 13 7 .. 8 3 Freight, cartage, and transport .. 61 2 8 95 14 5 239 1 10 305 16 2 252 4 6 48 1 8 353 1 5 438 9 9 0 4 6 1,794 6 11 Fuel, light, water, &c. .. .. 6,801 9 0 1,884 10 8 3,550 4 3 6,566 0 4 4,835 9 6 1,614 111 7,354 8 11 6,112 15 8 51 2 4 38,770 \ J Funeral expenses 82 10 0 32 10 0 110 3 0 117 5 0 38 5 0 .. 30 15 0 113 14 0 .. „ 2 0 Furniture and fittings .. .. 403 1 5 433 8 9 153 8 4 739 0 6 208 9 11 116 12 3 850 11 1 '88 4 9 .. 3,692 17 0 Gardens and shrubberies .. .. 53 16 0 19 15 8 12 1 6 58 3 7 25 16 1 15 13 / 142 19 7 36 16 3 .. _ Laundry .. .. .. .. 425 5 10 189 7 9 215 18 0 362 7 7 140 12 6 47 4 6 409 12 10 288 3 8 .. 2,078 12 8 Legal and inquiry costs .. .. 1116 .. .. •• •• •• 1® J® 1 .. .. Machinery, repairs, and stores .. 72 17 11 4 18 1 104 7 3 134 17 6 64 15 2 10 16 3 264 16 11 203 4 .. Medical fees .. .. .. 664 14 0 9 16 3 157 13 0 732 18 0 83 16 0 39 7 0 468 19 3 307 4 0 .. 2,464 7 6 Motor-vehicles Maintenance of .. .. .. 72 10 7 115 4 11 110 12 4 83 0 8 37 5 5 32 15 6 354 19 6 208 18 0 .. 1,015 6 11 Purchase of .. .. .. .. 371 6 7 127 8 11 243 1 6 243 1 6 129 19 11 .. .. .. MM 18 5 Nursing-staff uniforms .. .. 323 17 7 156 18 2 179 3 8 286 9 6 195 5 8 149 8 11 174 3 1 366 16 11 .. , ' Office equipment 3 16 0 .. 9 8 11 9 2 10 0 11 6 1 1 2 7 12 0 3 0 6 4 5 3 38 18 2 Patients, expenses connected with — „„ ,, . ,... 0 „ - Gratuities 21 10 0 .. 4 7 6 44 1 6 119 19 2 12 10 0 .. 36 0 3 .. 238 8 5 Friends . . .. •• •• •• •• •• •• 50 0 0 .. 50 0 0 Recreation .. .. .. 721 11 9 583 12 0 509 4 3 1,188 4 3 512 15 9 526 9 0 1,057 16 9 899 10 7 .. 5,998 14 4 Transfers .. .. .. 24 19 3 7 9 11 4 16 10 137 7 10 8 17 9 13 15 2 79 12 1 138 3 2 .. 415 2 0 Postages, telegrams, &c 86 17 5 44 9 1 52 12 3 139 9 9 44 3 4 12 0 0 115 9 4 136 3 11 18o 17 10 81/ 2 11 Printing and stationery .. .. 222 14 9 101 2 8 123 12 1 209 14 4 109 17 5 88 14 8 252 2 4 197 6 5 90 2 6 1,395 2 Rations .. .. .. 14,030 12 2 8,336 9 5 6,154 15 6 19,769 12 10 8,889 1 6 6,121 18 3 15,856 8 1 10,412 14 0 . . 89,571 11 9 Rents and rates .. .. .. .. •• •• 7 12 7 677 2 1 4 0 0 668 15 5 1,357 10 1 Stores .. .. .. .. 562 15 5 316 1 2 453 5 9 1,079 19 5 611 18 6 366 9 1 1,055 15 9 825 1 9 .. 5,271 6 10 Surgery and dispensary, drugs, &c. .. 377 10 1 165 18 6 130 0 0 345 16 11 232 17 6 134 8 1 448 6 8 250 15 4 .. 2 , 085 1 | Telephone services .. . .. 68 6 3 124 13 1 84 8 8 181 0 2 57 12 3 33 1 11 111 15 11 213 8 9 "4 9 5 989 6 5 Transfer and removal expenses .. 2 15 6 7 4 5 99 9 4 40 13 2 4 0 6 43 7 0 12 10 4 30 4 10 7 19 10 Travelling-allowances .. 42 6 2 103 14 11 58 4 10 78 16 3 90 7 5 52 13 9 25 13 11 209 7 9 251 15 6 1,013 0 6 Travelling-expenses 97 13 5 15 13 1 21 17 10 69 15 7 21 19 7 18 16 0 110 9 4 138 6 8 223 17 3 718 8 9 Treatment in general hospitals — ,,,, , . , Patients .... .. 179 15 3 40 8 6 20 14 10 225 14 10 6 1 6 28 7 0 78 19 6 116 1 0 .. 696 1 1 Staff .. .. .. .. 1 11 6 .. .. 2 18 0 .. • ■ 26 8 0 51 3 0 .. 82 0 6 Contingencies and miscellaneous .. 198 8 3 .. 8 8 6 18 10 6 15 0 7 29 8 0 139 8 5 113 13 10 7 2 6 530 0 Totals .. .. .. 88,410 3 6 35,103 4 6 56,051 18 2 112,462 9 1 55,912 15 9 36,154 9 0 105,874 6 6 106,779 11 0 11,578 16 10 608,327 14 5

