MENTAL HOSPITALS OF THE DOMINION. (REPORT ON) FOR 1940.

Appendix to the Journals of the House of Representatives, 1941 Session I, H-07

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1941. NEW ZEALAND.

MENTAL HOSPITALS OF THE DOMINION. (REPORT ON) FOR 1940.

Presented to both Houses of the General Assembly pursuant to Section 78 of the Mental Defectives Act, 1911. The Director-General to the Hon. A. H. Nordmeyer, Minister in Charge of the Department of Mental Hospitals. Sir,—- Wellington, Ist June, 1941, I have the honour to present my annual report upon the work of the Department of Mental Hospitals for the year ending 31st December, 1940. Statistical. There were 8,370 names of persons upon our register at the end of the year, including 40 patients and boarders at Ashburn Hall private licensed institution and 624 patients and boarders who were absent on probation in the care of relatives and friends. In actual residence in our eight State hospitals on 31st December there were 7,706 persons —an increase of 17 compared with the previous year —and of this number 7,394 were subject to a reception order, whilst 312 were voluntary boarders. There was a decrease of 50 in the number of those admitted for the first time, and 355 ex-patients and boarders returned for further treatment. Of all classes of admissions we were able to discharge 906, or 59-2 per cent., calculated upon the number admitted, but no more than 516, or 34-08 per cent., were fully recovered at the time of discharge. This number falls far short of the true recovery rate, as patients who go on probation and do not send a medical certificate or report to the institution require to be discharged as " unrecovered." We discharged 107 persons suffering from congenital mental deficiency. These patients do not recover, but many have sufficiently stabilized to be left in the care of friends and relatives, and a number have been absorbed into remunerative employment.

Voluntary Boarders.

Alterations, Additions, and Improvements. Capital expenditure incurred upon new buildings, additions, and improvements amounted to £126,644 during the year, made up of the following items : — Auckland (£2,659). Additions to the Nurses' Home and the erection of a new hairdressing-saloon have been completed. A new glasshouse has been erected. The general roading has been improved during the year,

Ifj r „f w nt T fi.. a |. Tntsi.l Transferred Remaining Year - ! Admission. Admission. AdmSms. * Died ' Discharged. on or Patients. 31st December. 1 1 M. IT. T. M. F. T. M. F. T. M. F. T. M. F. T. M. F. T. M. F. T. 1912 .. .. 6 17 23 0 0 0 6 17 23 1 3 4 0 0 0 4 3 7 1 11 12 1913 .. .. 18 19 37 0 2 2 18 21 39 2 5 7 0 1 1 12 12 24 S 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 1938 .. .. Ill 105 216 60 53 113 171 158 329 11 15 26 11 8 19 144 125 269 183 169 352 1939 .. .. 131 103 234 63 72 135 194 175 369 22 21 43 16 15 31 157 130 287 182)78 360 1940 .. ..128 124 252 65 63 128 193 187 379 18 18 36 10 12 22 176 167 343 171 168 339

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Kingseat (£45,095). The Nurses' Home is almost ready for occupation. A start has been made on the erection of seventeen staff residences. Two villas have been renovated and painted. Reading, drainage, and water-supply services have been extended where necessary. A new glasshouse has been erected. Tokanui (£13,662). The villa for male patients has been completed. The general roading has been improved and extended where necessary. The electrical reticulation has been overhauled. Porirua (£6,843). A suitable building for occupational therapy work has been provided by alteration of the old workshop. Extensive repairs to the cow-byres have been started. Work on the sewerage system has continued during the year. Nelson and Ngawhatu (£34,119). Three male villas have been completed. Roading has been extended and improved. Hokitika (£10,233). A new butcher's shop is in course of erection. The new Nurses' Home is nearing completion. Extensions to the laundry and installation of new machinery will be completed at an early date. Improvements have been carried out to the water-supply. Christchurch (£6,032). Alterations have been made to the main store. New laundry equipment has been installed. Templeton Farm Colony (£7,294). A new male villa is in course of erection. Seacliff (£707). The telephone system has been overhauled. The water-supply has been improved. Programme for Current Year. Subject to modification due to war conditions, the principal proposals for the ensuing year are Auckland. —It is proposed to rebuild the boiler-house on a new site. It is hoped to provide an occupational block for Male 3 patients. Kingseat.—Seventeen staff cottages are being erected. Tokanui. —Negotiations have been entered into with the County Council for the tar-sealing of the Otorohanga - Te Mawhai Road. Plans are well forwarded for the new services block. Porirua. —The provision of separate dining-rooms, additional office accommodation, and enlargement of the main hall are all under consideration. Nelson. —Plans are in preparation for the rebuilding on the villa system of the old Nelson City Mental Hospital. Hokitika.—The Nurses's Home is in course of erection, and its completion will pave the way for additional store accommodation. Christchurch. —A new villa at Jenkins Farm is under construction. Improvements to the children's playground and the erection of additional farm sheds at Templeton are to be proceeded with. Seacliff. —The main building at Waitati is overdue for replacement and plans are being considered. The Staff. Our male stafl has made a good response to the call to service, and four of our medical officers and one hundred other officers from the clerical, nursing, and artisan staff have gone overseas. Most of the staff who are eligible have been and are being released for training in the territorial camps. These absent officers have been replaced, so far as possible, by the engagement on a temporary basis of men ineligible for service, and so far we have had remarkably little interruptions of normal routine. Many of our senior officers have sons and daughters on active service, and to them we extend good wishes for health and safety. As could be expected, many of our nurses have married men about to go on active service, and we have so far as possible retained their services, thus benefiting both the nurse and the Department. The shortage of suitable female trainees persists, and it is little consolation to know that a similar scarcity is being experienced in other countries.

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A recent amendment to the Nurses and Midwives Registration Act enables our trainees, after following the prescribed course of study, to sit for the State Preliminary Examination for general trained nurses. This year eight of our trainees entered, and all were successful. With a view to accelerating the promotion of our most promising younger male staff an examination to qualify for promotion to Head Attendant has been instituted, and the successful candidates have all been of a good type. The War and Mental Disorders. Contrary to widely expressed popular belief, there is no reason to anticipate anything but a very small incidence of mental disorders amongst our soldiers on active service. Apart from the fact that our soldiers are a specially selected group between certain age-limits, past experience has clearly demonstrated that stable, fit, and disciplined men sharing a common interest with their fellows, and actuated and exalted in a cause they believe to be a just one, can face the extremes of danger and privation without losing their mental balance. It is of interest to note that out of approximately 6,000,000 troops who served between 1914 and 1918, the cases of insanity regarded as caused or aggravated by war numbered only 13,030. In New Zealand during approximately the same period only 264 soldiers who had served overseas were admitted to mental hospitals. Similar considerations would seem to apply to the civilian population of Great Britain to-day, as reports all seem to indicate that, in spite of the front-line positions of civilians, there has been no appreciable increase in the incidence of mental disorders. Experience of the last war indicated that the less stable and those who are mentally less well equipped than what we regard as " normal " would not be able to make a successful readjustment from civilian to military life. It was therefore arranged that the rolls of recruits should be submitted to this Department with a view to the removal of the names of all ex-patients from the Active Service list. This measure combined, with the disclosure under the stress of camp life of mental instability and deficiency not obvious upon first examination, has undoubtedly, prevented much wastage in training and transport. At the time of writing —that is, after fifteen months of war —only two soldiers and two sailors who have been on active service overseas have been admitted to our hospitals, whereas in the same period twenty-one soldiers have been admitted from training camps in New Zealand. Appreciation. I desire to express my keen appreciation of the work done throughout the year by the staffs of the Department and by other helpers, many of whom act in an honorary capacity. Owing to the wartime need for abbreviation of reports it has not been possible to make individual reference to services rendered but I am none the less grateful. T. G. Gray, Director-General.

AUCKLAND MENTAL HOSPITAL. Dr. Buchanan reports : — The total number of cases under care during the year was 1,851, with a weekly average of 1,285. The total admissions numbered 405 —under certification 131 males, 151 females ; by transfer 13 males, 5 females ; on remand 6 males, 2 females ; and as voluntary boarders 54 males and 43 females. During the year 180 patients (87 males and 93 females) and 98 voluntary boarders (51 males, 47 females) were discharged. Transfers to other hospitals numbered 48 (22 males, 26 females). At the end of the year 153 patients were on probation and 69 on full'parole and 151 on limited parole. I append figures relative to the Psychiatric Clinic held at the Auckland Public Hospital by Dr. Hunter and myself:— Tuesdays. «K., Total. (1) Number of separate persons seen .. M. 264 132 396 F. 14 .. 14 278 132 410 (2) Number of — (а) First visits .. .. .. .. 165 132 297 (б) Subsequent consultations .. .. 675 445 1,120 840 577 1,417 (3) Sources of reference — Pensions Department .. .. 175 93 268 Prisons Department .. .. 23 . . 23 Police Department .. .. 5 .. 5 Medical practitioners . . .. 34 22 56 Voluntary calls .. .. .. 16 3 19 Public hospital .. . . .. 13 10 23 Social Welfare League .. .. i . 2 Officer Commanding Northern Military Command .. .. .. 2 3 5 Christchurch Mental Hospital .. 2 1 3 Royal New Zealand Air Force .. 2 .. 2 Auckland Mental Hospital .. 3 .'. 3 Public Service Commissioner .. 1 .. 1 278 132 410

