MENTAL HOSPITALS OF THE DOMINION (REPORT ON) FOR 1946

Appendix to the Journals of the House of Representatives, 1947 Session I, H-07

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1947 NEW ZEALAND

MENTAL HOSPITALS OF THE DOMINION (REPORT ON) FOR 1946

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

The Hon. M. B. Howard, Minister in Charge of Mental Hospitals, Wellington. Madam, — Wellington, 6th June, 1947. I have the honour to present the annual report upon the work of the Mental Hospitals Department for the year ended 31st December, 1946. Portion of this report was prepared by Dr. T. G. Gray prior to his relinquishing his position as Director-General of the Department on 31st January, 1947. lam certain it is the wish of the New Zealand Government to extend to him thanks for his services, during the whole period of which he showed great zeal in his endeavours to better the conditions and treatment of patients under his care. Dr. Gray's medical colleagues and the whple of the staff of the Mental Hospitals Department extend to him their best wishes in his retirement. J. Russell, Acting Director-General. Dr. Gray reports : Madam, — I have the honour to present my annual report on the work of the Mental Hospitals Department for the year ended 31st December, 1946. Statistical At the end of the year there were 9,004 names of persons upon our registers, including 43 patients at Ashburn Hall private licensed institution and 787 patients who were absent on probation in care of relatives and friends. In actual residence in our ten State hospitals on 31st December there were 8,174 persons, an increase of 133 compared with last year, and of this number 7,799 were patients who had been committed and 375 were voluntary boarders. There were 1,627 patients and boarders admitted for the first time, an increase of 150 over the previous year, of whom 1,165 were the subject of a reception order and 462 were voluntary boarders.

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Of all classes of admissions we were able to discharge 1,316, or 62-31 per cent, calculated upon the number admitted, but no more than 770, or 36*46 per cent., were fully recovered at the time of discharge. This number does not represent the true recovery rate, as patients who are sent home to convalesce on probation often omit to send a medical certificate, in the absence of which we require to regard them for statistical purposes as " unrecovered."

Voluntary Boarders

. Shortage op Nurses Despite several increases in the salary scales and many minor improvements in the conditions of nursing service in our mental hospitals, we have been unable to recruit from New Zealand sufficient nurses to replace those who leave for various reasons, such as marriage, home domestic obligations, or unsuitability for the work. Because of the shortage, we have been obliged, as foreshadowed in last year's report, to extend our field of recruitment to Britain. In view of the fact that Dr. Lewis, our Director of Clinical Services, is at present in London, on sabbatical leave, we enlisted his services to select up to 200 nursing trainees and 25 cooks, and the first contingent of 26 arrived in October. Up to the end of the year nearly 100 girls had arrived, and the majority of them have proved well suited for the work and have settled down to getting to know their duties. As must almost inevitably have happened, a few of the recruits have not become acclimatized to New Zealand conditions and have been drafted to other avenues of occupation.

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Year. First Admission. Not First Admission. Total Admissions. Transferred to Register of Patients. Died. Discharged. Remaining on 31st December. M. p. T. M. p. T. M. P. T. M. p. T. M. p. T. M. p. T. M. P. 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 1938 111 105 216 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 31 157 130 287 182 178 360 1940 128 124 252 65 63 128 193 187 380 18 18 36 10 12 22 176 167 343 171 168 339 1941 93 104 197 48 58 106 141 162 303 11 9 20 10 13 23 140 151 291 151 157 308 1942 88 108 196 44 74 118 132 182 314 14 15 29 15 8 23 124 160 284 130 156 286 1943 95 126 221 66 87 153 161 213 374 2 8 10 13 14 27 115 159 274 161 188 349 1944 146 168 314 70 104 174 216 272 488 4 7 11 11 10 21 172 243 415 190 200 390 1945 178 181 359 90 112 202 268 293 561 9 8 17 20 8 28 244 272 516 185 205 390 1946 233 229 462 80 137 217 313 366 679 4 10 14 15 7 22 283 348 631 196 206 402