H.—7,

Table XIa.—Credits for the Financial Year, 1937-38.

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

24

Auckland. Kingseat. Tokanui. Porirua. Nelson. Hokitika. Christchurch. Seacliff. Head Office. Total. — _ . ; - - : ~~ : j j " £ s. d. £ s. d. £ s. d. £ s. d. £ s. d. £ s. d. £ s. d. £ s. d. £ s. d. £ s. d. Receipts for maintenance .. .. 27,967 8 1 11,066 16 9 13,051 13 5 35,298 11 2 11,026 10 11 5,479 4 6 27,656 10 4 24,256 6 7 .. 155,803 1 9 Receipts from farms .. .. 608 10 8 2,175 15 3: 5,229 15 2 1,107 10 10 2,372 19 6 57 4 10 2,911 18 6 4,399 0 0 .. 18,862 14 9 Miscellaneous .. .. .. 5,099 18 10 2,604 8 4 4,558 1 2 8,202 5 11 3,606 8 8 2,115 6 7 6,630 0 4 6,382 11 7 8 13 5 39,207 14 10 Totals .. .. 33,675 17 7 15,847 0 4 22,839 9 9 44,608 7 11 17,005 19 1 7,651 15 11 37,198 9 2 35,037 18 2 8 13 5 j 213,873 11 4

| Average I I [■ II • RpT)llv Number of Bedding | Buildings Fuel, light, | Surgery M , , | Total Cost | Other I Net Cost Net Cost i Decrease Increase . Mental Hospital. | Resident Salaries. and ; and Farm. Water, and j Provisions, j and Uinpnns I Per I Be- | per Previous I in j in j (inclusive of Clothing. ! Repairs. Cleaning. ! [Dispensary, 'aneous. j p at j payments.! Patient. Year. | 1937-38. I 1937-38. J Boarders). [ III ' renauce. | , i £ s. d. ! £ s. d. £ s. d. £ s. d. £ s. d. | £ s. d. £ a. d. j £ a. d. I £ s. d. £ s. d. £ s. d. £ s. d. £ s. d. £ s. d. £ s. d. Auckland .. .. .. 1,280 42 13 2 4 11 2 0 14 3 1 0 0 5 6 3 10 19 3 0 5 11 3 11 6 69 1 6 21 17 0 4 9 2 42 15 4 38 10 6 .. 4 4 10 Kingseat .. .. .. 583 31 19 9 3 14 1 0 0 9 1 12 6 3 4 8 14 6 0 0 5 8 5 0 10 60 4 3 18 19 8 8 4 0 33 0 7 30 16 6 .. 2 4 1 Tokanui .. .. .. 618 56 3 3 4 19 1 0 15 7 8 2 3 5 14 11 9 19 2 0 4 2 4 15 7 90 14 0 21 2 5 15 16 9 53 14 10 42 11 5 .. 11 3 5 Porirua .. .. .. 1,496 46 16 9 4 16 0 066 0 19 2 479 13 44 047 485 75 36 23 11 11 646 45 71 38 64 .. 709 Nelson .. .. .. 809 42 8 0 3 17 9 0 6 4 1 11 5 5 19 7 10 19 9 0 5 9 3 13 9 69 2 4 13 12 7 7 7 10 48 1 11 45 16 11 .. 2 5 0 Hokitika .. .. .. 450 51 15 11 5 11 2 0 8 9 0 18 4 3 11 9 13 12 1 0 6 0 4 2 10 80 6 10 12 3 6 4 16 7 63 6 9 54 16 8 .. I 8 10 1 Christchurch .. .. 1,298 51 1 1 4 17 5 0 16 7 1 3 0 5 13 4 12 4 4 0 6 11 5 8 8 81 11 4 i21 6 2 7 7 7 52 18 2 41 19 0 .. 10 19 2 Seacliff .. .. .. 1,172 59 14 5 4 12 2 0 15 5 6 10 8 5 4 4 8 17 8 0 4 3 5 3 3 91 2 2 20 13 11 9 4 0 61 4 3 50 7 8 .. 10 16 7 Head Office .. .. .. 159 .. .. .. 002 .. .. 042 1 10 1 .. .. 1 10 1180 .. 021 Total average coat .. 7,706 49 10 11 4 12 5 0 11 3 2 10 7 5 0 7 11 12 6 0 5 5 4 15 1 78 18 9 20 4 4 7 10 9 51 3 8 43 15 11 .. 7 7 9 I • i * Note. —Cost does not include interest and depreciation on land, buildings, &c.