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In company with Mr. F. K. Hunt, visits were regularly paid to the Inebriates' Homes on Rotoroa and Pakatoa Islands. The health of the inmates there has been satisfactory. The addition to our staff of two specially trained Occupational Therapists from England—Miss Inman and Miss Trotter —was an event of considerable importance. We had already introduced occupational therapy to this hospital. The interest of some of our staff helped the movement to a great degree, but with the advent of the two new officers a trained directional force made itself immediately felt with most beneficial results. The work is becoming well established, and in time it will embrace the whole institution. The gradual influence of this work in chronic patient wards is specially encouraging—better behaviour and less destruction is the result of attracting the interests of the inmates. However, this is by no means an easy task. A decided help to our occupational development was the recognition by the Health Department of our hospital as a training-school. Trainees were sent for tuition to fit them to instruct returned soldiers in therapeutic occupation when the time comes. These students, along with trainees from the Seacliff Mental Hospital, have been very helpful. They certainly had the benefit of expert training, and the practical application of their schooling was helpful both to themselves and to the patients. The year's progress in occupational work is encouraging. However, the objective will not be actually attained until at least 90 per cent, of the inmates are engaged and interested in some form of ploy. The average number engaged was 55 males and 227 females. New additions and constructions comprise a hairdressing-saloon of attractive appearance, erected in the grounds for the use of female patients, to whom it gives a considerable amount of interest, besides undoubtedly stimulating personal pride which is of therapeutic value. The additions to the Nurses' Home have been completed. An entrance hall to F. 7 made by the alteration of a dormitory gives an attractive introduction to the hospital to newly arrived patients. A glasshouse was built for the nursery garden. The usual general painting and maintenance programme was carried out, but many other minor, though important, works received attention. The annual bazaar was held in December and, thanks to the enthusiasm of the Matron, the staff, and friends, the sum of £240 was realized. Mrs. Morrison, an old friend of the hospital, instituted a bowling club for the women patients. This was a great success and certainly will be continued in the coming year. Like every other hospital, we are beginning to feel the effects of the war. Many of our staff have been called up, and suitable replacements have not been easy. Our best wishes go out to those who have gone on service. There is an inevitable shortage of Medical Officers, which throws much extra work and responsibility on those remaining. I would like to express my gratitude to my Medical Officers for the way in which they have uncomplainingly accepted the additional burden. The nurses have formed a Patriotic Club, and during the year have provided many useful and needed articles for the Forces. Four nurses entered for the State Preliminary Examination, and it redounds to their credit that .they all passed. We have all felt a great loss in the death of the Rev. Mr. Rattray. During the time he was associated with us he proved himself a genuine and interested friend to all. Finally my thanks are due to all the members of the staff for their helpful work during the year.

KINGSEAT MENTAL HOSPITAL. Dr. Hunter reports :■ — The total number of patients under care during the year was 711 (381 males and 330 females), with a weekly average of 636. Patients admitted for the first time numbered 10 (5 males and 5 females) and 2 male patients and 2 female patients were readmitted during the year. Patients admitted by transfer were 96 (70 males and 26 females). Transfers to other hospitals numbered 5(3 males and 2 females). There were 9 patients (4 males and 5 females) discharged, and there were 15 deaths (9 males and 6 females). The total number of voluntary boarders under care during the year was 16 (10 males and 6 females), with a weekly average of 11. Boarders admitted for the first time numbered 6 (4 males and 2 females). One female was readmitted. There were 6 male boarders discharged, and there were no deaths. The general health of both patients and staff has been excellent. Owing to the outbreak of war there has been a slowing-down of building activity. The Nurses' Home, which was commenced the previous year, has been completed, furnished, and equipped, but the opening has been delayed due to the non-arrival of sewage pumps, which are expected in February, 1941. The 300,000-gallon water-storage reservoir has been completed and connected with our previous supply, but the direct main from the new reservoir to the hospital, although installed, has not been connected up. A male villa, No. 7, has been opened by the transfer of 50 patients from Porirua. Villa 8, another villa for male patients, is being used as a temporary Nurses' Home, and the opening of the new Nurses' Home early in 1941 will release accommodation for a further 50 male patients. The increasing number of patients and staff is overtaxing the accommodation available for entertainments. More patients than can be accommodated are wanting to attend the various entertainments and recreations. I hope that this difficulty will be overcome in the near future by the building of a hall. I regret that the Hospital has lost, through ill health, the services of Miss M. A. McNoe, who retired on Ist December. She has been at Kingseat since 1932, when Villas 1 and 2 were opened, and, together

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with Mr. Fowlie, the Head Attendant, has given of her best to promote the welfare of the patients and to bring the hospital up to its present standard of efficiency. We wish her a speedy restoration to health. Mr. MacFarlane, who has taken a keen interest in the hospital since its commencement, and has given valuable assistance in the planning and lay-out of Kingseat, has retired from the Public Works Department. I would like to thank him for his many helpful and practical suggestions. There is a shortage of housing accommodation for married staff, and as our single members are called up for military service the housing shortage has become more acute, making the replacement of staff difficult. The patients have been fully occupied with constructional work on the farm, around the villas, and the Nurses' Home, in gardening, in the laundry, and in the sewing-room. The weekly occupational classes conducted by Mrs. Waugh for the women, and the Rev. Jasper Calder during the winter for the men, have been well attended. The patients look forward to these, and there has been a marked improvement in the mental conditions and conduct of those attending. The weekly clinic is held at the Auckland Public Hospital, where 132 new cases were treated, while there were 445 attendances. New cases were referred by the Pensions, 93 ; medical practitioners, 22 ; hospital, 10 ; Army, 3 ; spontaneous 3 ; other mental hospitals, 1.

TOKANUI MENTAL HOSPITAL. Db. Tothill reports The total number of cases under care during the year ended 31st December, 1940, was 851, including 38 voluntary boarders. Admissions numbered 160, of whom 96 were committed patients, 21 voluntary boarders, and 43 transferred from other institutions. The discharges were 38 patients under certificate, 16 voluntary boarders, and 8 transferred. Deaths totalled 30, senile decay and heart-disease being the principal causes. At the end of the year 738 patients, including 59 on probation and 16 voluntary boarders, remained on the registers. Continued progress has been made in effecting improvements throughout the hospital. A new male villa was completed and occupied. Modern sanitary and washing facilities have been installed in Wards E. 3, A, and C, and a veranda built on to the male staff quarters. Extensive interior and exterior painting has been carried out. The internal roading is being improved, and repairs to the electrical system are in progress. The switchboard of our local telephone was burnt out and has been replaced. This system is not very efficient, and an automatic exchange. would give better service. Erection of a new laundry is under consideration. With the increase of patients this has become an urgent necessity. A modern bakehouse and butcher's shop are also badly needed. Occupational therapy has been actively pursued. Practically aIJ able-bodied male patients are engaged in work on the farm, in the gardens, and wards. Shortage of female staff has limited our efforts on the female side, and I would welcome the appointment of a trained occupation officer to place this work on a sound basis. The slaughterhouse, boiling-down works, and skin-room are in operation. The power-spraying plant for the orchard has been of great benefit. The carpenter's shop was provided with a circular band-saw, and the plumber with guillotine shears. Difficulty in procuring nurses has necessitated the working of overtime. Thirteen of our male staff are on active military service. Our best wishes go out to them, and we wish them a safe and speedy return. Dr. Couston is overseas with the New Zealand Medical Corps, and his place has been filled by Dr. Calvert. Mr. Howie, our Head Attendant, was promoted to Porirua, and Miss Mcßae to Matron, B Class, at Seacliff. They had both given much valuable service to this hospital. Several members of our staff and most of their wives are actively engaged in Red Cross work, and a very successful sports carnival was held in the hospital grounds in aid of the Patriotic Fund.

PORIRUA MENTAL HOSPITAL. Db. Hart reports :— The total number of cases under care during the year was 2,051 ; of these, 1,820 were the subjects of a reception order, 224 were voluntary boarders, and 7 were remanded for observation. Admissions numbered 442—under certification 313, as voluntary boarders 122, and on remand 7. During the year 233 persons (129 committed patients and 104 boarders) were discharged. Deaths numbered 121, and 120 transfers were made to other mental hospitals. The usual psychiatric work has been continued outside the hospital, such as the supervision of the psychiatric wards at the Wellington Public Hospital and the out-patients' clinic at the Wellington and Palmerston North Hospitals. The number of separate cases dealt with in this work was 415, of which 238 were in-patients at the Wellington Public Hospital, 104 at the Wellington Hospital Outpatients' Clinic, and 73 at the Palmerston North Hospital Clinic. A series of cases was treated by cardiazol during the year and the result indicates that convulsive therapy is of very real benefit in certain cases of mental disorder. Specialized occupational work, such as weaving, spinning, basket-work, and various handcrafts, has been extended during the year. Apart from the simpler type of work undertaken in the wards, the old artisans' block has been reconstructed as a centre for female patients, whilst the old engineers' block, as portions become available, is being used as a centre for male patients. As well as the therapeutic benefits obtained, much of the work is of economic value, and the occupational therapy account is financially healthy. New bakery and butcher-shop block were brought into use during the year, and the cool-storage facilities of the latter has provided a very desirable amenity. The installation of the new sewage system is incomplete, and although the new boiler-house engineering block has been completed some time, war factors have delayed the installation of hot water

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and steam reticulation, so that it will be some months before this unit cati be brought into full use. The reorganization and re-equipping of the various hospital kitchens now remains the most urgent of the reconstruction problems. The artisan staff has been fully occupied during the year in minor repairs and general maintenancework, whilst the work on the farm, orchard, flower and vegetable gardens has continued as formerly. There has been a natural shortage of nursing staff during the year, and many of the male staff have gone with the Forces overseas. In their places temporary officers have been employed who are at present not liable for military service. I regret to have to report the death of Mr. Quill, who retired after forty years' service and died suddenly some weeks after his retirement. For many years Mr. Quill was Head Attendant at this hospital, and he will be much missed by fellow-members of the staff and his many friends in the district.

NELSON MENTAL HOSPITAL. De. Williams reports: — The number of persons under care during this period was 924, of whom 896 had been admitted under reception orders and 28 as voluntary boarders. The admissions numbered 95, including 14- voluntary boarders. The number of persons discharged was 34, including 13 voluntary boarders, and 10 patients were transferred to other institutions. There were 45 deaths. Of the patients under care, 523 suffered mental disorder and 373 mental defect. Of the latter, 196, comprising the younger ones, were situate at Nelson ; 177 adult defectives were at Ngawhatu. As was to be expected, the building and other operations have been considerably interfered with ; and male villas, for example, which would normally have been occupied months ago, are not yet completed because of military requirements rendering necessary the shifting hither and thither of many of the workmen engaged. The war has touched us in other ways, too, though comparatively lightly. A number of the male staff, whose places have been filled by temporary officers, have departed for service overseas. We hope for their safe return. Shortage of female staff has been and is very marked, and rendered the more acute by the absorption of young women into industries directly concerned with, or stimulated by, war activities. Very much larger wages may be earned in some of these industries, so until conditions become normal again shortage must unfortunately persist. Maintenance-work has been kept at a reasonably high level. The swimming-baths have been relined and repaired generally ; tar-sealing has been continued, and concreting about many of the villas completed. Two female villas have been painted, and much other painting-work carried out by the working party regularly engaged in this. A sewing-room and two rooms for Occupational Therapy have been made by the conversion of staff quarters in some of the female villas. Unfortunately the extreme staff shortage has prevented much expansion in this important form of treatment. It now appears that some replacement of buildings at Nelson may be possible in the coming year. The need is really very urgent. There are other matters which need attention, too —a new telephone system and increased medical staffing are two I have in mind —but these can more readily be held over. Following the need for greater production, farm activities and resources have been developed a good deal. Eighteen acres of gorse land in Poorman's Valley was cleared, and ploughed. One and a half acres was sown in early potatoes, and the balance in rape and turnips for fattening of lambs and for winter feed. Nearly 6 acres of potatoes have been sown on other parts, and with excellent results. Approximately 24 acres of new pasture has been sown down, and one paddock of old pasture treated, and sown with clover, rye, and cocksfoot. Comparative experiments in top-dressing pastures with basic slag, super, and potash, and with lime have been satisfactory, but have shown that the need for lime is much greater than that for manure. Five Romney rams were secured this year from a noted local breeder, in order that the quality of the flock might be further improved, and it is intended to do likewise next year. Sows have been increased to capacity, but the demand for weaners has- been greater than the supply. The season for the dairy herd, too, has been very favourable, so that production here also has shown a marked increase.

HOKITIKA MENTAL HOSPITAL. Dr. Childs reports : At the commencement of the year the patients on the register numbered 532. The admissions proper were 21, while 13 males and 9 females were received on transfer. The discharges numbered 14, transfers to other institutions 12, and deaths 20. The total number under treatment was 575, and the number remaining on the register at the end of the year 529. There were 6 voluntary boarders on the register at the beginning of the year, 4 were admitted during the year, and 6 discharged. The general health of the patients has been uniformly good. Occupational therapy has been carried on during the year, but, owing to the lack of a trained instructor and shortage of staff', has been interrupted occasionally. Iringatau has been completely renovated, and is now a pleasant villa, while the electrical system of the whole institution has been overhauled, and renewed where necessary, both externally and internally.

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Works in progress at present are the erection of a Nurses' Home, the installation of an intercommunicating telephone system, the installation of new pumping-equipment for the water-supply, and a new butcher's shop. These are all very necessary, and will add considerably to the efficiency and welfare of the hospital. Tenders for the additions to the laundry are at present being called. The usual routine of farming, draining, and gardening has continued, 5 acres of land being drained, cleared, and left fallow, while 7 acres of last year's fallow land has been sown down in grass. In addition, a fairly large programme of draining and roading has been carried out. The painting gang has been fully occupied, and the usual maintenance-work carried out. A Works Overseer was appointed during the year. A monthly clinic has been held at the Grey River Hospital, and the Westland Hospital visited when required.

CHRISTCHURCH MENTAL HOSPITAL. Dr. Bellringer reports The number of cases under care during the year was 1,776 (974 males, 802 females). The admissions numbered 300 —under certification, 107 males, 129 females ; by transfer, 9 males, 4 females ; as voluntary boarders, 26 males, 25 females ; and, in addition, 3 males and 6 females were admitted on remand. During the year 109 patients (62 males, 47 females) and 52 voluntary boarders (26 males, 26 females) were discharged. There were 92 deaths (43 males, 49 females) and transfers to other hospitals numbered 32 (20 males, 12 females). At the end of the year the total on probation was 194. Considerable use continues to be made of the alternative method of committal provided by section 8 of the Mental Defectives Act, and no less than 80 patients were admitted in this manner. This constitutes 37 per cent, of our admissions, excluding minors and voluntary boarders. The clinic at the Christchurch Hospital has been field weekly, and the monthly clinic at the Timaru Hospital has been continued. These psychiatric out-patient activities have been extensive, the number of separate cases seen being 291 (including 25 at Timaru). Tfio total number of consultations was 904, and 52 cases were investigated and reported on for the Child Welfare Department. The health of the patients has been satisfactory, the main causes of death being senile decay and cardiac disease, mainly senile in basis. Various special therapies have been employed in addition to the usual medical treatment, and frequent use has been made of the specialized clinics available at the Christchurch Public Hospital. Cardiazol treatment for schizophrenics has been continued. It is impossible to dogmatize on the ultimate benefits of this treatment, but our results are encouraging. Seven patients received treatment during the year —2 have made complete recoveries and 2 have noticeably improved. None of the 5 patients who received cardiazol treatment last year and were discharged have returned, and reports indicate that each is doing well. Altogether 15 patients have received cardiazol treatment since its inception in 1939. Occupational work is being steadily developed, but there still remains much to be done. The work covers a wide range of attractive crafts and the proceeds from the stall on Anniversary Day amounted to £17. The usual exhibit at the Winter Show was made, and through the generosity of Hay's Ltd. the window displays have been continued. At Templeton 261 children are receiving useful training in such varied places as the laundry, sewing-room, kitchens, villas, farm, flower and vegetable gardens, bootmaker and carpenter's rooms. The vocational block continues its useful activities, and a fairly satisfactory system is in operation by which every boy takes his turn for instruction. The health of the children has been good. The usual recreation has been provided in the way of weekly pictures, dances, bowls, cricket, basket-ball, folk-dancing, concerts, &c. In addition, large parties have attended (free of charge) numerous sporting fixtures, the shows, and picture-theatres in the city. Seventy-six patients spent enjoyable holidays at the New Brighton seaside cottage. I desire to thank the many organizations, firms, and individuals who have so generously provided these entertainments. During the year considerable maintenance-work has been carried out. The new workshops were taken over, machinery installed, and now, with the exception of one machine, the workshops have been completed. In response to the appeal for increased production, extensive alterations have been made to the piggeries at Sunnyside, and new pig-styes were erected at Templeton, where the number of pigs has been doubled. A modern ironing-machine was installed in the Sunnyside laundry. The erection of a new villa at Jenkin's Farm was commenced, and building has progressed rapidly. A new vegetable garden has been established at Sunnyside, a water-supply installed, and a concrete implement-shed erected. The farm has had a satisfactory year. Early in February, the Medical Superintendent, Dr. A. C. McKillop, was appointed 0.C., Ist N.Z. General Hospital. Nine members of the staff also went on military leave, bringing the total on service overseas to seventeen. We wish them all good luck and a speedy return. During the year Matron M. J. Martin, M.8.E., retired on superannuation after thirty-one years of valuable service. To the District Inspector, the Official Visitors, and the visiting clergy I tender thanks for regular visits and attention to the patients' needs. I desire to record my thanks to the staff for their work during the period I have been privileged to be in charge of this Hospital.