H.—7.

Table XIV.—Total Expenditure out of Public Works Fund for Buildings and Equipment at each Mental Hospital from 1st July, 1877, to 31st March, 1938.

Table XIII.—Expenditure out of Public Works Fund on Mental Hospital Buildings, etc., during the Financial Year ended 31st March, 1938.

Approximate Cost of Paper.—Preparation, not given; printing (610 copies), £38 10b.

By Authority : E. V. Paut., Government Printer, Wellington. —1938.

Price 9d.]

25

Total Net Expenditure Mental Hospitals. : 1877-1928. 1928-29. 1929-30. 1930-31. 1931-32. 1932-33. 1933-34. I 1934-35. 1935-36. 1936-3 1937-38. 1st July, 1877, to | I 1 i 31st March, 1938. i 1 I j I ! , ,, £ £ i £ £ J £ | £ £ £ £|£ £ £ Auckland .. .. 211,930 12,461 , 2,279 3,372 J 621 676 155 2,321 307 ; 842 5,658 240,622 Christchurch (Sunnyside) .. 224.275. 7,777 35,291 23,993 I 4,650 7,960 1 3,481 23,489 12,397 23,970 16,397 383,680 Dunedin (The Camp) .. 4,891 .. .. 1 '. | .. .. .. .. 4,891 Hokitika .. .. .. 45,649 401 3,064 14,764 i 8,381 3,io7 ! 8,753 5,629 2,739 7,580 2,097 102,164 Hornby .. .. .. 11,102 . .. •• 11,102 Motuihi Island .. .. 561 .. _ j .. .. • • 561 Napier .. .. .. 147 _ _ _ _ _ _ _ ,. I .. .. • • • • i 147 Nelson and Stoke .. .. 63,600 956 3^339 ! 12,251 28,552 18,307 16,218 2,234 ! 207,881 Puhitahi (Kingseat) ... .. .. 16,130 16,433 10,278 35,438 29,784 21,973 65,192 52,144 247,372 Seaclifi .. .. .. 225,055 27,132 34,609 8,914 3,065 414 6,618 4,888 1,453 2,958 570 315,676 Tokanui .. .. .. 126,708 19,887 32,405 27,787 7,164 2,918 6,295 3,797 12,682 18,839 2,855 261,337 Waitati .. .. .. 18,289 ! 853 2,170 ! 9,557 936 516 .. .. i •• •• •• 32,321 Wellington .. .. 29,641 .. .. .. •• 29,641 Wellington (Porirua) .. 305,302; 27,315 1 j349 207 29 170 | .. 6,510 20,502 373,541 Totals .. .. 1,267,150 96,782 152,096 134,140 45,938 28,756 73,020 98,630 69,858 142,109 102,457 2,210,936

n«- ( i *rr # j i ! Net Expenditure for Year Mental Hospitals. j ended 31st March, 1938. £ Auckland .. .. .. .. .. .. .. .. .. 5,658 Christchurcli (Sunnyside) .. .. .. .. .. .. .. 16,397 Hokitika .. .. .. .. .. .. .. .. .. 2,097 Nelson and Stoke .. .. .. .. .. .. .. .. 2,234 Porirua .. .. .. .. .. .. .. .. .. 20,502 Kingseat .. .. .. .. .. .. .. .. .. j 52,144 Seacliff .. .. .. .. .. .. .. .. .. I 570 Tokanui .. .. .. .. .. .. .. .. .. j 2,855 Waitati .. .. .. .. .. .. .. .. .. i Total ! 102,457