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SEACLIFF MENTAL HOSPITAL. Dr. Brown reports : — At the beginning of the year there were 1,035 patients on the register. During the year 149 patients were admitted, 68 were discharged, and 6 were transferred to other hospitals. There were 90 voluntary boarders under care, of whom 41 remain. The total death-rate was low. Deaths numbered 58, the majority of them being due to senile decay. The necessary repairs and renovations were carried out by the artisan and engineering staffs. As I have emphasized before, the slipping ground on which the hospital stands and the old buildings make this work heavy and costly. The completion of the kitchen in F. 2 villa at Waitati gives each ward on the female side there its own kitchen, and there has been a very obvious improvement in the meals on that account. The Public Works Department are installing pumping-machinery at the Evansdale Creek to augment the water-supply during dry periods. The completion of this should remove a recurring source of worry and inconvenience. The farm and garden have had a successful year, and the patients have had an abundant supply of fresh vegetables at all times of the year. Further experience in the treatment of schizophrenia with insulin has shown that it has much to recommend it. In a batch of picked cases —that is to say, cases which the medical staff considered were suitable for this type of treatment —7 have been discharged, and the remaining patient has shown improvement. I would emphasize again that not every case of schizophrenia will respond to this treatment. Ido so advisedly, for many relatives entertain false hopes of its success, and its failure is a sad disappointment to them. As time goes on one is beginning to get some idea of the permanency or otherwise of our results. This treatment has been used here for about two and a half years. During that period only two of the cases discharged have had to return to the hospital, and these two were patients about whom we were very doubtful but whom we allowed home on probation to the care of their people. Wherever possible the case is followed up after discharge, and a surprising number of these patients write to tell us how they are faring. In last year's report I spoke of the first of these cases whom we discharged after he had been in stupor for five years before treatment. His follow-up is most interesting. For a period he was only able to perform unskilled work, but now he has been able to resume his former highly-skilled work as a technical draughtsman, A number of schizophrenics, chiefly female patients, have been given convulsive treatment with cardiazol, with good but not such spectacular results as insulin. I have not yet the material with which to make comparisons between the two methods of treatment. I would again express my thanks to Dr. Thomson, of the Dunedin Public Hospital, and to various members of the Otago Medical School for their help in scientific investigations of these schizophrenic patients, which are beyond the facilities of this hospital. Without their co-operation and assistance it would be very difficult to carry out insulin treatment. Occupational therapy has been carried out on a scale which I hope to see greatly increased shortly. I am grateful to you for the opportunity I had to see the occupational units in Auckland Mental Hospital. As you are aware two nurses and an attendant have been seconded there for training, and a considerable extension of this form of treatment should be possible on their return. I continue to visit Dunedin Public Hospital twice weekly in my capacity as honorary physician in charge of the mental wards. An increased number of cases were seen, at my monthly clinic in Oamaru Public Hospital. My Deputy Superintendent, Dr. Hay, visits Invercargill Public Hospital once a month. On his visits there he has examined and furnished reports on 55 inmates of the Borstal Institution. It is of interest to record that our oldest patient is now, so far as our records show, one hundred years of age. He is very hale and able, when he runs short of tobacco, to walk from Simla Ward to my office to detnand a further supply. I need hardly say that this is never refused. The majority of the younger attendants are on leave of absence with the Forces, and I wish them a speedy return.

MENTAL NURSES. In November the usual examination was held for the registration of mental nurses, when the following passed: — Passed top for Dominion : Miss M. J. Middleton (Nelson). Auckland: Attendants —A. Dracevich, M. T. B. Harris, B. H. Taylor. Nurses—A. C. Kingdon, S. M. Moore, A. O'Brien, G. E. Vernon. Papakura : Attendant —E. McSweeney. Nurses —A. E. Hawke, M. J. Hubbers, R. McNaught, N. Thompson*, I. 6. Wigglesworth*, I. Willshaw. Te Awamutu: Attendant —E. F. Evans. Nurses —M. H. Anderson, E. K. Graham, E. M. Frogatt, M. J. Hodson, M. M. Phillips. Porirua: Attendants —A. E. Mexted, W. C. K. Parker, F. M. Wilson. Nurses—A. Adank, G. E. Davies, K. A. Hill, N. H. Pryke. Nelson : Attendant —H. H. A. Holland. Nurse's —G. F. M. Andrews, F. Cobeldick, M. J. Middleton*, B. I. Eobb, L. M. Bowlings. Hokitika : Nurse—H. M. Cooinbes. Christchurch : Attendants —E. Beattie, J. S. Burford, J. E. Hartland, A. L. McDrury, E. K. Newton. Nurses —M. B. Machirus, E. C. P. Smith, L. M. Urquhart. Templeton Farm: Institution Officers (Male) —N. L. Milliken, J. H. Wisker. Institution Officers (Female) —J. L. Guy, F. L. P. Crawford, A. Quinn. Seacliff: Attendant—W. L. Chisholm.* Nurses—E. M. Anderson, G. Booker, E. M. Butler, M. Cleghorn, L. B. Garbutt, B. I. Key*, E. I. Lee, E. M. Mathieson, G. M. Mcintosh*, H. M. McLean, K. M. McVie, M. M. Smith, A. J. Townsend, E. L. Ward.

* Passed with distinction,

8

H.—7

APPENDIX.

Table I.—Showing the Admissions, Readmissions, Discharges, and Deaths in Mental Hospitals during the Year 1940.

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 1940.

2—H. 7.

9

M. F. T. M. F. T. In mental hospitals, 1st January, 1940 .. .. .. .. 4,369 3,581 7,950 Admitted for the first time .. .. .. .. 458 462 920 \ i i/i« Readmitted 95 133 228 ) 553 595 1 > U * Total under care during the year .. .. .. 4,922 4,176 9,098 Discharged and died— Recovered .. .. .. .. .. . ■ 153 188 341 Not recovered .. .. .. .. .. 135 95 230 Died .. .. .. .. .. .. 281 215 496 569 498 1,067 (Not including transfers —Males, 176; females, 66). Remaining in mental hospitals, 31st December, 1940 .. .. .. 4,353 3,678 8,031 Decrease over 31st December, 1939 .. .. .. .. . . 16 Inorease over 31st December, 1939 .. .. .. .. .. . . 97 81 Average number resident during the year .. .. .. .. 4,168 3,422 7,590

Admissions in 1940. Total Number In Mental Hospitals , 1 otaI ty imber Mental Hospitals. on i i Pqtipnt* 1st January, 1940. Admitted for the Not First | Transfers under Care First Time. Admissions. I iransiers. under oare. i M. F. T. M. If. T. M. P. T. M. F. T. M. », T. Auckland .. .. 746 601 1,347 117 113 230 14 38 52 13 5 18 890 7.57 1,647 Kingseat . . .. 304 297 601 6 5 10 2 2 4 70 26 96 381 330 711 Tokanui .. . . 326 348 674 32 41 73 10 13 23 42 1 43 410 403 813 Porirua .. .. 865 642 1,507 112 113 225 34 32 66 14 8 22 1,025 795 1,820 Nelson . . . . 454 361 815 34 20 54 5 2 7 9 11 20 502 394 896 Hokitika .. . . 247 285 532 10 7 17 1 3 4 13 9 22 271 304 566 Christohuroh .. .. 793 612 1,405 82 101 183 25 28 53 9 4 13 909 745 1,654 Seacliff .. .. 622 413 1,035 64 59 123 4 14 18 6 2 8 696 488 1,184 Ashburn Hall (private 12 22 34 2 3 5 .. 1 1 14 26 40 mental hospital) Totals .. 4,369 3,581 7,950 458 462 920 95 133 228 176 66 242 5,098 4,242 9,340 Patients discharged, transferred, and died. In Mental Hospitals Mental Hospitals. i Tnt , ji.pv.-_-j 011 Discharged Discharged Transfe rred Died teansfeml 31st December, 1940. recovered. | not recovered. "ansterrea. Died. transterred, M. F. T. M. F. T. M. F. T. M. F. T. M. F. T. M. F. T. Auckland .. .. 41 57 98 46 36 82 22 26 48 70 58 128 179 177 356 711 580 1,291 Kingseat .. .. 4 4 8., 11 3 2 5 9 6 15 16 13 29 365 317 682 Tokanui .. 10 15 25 11 2 13 5 3 8 12 17 29 38 37 75 372 366 738 Porirua .. .. 44 56 100 18 11 29 110 10 120 77 34 111 249 111 360 776 684 1,460 Nelson .. .. 3 9 12 5 4 9 7 3 10 30 14 44 45 30 75 457 364 821 Hokitika . . . . 4 1 5 4 5 9 4 8 12 12 8 20 24 22 46 247 282 529 Christchurch .. 25 20 45 37 27 64 20 12 32 39 48 87 121 107 228 788 638 1,426 Seacliff .. .. 22 25 47 14 7 21 5 1 6 29 28 57 70 61 131 626 427 1,053 Ashburn Hall (private ..11 2 2.. 1 1 32 5 36 9 11 20 31 mental hospital) Totals .. 153 188 341 135 95 230 176 66 242 281 215 496 745 564 1,309 4,353 3,678 8,031 I, m ™ Nnmhpr Percentage Percentage of ,, . | n .. . ri.u;,ioni iinririTr °t Recoveries on Deaths on Average Mental Hospitals. resident during Admissions number resident me lear ' during the Year. during the Year. I M. F. T. M. F. T. M. F. T. Auckland .. .. .. .. 675 515 1,190 31-30 37-75 34-75 10-37 11-26 10-76 Kingseat .. .. .. •• 327 309 636 57-14 57-14 57-14 .2-75 1-94 2-36 Tokanui .. .. .. .. 312 337 649 23-81 27-78 26-04 3-85 5-04 4-47 Porirua .. .. .. 821 627 1,448 30-14 38-62 34-36 9-38 5-42 7-67 Nelson .. .. .. .. 444 346 790 7-69 40-91 19-67 6-76 4-05 5-57 Hokitika .. .. .. .. 244 281 525 36-36 10-00 23-81 4-92 2-85 3-81 Christchurch .. .. .. .. 729 576 1,305 23-36 15-50 19-07 5-35 8-33 6-67 Seacliff .. : •• 603 411 1,014 32-35 34-25 33-33 4-81 6-81 5-62 Ashburn Hall (private mental hospital) .. 13 20 33 00-00 25-00 16-67 23-08 10-00 15-15 Totals .. .. .. 4,168 3,422 7,590 27-67 31-60 29-70 6-74 6-28 6-53

H.—7.

Table IV.—Ages of Patients on 31st December, 1940.

Table III.— Native Countries.

10

Ashburn Hall I Countries. ! Auckland. Kingseat. j Tokanui. Porirua. ! Nelson. Hokltika. i Cliristchurch. j Seacliff. (Private Mental j Total. Hospital). j ' M. F. T. M. F. T. M. F. T. M. F. T. M. F. T. M. F. T. M. F. T. M. F. T. M. F. T. 55. F. T. England and Wales .. 108 68 176 69 56 125 49 37 86 110 90 200 41 36 77 19 23 42 51 48 99 42 27 69 2 1 3 491 386 877 Scotland .. .. 20 14 34 13 11 24 17 5 22 33 19 52 19 11 30 7 6 13 24 11 35 35 27 62 1 1 2 169 105 274 Ireland .. .. 22 22 44 20 16 36 18 12 30 28 21 49 10 5 15 14 11 25 21 16 37 20 13 33 .. i 153 116 269 New Zealand .. .. 429 401 830 198 199 397 241 263 504 503 496 999 349 285 634 170 194 364 667 541 1,208 496 340 836 7 17 24 | 3,060 2,736 5,796 Australian States .. 36 20 56 16 15 31 10 16 26 29 21 50 7 8, 15 10 8 18 15 13 28 14 9 23 1 1 2 i 138 111 249 France .. .. .. . 101112 .. .. .. .. .. 213 Germany .. I. .1 101 213 224 101 101 112 213 .. 11 5 16 Austria * .. ..9. .9 7 0 7 3 0 -3 .. 202 .. .. .. .. 21.. 21 Norway .. .. .. 505202101101 .. .. .. .. 9.. 9 Sweden .. 1.. 1 123 022 101 101 202 .. 202 .. 8 4 12 Denmark .. ..2.. 2 .. 213213404101 .. 101 . . 12 2 14 Italy .. 3. .3 01 1 101 101 01 1 30 3 .. .. .. 8 2 10 China .. ..1.. 1202202314 .. .. .. 101 .. 91 10 Maoris .. 12 22 34 9 1 10 12 25 37 34 24 58 8 6 14 .. 5 5 10 1 0 1 .. 81 83 164 Other countries 46 16 62 19 11 30 12 4 16 20 5 25 3 1 4 3 0 3 4 3 7 4 2 6 .. Ill 42 153 Unknown .. 21 17 38 5 5 10 .. 8 3 11 II 11 22 17 40 57 .. 8 8 16 .. 70 84 154 Totals .. 711 580 1,291 365 317 682 372 366 738 776 684 1,460 457 364 821 247 282 529 788 638 1,426 626 427 1,053 11 20 31 4,353 3,678 8,031

Ashburn Hall Ages. Auckland. ; Kingseat. ; Tokanul. Porirua. Kelson. | Hokitika. I Christclrarch. Seacliff. (Private Mental Total. Hospital). M. F. T. M. F. T. M. F. T. M. F. T. M. F. T. M. F. T. M. F. T. M. F. T. M. F. T. M. F. T. From 1 to 5 years .. 112 .. 011011 12 4 16 101224022 .. 16 11 27 „ 5 „ 10 „ .. 2 0 2 .. 3 7 10 0 6 6 25 6 31 .. 3 3 25 15 40 1 5 6 .. 56 42 98 „ 10 „ 15 „ .. 5 2 7 .. 6 4 10 1 14 15 36 17 53 1 2 '3 67 33 100 4 2 6 .. 120 74 194 15 „ 20 „ .. 23 20 43 4 2 6 15 6 21 18 20 38 51 23 74 3 3 6 111 78 189 17 6 23 0 1 1 242 159 401 „ 20 „ 30 „ .. Ill 60 171 24 12 36 - 50 45 95 110 72 182 96 50 146 16 21 37 148 106 254 76 48 124 2 3 5 633 417 1,050 „ 30 „ 40 „ ..124 123 247 41 42 83 60 59 119 150 123 273 57 56 113 41 27 68 99 84 183 136 41 177 1 0 1 709 555 1,264 „ 40 „ 50 „ .. 151 125 276 74 63 137 62 79 141 153 138 291 39 51 90 36 53 89 108 82 190 113 80 193 3 0 3 739 671 1,410 „ 50',, 60 „ .. 139 117 256 90 90 180 77 81 158 174 154 328 49 76 125 74 80 154 121 113 234 136 101 237 1 5 6 861 817 1,678 „ 60 „ 70 „ .. 94 81 175 84 65 149 70 52 122 121 91 212 j 57 45 102 45 67 112 76 79 155 83 97 180 0 6 6 630 583 1,213 „ 70 „ 80 „ .. 33 32 65 40 32 72 26 27 53 37 47 84 26 29 55 27 22 49 20 35 55 50 37 87 4 2 6 263 263 526 „ 80 „ 90 „ .. 8 4 12 3 3 6 1 1 2 12 17 29 4 6 10 1 1 10 11 21 8 4 12 0 3 3 46 50 96 Upwards of 90 ..303 .. .. 011 .. .. 101213 .. 6 28 Unknown .. 17 15 32 5 8 13 2 4 6 .. 5 1 6 3 3 6 .. 0 3 3 .. 32 34 66 Totals .. 711 5801,291 365 317 682 372 366 738 776 6841,460 457 364 821 247 282 529 788 6381,426 626 4271,053 11 20 31 4,353 3,678 8,031

H.—7

Table V.—Length of Residence of Patients discharged "Recovered" during 1940.

3—H. 7.

11

] I Ashbuin Hall Length of Residence. Auckland. j Kingseat. Tokanui. ! Porirua. Nelson. Hokitika. Christcliurch. i Seaclifl. (Prirate_ Mental Total. I ! I M. r. T. i M. r. T. M. F. T. M. p. T. M. F. T. H. F. T. M. F. T. M. F. T. M. F. T. M. F. T. Under 1 month .. | 3 2 5 | .. Oil .. •• 112 .. .. 4 4 8 From 1 to 3 months .. j 5 6 11 .. 1 3 4 6 4 10 .. \ • ■ 3 0 3 1 4 5 .. 16 17 33 3 6 .. i 2 1 3 .. 1 1 2 3 15 18 .. 1 0 1 5 8 13 8 5 13 .. 20 30 50 6 9 .. 6 7 13 .. 246 74 11 011 101 819 65 11 011 30 23 53 9 " 12 7 11 18 .. 2 1 3 8 8 16 3 1 4 .. 1 2 3 1 2 3 .. 22 25 47 " 1 2 years . . ! 13 20 33 4 1 5 3 2 5 11 15 26 0 2 2 2 0 2 3 6 9 2 8 10 .. 38 54 92 2 3 ..11.4 5 0 1 1 123 257 .. 011 011 112 .. 5 15 20 , 3,5 .. j 1.3 4 .. 022 235 033 .. 213 101 .. 6 12 18 „ 5 „ 7 „ .. | 1 1 2 I 0 1 1 .. 213 022 .. 202 202 .. 75 12 „ 7 „10 „ ..1112; .. .. 2 0 2 .. .. .. -• •• 314 „ 10 „ 12 „ .. 1 1 12! .. .. 101 .. .. •. •• •• 213 „ 12 „15 „ .. .. •• ■■ •• •• •• •• V ■■ Over 15 years .. .. 011 .. ■■ Oil Totals .. 41 57 98 4 4 8 10 15 25 44 56 100 3 9 12 4 1 5 j 25 20 45 | 22 25 47 0 1 1 153 188 341

H.—7.

Table VI.—Causes of Death, 1940.

12

i I j, ' flj I •?, * ' d . 1 Causes. I 1 I I a 3 SillS 5 §|| ! i I t i i i l fi«' i W. I H P-, K W I S EH T.—General Diseases. Tuberculosis— M. r. m. f. m. f. m. f. m. f. m. f. m. f. m. f. m. f. m. f.^ Lungs" 1 :: :: :: :: r - - ■>"' 2 "° ■ " ° °' 1 ; ;; 12 " Spine .. .. •• •• •• •• •• •• " '• '• 10 '• J J Can n c r ines . :: :: :: r i °. r 8 ri :: <r 2 :: » • Typhoid .. .. ■ ■ ..1101 . . .. • • • ■ • • • • • • | % Toxaemia .. .. . • ..4 2 0 1 .. .. •• •• ■■ •• Diabetes • • • • • ■ • • ( * •' 01 '' '' '' " f. Syphilis 1 2 ' ' '' 10 I 7 Bacillary dysentery 8 / •• •• " " •• " ' Septicemia .. • • • • • • • • • • 0 " • • ' ' '' 7 t Peritonitis .. .. • ■ ..11 • • . • • • • • • • • • • • • • 10 Pseudo muscular hypertrophy .. • • • • • • • • j • • • • • • • • • ' " Exhaustion following congenital debility .. i n n l ' " 11 Pernicious anaemia .. .. • • • • • • • • • • • • in " 10 Graves disease II.—Diseases of the Nervous System. Mania, exhaustion from .. . . • • • • 0 i i ? " " " " " •> i Melancholia, exhaustion from ..2 1 .. 10 01 .. .. .. ... .. General paralysis of the insane ..11 .. 1 0 5 1 .. - - 0 10 .. 10 2 aaasar.. :: :: ' :: . » ' •• ■■ f i ■■ WT". :: :: « • :: •"» •"> «"• * ; Post-encephalitie Parkinsonism .. • ■ ■ ■ 10 .. .. 0 1 .. .. .. J j Cerebellar tumour .. .. . • • ■ • ■ 0 1 • • '' '' '' ,'' ' ' on Tabo-paresis .. • • • • • • • • ■ • ," n " " Cerebral diplegia HI, —Diseases of the Respiratory System. "Sf- 18.. 1114.. .. 0210.. 4 10 Broncho:: 7 11 .. 1 0 0 3 2 1 1 2.. 11 17 Hypostatic .. .. ..11 . • • • • • 010110 .. 1 0 3 3 Bronchitis .. .. •• •• •• •• •• •• 10 •• •• •• " 10 IV. —Diseases of the Circulatory System. Heart-disease 9 4 4 1 I 0 20 6 6 2 4 0 0 20 1 4 1 0 52 43 Arterio-selerosis .. .. 2 I 1 0 0 1 .. .. 0 0 3 1 .. 8 5 Coronary thrombosis . • . • 5 0 . . .. 3 3 0 .. .. 11 V.—Diseases of the Digestive System. Enteritis ' ' " ® ' Colitis .. •• •• .. .. •• •• •• 9 " a " on Intestinal obstruction .. .. • • • • • • • • • • • • • • „ V " n V Cirrhosis of liver .. .. ■ • • • ■ • • ■ • • • • • • • • 0 1 .. 0 I Intestinal haemorrhage VI.—Diseases of Genito-urinary System. Nephritis .. .. ..01 .. .. 1 1 .. •• •• •• 1 2 Uraemia .. •• •• ..7 1 .. 10 2 0 VII. —Old Age. Senile decay 4 7 0 1 4 5 25 3 3 4 .. 13 10 16 17 1 0 66 47 VIII. —External Causes. Shock following burns .. .. •• •• •• * * * * ?! " " " o! Suicide .. 10 .. .. 2 0 .. 0 1 3 Asphyxia .. .. ' • • • • • • 10 .. 11 IX. —Died whilst on Probation ..3 5 . . 1 0 1 0 2 0 .. 3 3 01 .. 10 9 Totals .. .. 70 58 9 6 12 17 77 34 30 14 12 8 39 48 29 28 3 2 281 215

H.—7.

Table VII.—Principal assigned Causes of Insanity, 1940.

Table YITI. —Showing the Admissions, Discharges, and Deaths from Ist January, 1876, to 31st December, 1940 (excluding Transfers). M. Jf. T. In hospitals, 31st December, 1875 .. .. .. .. 482 254 736 Admissions .. .. .. .. .. .. .. 25,284 . 19,775 45,059 25,706 20,029 45,795 Discharged— m. f. t. Recovered .. .. .. 8,769 7,815 16,584 Not recovered .. .. 2,806 2,492 5,298 Died .. .. .. .. 9,838 6,044 15,882 —21,413 16,351 37,764 Remaining on 31st December, 1940.. .. .. 4,353 3,678 8,031

Table IX. —Summary of Total Admissions: Percentages of Gases since the Year 1876.

13

4 si. * i «* , ■ „• i w^i CaUB0S - I I I I i a- I f «• §£'& a - ■s I 3 i x 3 -g 1 I 3 a i S $ S fi 3 $ f P w o 1 M | H 6 £5 W O 03 H M. F. M. F. M. F. M. F. M. F. M. F. M. F. M. F. M. F. M. F. Alcohol .. ..71103 0 4 2 1 0 ..1 2 8 0 .. 25 5 Arterio-sclorosis .. 6 6 .. 1 2 1 2 .. 1 0 10 4 3 5 .. 22 19 Climacteric .. .. .. .. 0 9 0 5 .. .. .. . . .. 0 14 Congenital .. .. 9 15 0 2 6 8 9 10 24 10 1 0 25 24 7 8 . . 81 77 Constitutional 23 58 .. . . 30 24 .. 2 3 .. .. .. 55 85 Encephalitis.. ..20 .. .. .. .. .. 01 .. .. 21 Epilepsy .. ..90 10 1 1 21 .. 0 1 8 4 5 0 . . 26 7 Heredity .. ..6 0 .. 7 10 20 14 4 1 4 0 5 6 . . 1 2 47 33 111 health .. ..45 .. .. 11 .. 10 .. .. .. 66 Involution .. ..3 3 .. 5 0 3 14 .. .. 3 17 4 2 .. 18 36 Mental stress .. 7 3 1 2 10 5 5 3 2 2 1 0 9 7 12 17 0 1 47 40 Organic brain-disease 10 .. 0 13 3 .. 0 1 . . . . . . 4 5 Parkinsonism l'ost operative Previous attack 14 38 3 2 2 5 34 32 7 4 1 3 16 20 9 20 0 1 86 125 I'ubcrty or adolescence 8 1 . . .. 0 3 0 1 .. 13 10 6 2 .. 27 17 Puerperal .. .. . . . . 0 4 0 3 0 1 . . 0 2 0 2 .. 0 12 Senility .. .. 23 19 1 1 5 8 28 26 I 3 0 1 13 28 11 17 1 0 83 103 Syphilis .. ..82 .. 1 0 61 .. .. 31 30 .. 21. 4 Toxic .. ..10 .. .. 01 .. 0102 .. .. 14 Traumatic .. .. .. .. 11 .. .. .. 11 .. .. 22 Transfers .. .. 13 5 70 26 42 1 14 8 9 11 13 9 9 4 6 2 .. 176 66 Totals .. 144 156 77 33 84 55 160 153 48 33 24 19 116 133 74 75 2 4 729 661 *

J Malos. j Females. | Both Sexes. Recovered .. .. .. .. .. j 34-03 39-02 36-21 Not recovered .. .. .. .. .. 10-89 12-44 11-57 Died .. .. .. .. .. .. | 38-18 30-18 34-68 Remaining . .. .. .. .. 16-90 18-36 17-54 100-00 100-00 100-00

H.—7.

Table X.—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.

14

„ . „ „ . * ! ; I Remaining, w„ m hpr= Percentage Percentage of Deaths * ear * j Admitted. Died. 31st December in resident of R ec °veries on on Average Numbers Recovered. Relieved. Not Improved. each Year. * " Admissions. resident. L I j j i I i i — " ~ " "" "" r""' 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 .. .. j .. .. .. .. r .. 482 254: 736 . .. ! .. 1876 .. ! 221 117 338 | 129 i 79 208 S 17 8 25 2 8 10 36 12 : 48 519 264 783 491 257: 748 54-53I 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 49 14 63 769 406 1,175 747 388 1,135 40-08 51-10 44-01 6-29 3-60 5-55 1882 .. 267 152 419 95 59 154; 49 32 81 5 6 11 60 19 79 827 442 1,269 796: 421 1,217 35-58 38-81 36-75 7-53 4-51 6-49 1883 .. 255 166 421 1 102 78 180 13 20 33 10 9 19 65 18 83 892 483 1,375 860 475i 1,335 40-00 46-98 42-75 7-55 3-78 6-21 1884 .. 238 153 ] 391 89 77 166 17 9 26 18 12 30 68 24 92 938 514 1,452 911 497 1,408 37-39 50-32 42-45 7-46 4-82 6-53 1885 .. 246 | 133 | 379 j 95 76 171 ! 10 5 15 25 2 27 73 22 95 981 542 1,523 965 528 1,493 38-62 57-14. 45-12 7-56 4-16 6-36 1886 .. 207 j 165 | 372 j 99 60 159 I 11 17 28 12 ! 7 19 57 19 76 1,009 604 1,613 984 559 1,543 47-82: 36-36 42-74 5-79 3-39 4-91 1887 .. 255 161 I 416 103 i 78 ! 181 34 17 51 74 27 101 1,053 643 1,696; 1,034 613 1,647 40-39 48-75 43-61 7-15 ! 4-40 6-13 1888 .. 215 146 361 116 92 208 31 28 59 2 3 5 78 26 104 1,041 640 1,681 1,045 641 1,686 53-95 63-01 57-62 7-56 4-05 6-16 1889 .. 230 j 161 I 391 | 93 53 146 31 i 30 61 3 1 4 70 30 100 1,074, 687 1,761 1,046! 660 1,707 40-43 32-92 37-34 6-69 4-54 5-86 1890 .. 230 1 160 : 390 ! 98 88 186 23 17 40 12 5 17 76 35 111 1,095! 702 1,797 1,078 ! 685 1,763 42-61 55-00 47-69 7-05 5-11 6-29 1891 .. 234 171 405 88 74 162 33 i 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 j 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 i 4-76 5-87 1893 .. 281 179 460 101 89 190 17 12 29 10 8 18 78 23 101 1,229' 810 2,039 1,172 758 1,930 35-94 49-72 41-30 6-66 3-03 5-23 1894 .. 270 176 446 107 76 183 15 11 26 | 5 4 9 64 35 99 1,308: 860 2,168 1,241 812 2,053 39-63 43-13 41-03 5-16 4-31 4-82 1895 .. 252 165 417 j 105 77 182 24 19 43 1 2 3 101 42 143 1,329! 885 2,214 1,313 849 2,162 41-67 46-66 43-64 7-69 4-94 6-61 1896 .. 278 159 437 j 104 70 174 25 16 41 2 1 3 86 32 118 1,3901 925 2,315 1,347 882 2,229 37-41 44-02 39-13i 6-38 3-63 5-29 1897 .. 284 193 477 102 73 175 17 12 29 10 .. 10 105 43 148 1.440' 990 2,430 1,411 944 2,355 35-92 37-82 36-69 7-44 4-55 6-28 1898 .. 254 212 466 114 110 224 13 23 36 7 1 8 88 60 148 1,472 1,008 2,480 1,438 973 2,411 44-88 51-89 48-07 6-12 6-17 6-14 1899 .. 259; 199 j 458 j 88 99 187 15 19 34 2 1 3 114 43 157 1,512 1,045 2,557 1,487 1,004 2,491 33-98 49-49 40-83 7-67 | 4-28 6-30 1900 .. 300 202 502 103 96 199 29 10 39 4 4 99 46 145 1,581 1,091 2,672 1,534 1,049 2,583 34-33 47-54 39-64 6-45 4-38 5-61 1901 .. 320 ! 223 j 543 | 125 104 229 20 17 37 .. 2 2 102 72 174 1,654 1,119 2,773 1,622 1,094 2,716 39-06 46-64 42-17 6-29 6-58 6-41 1902 .. 352 192 544 135 99 234 26 15 41 10 9 19 120 55 175 1,715 1,133 2,848 1,671 1,114 2,785 38-35 51-56 43-01 7-18 4-94 6-28 1903 .. 355 226 581 144 101 245 26 24 50 2 2 129 44 173 1,771 1,188 2,959 1,741 1,160 2,901 40-56 44-69 42-17 7-41 3-79 5-96 1904 .. 332 236 . 568 157 106 263 24 11 35 1 1 120 70 190 1,801 1,237 3,038 1,780 1,198 2,978 47-59 44-91 46-30 6-74 5-84 6-38 1905 .. 360 251 611 149 121 270 29 24 53 147 67 214 1,836 1,276 3,112 1,796 1,232 3,028 41-39 48-21 44-19 8-18 5-44 7-07 1906 .. 395 264 659 157 126 283 28 22 50 1 1 146 85 231 1,900 1,306 3,206 1,823 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 .. j 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 i 6-96 | 7-98 1914 .. 509 359 868 j 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 I 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— 3,044 males, 2,346 females.

15

1917 .. 470 374 844 171 152 i 323 32 i 20 52 ! 6 5 11 205 113 318 2,611 1,904! 4,515i 2,543 1,825 4,368 36-38; 40-64 38-27 8-06 6-19 j 7-28 1918 .. 437 402 839 142 141 283 17 36 53 12 12 24 274 174 448 2,603 1.943 4,546| 2,602 1,899 4,501 32-49 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 i 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 1 313 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 3S-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 j 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 j 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 i 22-22 27-00 24-29 7-51 6-64 i 7-15 1931 .. 587 476 1,063 127 120 I 247 29 30 59 I 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 j 6-76 1932 .. 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 1933 563 554 1,117 117 144 261 35 27 62 28 22 50 221 124 345 4,065 3,217 7,282 3,809 2,932 6,741 20-78 25-99 23-36 5-80 4-23 ; 5-16 1934 479 504 983 114 146 260 64 72 136 233 203 436 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 7,288i 21-88 26-80 26-76 6-18 6-66 | 6-38 1937 .. 557 567 1,124 180 179 ! 359 121 110 231 I .. .. .. 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 1938 .. 527 575 1,102 170 210 : 380 140 135 275 i 273 274 547 4,296 3,501 7,797 4,129 3,287 7,416 32-26 36-52 34-48 6-61 8-33 7-38 1939 .. 603 595 1,198 147 181 328 132 125 257 251 209 460 4,369 3,581 7,950 4,106 3,320 7,426: 24-38 30-42 27-38 6-11 6-30 6-19 1940 .. 553 595 1,148 153 188 341 135 95 230 281 215 496 4,353 3,678 8,031 4,168 3,422 7,590 27-67 31-60 29-70 6-74 6-28 6-53 25,284 19,775 45,059 8,769 7,815 16,5842,806 2,492 5,298 9,838 6,044 15,882 i .. .. I

H.—7.

Table XI.—Debits for the Financial Year, 1940-4 1.

16

I j Auckland. Kingseat. Tokanui. Porirua. Nelson. Hokitika. Christchurch. Seacliff. Head Office. Totals. £ s. d. £ s. d. £ s. d. £ s. d. £ s. d. £ s. d. £ s. d. £ s. d. £ s. d. £ s. d. Salaries, including overtime .. .. 62,992 13 2 30,266 5 8 38,956 19 3 78,500 4 3 40,101 3 0 28,180 1 5 74,765 2 7 74,799 3 4 8,585 3 6 437,146 16 2 Official visitors .. .. .. 48 6 0 .. .. 25 0 0 .. 11 11 0 25 4 0 .. .. 110 1 0 Advertising, books, &c. .. .. 30 17 10 24 18 6 47 10 2 11 8 2 7 2 6 23 13 1 12 8 9 36 15 0 60 4 0 254 18 0 Bacteriological research .. .. 113 13 6 .. 7 17 6 143 12 0 0 10 6 1 1 0 5 3 6 .. .. 271 18 0 Bedding and clothing .. .. 4,581 9 4 1,618 7 5 3,100 19 6 6,652 10 3 3,874 17 11 3,246 17 3 4,664 19 4 5,259 14 7 .. 32,999 15 7 Buildings, including additions, &c. .. 912 11 9 212 18 6 427 3 1 494 18 9 279 11 11 273 19 10 830 0 4 822 3 11 .. 4,253 8 1 Dental services .. .. .. 1 16 0 3 3 2 8 6 5 71 19 3 7 4 5 9 13 3 20 8 6 19 14 3 .. 142 5 3 Farms, maintenance of .. .. 1,646 9 6 769 6 10 6,122 17 2 2,418 12 2 1,169 12 2 503 13 2 1,004 18 1 8,370 16 8 .. 22,006 5 9 Fencing, draining, and reading .. 24 12 2 37 17 0 122 12 0 140 15 7 49 18 4 16 12 4 76 11 5 78 6 10 .. 547 5 8 Freight, cartage, and transport .. 68 4 3 170 15 0 202 6 8 349 4 10 324 18 2 46 6 10 418 10 4 325 13 3 0 1 5 1,906 0 9 Fuel, light, water, &c. .. .. 7,632 19 9 3,149 15 5 4,574 1 7 7,575 2 8 6,374 5 10 2,469 4 6 8,295 9 5 5,878 3 11 35 6 7 45,984 9 8 Funeral expenses .. .. .. 94 10 0 71 6 0 44 0 0 141 0 0 84 0 0 8 10 0 76 15 0 85 10 0 .. 605 11 0 Furniture and fittings .. .. 355 1 5 163 1 3 189 17 5 531 7 8 232 10 8 225 5 4 643 11 10 372 17 3 2 11 1 2,716 3 11 Gardens and shrubberies .. .. 42 8 5 54 15 9 116 13 6 32 7 10 45 9 3 3 9 3 83 7 7 20 12 7 .. 399 4 2 Laundry .. .. .. .. 299 0 8 342 19 11 235 17 5 429 16 11 211 17 4 115 10 6 310 9 10 271 19 7 .. 2,217 12 2 Legal and inquiry costs .. .. 234 .. 2 12 6 6 11 3 .. .. .. .. .. 11 71 Machinery, repairs, and stores .. 94 15 2 84 9 4 274 10 1 175 11 3 146 6 5 15 8 7 171 4 6 238 2 0 .. 1,200 7 4 Medical fees .. .. .. 714 13 4 13 19 6 222 12 3 673 19 9 77 19 9 64 19 0 491 3 3 350 7 6 .. 2,609 14 4 Motor- vehicles — Maintenance of .. .. .. 35 19 10 62 1 9 75 5 10 244 9 11 108 14 5 23 16 8 216 13 3 171 8 5 .. 938 10 1 Purchase of .. .. .. .. .. 347 8 10 235 18 9 .. .. .. .. 583 7 7 Nursing staff uniforms .. .. 129 5 11 121 4 2 245 18 2 1,107 15 6 173 4 4 175 18 10 211 8 5 298 4 9 .. 2,463 0 1 Office equipment .. .. .. 10 18 7 2 15 3 9 0 7 1 2 6 0 14 6 6 13 2 6 5 3 10 5 10 6 14 6 54 10 2 Patients' expenses connected with — Gratuities .. .. .. 24 1 6 1 2 0 2 17 6 87 0 6 121 13 6 14 0 0 .. 26 8 3 .. 277 3 3 Friends .. .. .... .. . . .. .. .. . . .. 50 0 0 .. 50 0 0 Recreation .. .. .. 937 6 1 491 17 5 577 1 9 1,386 17 6 593 17 3 451 17 2 1,004 3 6 1,013 19 4 .. 6 457 0 0 Transfers .. .. .. 39 2 10 32 16 1 6 13 9 230 11 7 19 8 10 2 10 9 40 18 1 .. .. 372 1 11 Postages, telegrams, &e. .. .. 152 14 10 77 3 7 108 2 6 191 12 2 70 0 9 32 1 8 164 8 10 198 1 11 130 18 11 1,125 5 2 Printing and stationery .. .. 206 9 7 62 4 1 88 11 2 237 0 1 93 10 7 62 3 3 163 6 0 142 5 0 55 13 6 1,111 3 3 Rations .. .. .. .. 16,742 3 7 9,735 19 7 6,621 4 1 22,247 7 9 11,140 6 2 8,241 14 9 19,322 15 4 9,540 5 5 .. 103,591 16 8 Rents and rates .. .. .. .. .. .. .. 7 12 7 .. 518 16 8 4 0 0 650 10 5 1,180 19 8 Stores .. .. .. .. 838 12 10 382 15 11 600 6 8 1,090 6 6 369 0 5 374 11 10 906 19 5 916 9 11 .. 5,479 3 6 Surgery and dispensary, drugs, &c. .. 486 13 11 111 9 9 117 18 4 890 19 2 79 16 6 83 9 11 397 15 3 194 12 6 .. 2,362 15 4 Telephone services .. .. .. 83 15 8 120 0 6 135 9 0 173 8 4 57 0 1 35 11 6 132 6 0 201 17 6 116 6 8 1,055 15 3 Transfer and removal expenses .. 11 10 5 73 14 2 73 8 6 21 16 3 99 10 6 108 11 II 87 17 6 11 13 9 5 17 9 494 0 9 Travelling-allowances .. .. 65 14 8 105 16 1 62 3 2 24 0 1 62 9 10 44 12 6 67 9 5 251 11 11 149 7 0 833 4 8 Travelling-expenses .. .. 160 1 2 33 12 3 26 10 6 50 11 3 14 3 2 20 13 7 130 16 6 151 0 0 193 11 3 780 19 8 Treatment in general hospitals — Patients .. .. .. 55 1 0 16 19 6 16 2 6 51 17 0 26 8 0 2 2 0 19 0 0 28 10 0 216 0 0 Staff .. .. .. .. 6 0 0 2 8 0 15 7 0 13 12 6 29 10 0 1 1 0 4 11 6 .. 72 10 0 Contingencies and miscellaneous .. 188 2 6 1 14 6 1 18 6 76 3 2 378 11 10 10 15 0 48 12 9 16 11 0 .. 722 9 3 Totals .. .. .. 99,830 0 6 48,419 13 10 63,440 16 0 126,848 3 2 66,669 0 2 44,908 110 115,339 1111 110,157 6 2 9,992 6 7 685,605 0 2

H.—7.

Notes.—(a) Cost does not include interest and depreciation on land, buildings, &c. (b) "Receipts from Maintenance" shown in Table Xla not included.

Table XIa.—Credits for the Financial Year, 1940-41.

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

17

Average Contribu- „ i Number ] Bedding : Buildings J Fuel, Light, j Surgery j , r . ,, Total Cost itionsfrom Other Net Cost Net Cost ! Decrease I Increase Mental Hospital. j Resident ] Salaries. j and and Farm. Water, and I Provisions. and ! per Social Re- per Previous 'in I in (inclusive of] Clothing. ] Repairs, j Cleaning. ! Dispensary. a ' Patient. Security payments. ! Patient. Tear. 1940-41. i 1940-41. ! Boarders). | j j fa) Fund. (ft) (ft) £ s. d. £ s. d. £ s. d. £ s. d. £ s. d. £ s. d. £ s. d. £ s. d. £ s. d. £ s. d. £ s. d. £ s. d. £ -s. d. £ s. d. £ s. d. Auckland .. .. .. 1,287 48 18 11 3 11 2 0 14 2 1 5 7 5 18 7 13 0 2 0 7 7 3 15 2 77 11 4 21 11 10 6 1 7 49 17 11 47 6 0 .. 2 11 11 Kingseat .. .. .. 665 45 10 3 2 8 8 0 6 5 1 3 2 4 14 9 14 12 10 0 3 4 3 16 10 72 16 3 21 11 10 8 8 8 42 15 9 42 17 6 0 1 9 Tokanui .. .. .. • 677 57 10 10 4 11 7 0 12 7 9 0 11 6 15 2 9 15 7 0 3 6 5 4 0 93 14 2 21 11 10 14 17 1 57 5 3 58 7 8 1 2 5 Porirua .. .. .. 1,534 51 3 7 4 6 9 0 6 5 1 11 6 4 18 9 14'10 1 0 11 7 5 5 2 82 13 10 21 11 10 7 18 4 53 3 8 49 18 0 .. 3 5 8 Nelson .. .. .. 805 49 16 4 4 16 3 0 6 11 1 9 1 7 18 4 13 16 9 0 2 0 4 10 8 82 16 4 21 11 10 7 18 8 53 5 10 50 9 8 .. 2 16 2 Hokitika .. .. .. 528 53 7 5 6 3 0 0 10 5 0 19 1 4 13 6 15 12 2 0 3 2 3 12 4 85 1 1 21 11 10 5 15 10 57 13 5 58 15 9 1 2 4 Christchurch .. .. 1,372 54 9 10 3 8 0 0 12 1 0 14 8 6 0 11 14 1 8 0 5 10 4 8 4 84 1 4 21 11 10 8 0 5 54 9 1 55 6 10 0 17 9 Seacliff .. .. .. 1,052 71 2 0 5 0 0 0 15 8 7 19 2 5 11 9 9 1 5 0 3 8 5 0 7 104 14 3 21 11 10 11 15 6 71 6 11 65 18 5 .. 5 8 6 Head Office .. .. 7,920 118 j .. .. 00 1 .. 036 153 .. 005 14 10 164016 Total average cost .. 7,920 55 3 11 4 3 4 i 0 10 9 2 15 7 5 16 1 |l3 1 7 0 6 0 4 14 1 86 11 4 21 11 10 8 13 4 56 6 2 54 15 3 .. 1 10 11

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. *Receipts from maintenance.. .. 3,858 14 6 1,501 18 11 1,345 5 1 3,874 7 7 2,437 0 9 721 3 8 3,804 13 3 2,749 19 4 .. 20,293 3 1 Contribution from Social Security Fund 27,787 10 0 14,357 19 1 14,617 0 10 33,120 9 1 17,380 13 8 11,400 0 0 i 29,622 14 7 22,713 12 9 .. 171,000 0 0 Receipts from farms .. .. 648 0 2 2,127 6 4 5,923 4 3 1,428 6 5 2,292 14 9 90 9 0 2,718 11 8 4 5 .. 19,699 17 0 Miscellaneous .. .. .. 7,175 4 10 3,480 13 10 4,132 15 9 10,713 17 8 4,093 15 1 2,968 1 8 8,284 12 10 7,917 5 1 175 1 9 48,941 8 6 Total .. .. .. 39,469 9 6 21,467 18 2 26,018 5 11 49,137 0 9 26,204 4 3 15,179 14 4 44,430 12 4 37,852 17 175 1 9 259,934 8 7 * Outstanding accounts as at 31st March.. 1939.

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, 1941.

Table XIII.—Expenditure out of Public Works Fund on Mental Hospital Buildings, etc., during the Financial Year ended 31st March, 1941.

By Authority: E. V. Paul, Government Printer, Wellington.— 1941. Price 9d.~\

Approximate Cost of Paper.—Preparation, not given; printing (545 copies), £35.

18

Total Net Expenditure Mental Hospitals. : 1877-1931. 1931-32. 1932-33. 1933-34. 1934-35. 1935-36. j 1936-37. 1937-38. 1938-39. 1939-40. 1940-41. 1st July, 1877, to ! 31st March, 1941. £ £ £ £ £ £ £ £ £ £i£ £ Auckland .. .. 230,042 621 676 155 2,321 307 842 5,658 907 7,118 2,659 251,306 Christehurch .. .. 291,336 4,650 7,960 3,481 23,489 12,397 23,970 16,397 6,784 17,252 j 13,326 421,042 Dunedin (The Camp) .. 4,891 .. .. .. .. .. .. .. .. j 4,891 Hokitika .. .. .. 63,878 8,381 3,107 8,753 5,629 2,739 7,580 2,097 1,140 26,793 10,233 140,330 Hornby .. .. .. 11,102 '.. .. .. .. .. .. .. .. .. .. 11,102 MotuiM Island .. .. 561 .. .. .. .. .. .. .. .. .. .. 561 Napier .. .. .. 147 .. .. .. .. .. . . .. .. .. . . 1 147 Nelson and Stoke .. .. 124,300 3,339 2,680 12,251 28,552 18,307 16,218 2,234 15,458 39,469 34,119 i 296,927 Puhitahi (Kingseat) .. 16,130 16,433 10,278 35,438 29,784 21,973 65,192 52,144 71,149 62,896 45,095 ! 426,512 Seaeliff .. .. .. 295,710 3,065 414 6,618 4,888 1,453 2,958 570 2,527 1,082 707 ! 319,992 Tokanui .. .. .. 206,787 7,164 2,918 6,295 3,797 12,682 18,839 2,855 6,903 9,922 13,662 j 291,824 Waitati .. .. .. 30,869 936 516 .. .. .. .. .. .. .. .. 32,321 Wellington .. .. 29,641 .. .. .. .. .. .. .. .. .. .. 29,641 Wellington(Porirua) .. 344,774 1,349 207 29 170 .. 6,510 20,502 23,948 10,894 j 6,843 415,226 Totals .. .. 1,650,168 45,938 28,756 j 73,020 98,630 j 69,858 142,109 102,457 128,816 175,426 126,644 2,641,822 | |

Hospitals. ■£" £ Auckland .. .. .. .. .. .. .. .. .. 2,659 Christchurch .. .. .. •• .• .. .. .. .. 13,326 Hokitika .. .. .. •. •• .. .. .. .. 10,233 Nelson and Stoke .. .. •• •• .. .. .. .. 34,119 Porirua .. .. .. .. . • .. .. .. .. 6,843 Kingseat .. .. .. .. .. .. .. .. .. 45,095 Seacliff .. .. .. .. .. .. .. .. .. 707 Tokanui .. .. .. .. .. •• .. .. .. 13,662 Total .. .. .. .. .. .. .. 126,644