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At the initiation of this scheme we were over 300 nurses short, and so far the drift away from the service has continued, so that, in spite of recruitment from overseas, our shortage at the end of the year amounted to 286 nurses. Building Programme The rebuilding of Porirua upon the villa system is progressing somewhat less quickly than is necessary to keep pace with the admissions to that hospital but the new institution near Marton is being erected at the same time and should afford at least some relief to our overcrowding in about eighteen months. Preliminary work at Cherry Farm, which is intended to replace Seacliff, is well forward, and building should soon be under way. At Levin Farm, after considerable alteration to a number of the buildings, we have 94 lads in residence, and accommodation for many more will soon be available. Alterations, Additions, and Improvements Capital expenditure on new buildings and improvements amounted to £288,230 during the year, and the following summary shows the principal items making up the total:— (1) Auckland (£10,972). —Two residences for Medical Officers have been erected, additional buildings for occupational therapy have been completed, and new fire-alarm system has been installed and fire-protection services improved. (2) King seat (£3,985). —Fire-protection services and roading have been improved. Two new staff residences are in course of erection. (3) Raventhorpe (£107,567). —The convalescent depot at Raventhorpe was taken over from the Army Department to house patients evacuated from Wairakei and the Chateau. (4) Porirua (£67,503). —Erection of new laundry has been completed. Fireprotection services have been improved. Two new villas have been erected and two more are in course of construction. (5) Nelson (£5,840). —At Ngawhatu a new sports pavilion and two residences for Medical Officers have been completed, and fire-protection services at Nelson have been improved. (6) Hokitika (£1,250). —A new residence for a Medical Officer has been commenced. (7) Christchurch (£2,683). —Additions have been made to occupational therapy building at Sunnyside, and a residence for a Medical Officer erected at Templeton Farm. (8) Seacliff (£16,155). —An area of land was purchased and progress has been made on roading, water-supply, &c., at Cherry Farm. (9) Lake Alice (£48,276). —Erection of water-tower, has been completed, and progress made on the erection of new villas. Medical Staff During my visit to Britain last year I selected six medical officers for appointment to the Department. They have now assumed duty at the hospitals mentioned : Dr. Lamb, Auckland; Dr. Mulinder, Kingseat; Dr. Stenhouse, Tokanui; Dr. Reid, Porirua ; Dr. Latham, Nelson ; Dr. Saville, Christchurch. These officers have now been with us sufficiently long for me to say that we have been very fortunate in those appointments, and I consider that a valuable addition, has been made to the ranks of those practising psychiatry in New Zealand.

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Registration as State Psychiatric Nurses The following have passed the State Final Psychiatric Examination, held in December, and are therefore qualified for State registration : Passed top equal for Dominion : Nurses J. E. Kedge and C. B. Spear (Auckland), Auckland— Attendants : R. T. Hall, H. W. Moore. Nurses : D. A. Begley, B. M. S. Gray, *J. E. Kedge, *C. B. Spear. Tokanui— Nurses : M. P. A. Power, J. Seymour. Porirua — Nurses : H. A. Hannan, J. B. A. Mist. Nelson — Attendant: W. E. Rendle. Nurses : E. R. E. Harper, P. M. Hayes, D. K. Roughton, J. L. Russ. Hokitika — Attendant: H. R. Hall. Christchurch— Attendant: J. G. Shepherd. Seacliff— Attendant: J. J. Ford. The following obtained partial passes Porirua— Attendants : S. Scott, R. J. Tabb. Hokitika— Attendant: M. Nuttall. * Passed with distinction. Valedictory As I have intimated my retirement at the end of January from the position of Director-General of the Department with which I have been associated for over thirtyfive years, I take this opportunity of thanking all those officers whose loyalty and support have been of inestimable help during my term of office. I have to thank my medical colleagues for many kindnesses throughout the years, and I would especially acknowledge my debt to Mr. Sinclair, Chief Clerk of the Department, and his staff at Head Office, without whose help, ungrudgingly given at all times, my work would have been very much less easy of accomplishment. Theo. G. Gray, Director-General. AUCKLAND MENTAL HOSPITAL Dr. Buchanan reports : I have the honour to present mv annual report for the year ended 31st December, 1946. The total number of cases under care at this hospital was 1,933, and the weekly average of those resident was 1,309. The tables accompanying your report will give the figures regarding admissions, discharges, &c. Besides the physical and psychological care of these patients, our work is extended to psychiatric clinics at the public hospital and other extra-mural work connected with the Prison and Pensions Departments.

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The time I think is now overdue for the establishment of a psychiatric ward at the public hospital. I have tentatively approached the Hospital Board through its Superintendent about this matter. The basis I suggested is that such a ward should be staffed by trained Psychiatric Nurses and that 50 per cent, of the beds should be allocated to the Medical Superintendent of the Auckland Mental Hospital in his capacity of Honorary Psychiatrist. The Superintendent of the Auckland Hospital is quite alive to the necessity of such a ward, but, as he points out, it is all contingent upon buildings, which means time. As voiced through the clinics, there is an increasing demand from the public for ■out-patient treatment by E.C.T. at the mental hospital, where it is realized we have the necessary trained staff to undertake this work, which does not end in the actual shock, but includes appropriate accompanying psychological care. There were 302 cases treated by E.C.T. during the year. In 210 of these it was prescribed for the first time. There were no complications of note. This treatment continues to be a most admirable and essential feature in our therapeutic armamentorium. Leucotomy was performed in two cases, only one of which is showing much improvement. Pentothal narcosis is utilized to a great and useful extent. Occupational therapy, along with psychological treatment, plays a big part in this hospital. Nine separate classes are held, and these range from those for the demented chronic cases to those for acute and recent recoverable patients. The approximate daily attendance at these classes is 240. In the figures I give below I have drawn a definite line between these classes and the activities performed by the " utility " departments, the latter including such work as garden, farm, kitchen, workshop, sewing-room, laundry, domestic, and ward work. During the year under review, 255 patients have passed through the occupation •classes —35 men and 79 women have been discharged directly from the classes to their homes, and 59 men and 82 women have been transferred from the classes to the various utility spheres. As important as this work is among these acute recoverable cases, it is by no means less so among the chronic degenerated types, among whom we endeavour to restore interest and good-habit training. During the year 76 men and 60 women who are in this group and who were admitted to the hospital prior to 1942 have attended these classes, and 13 men and 7 women were sufficiently readjusted to be transferred to utility departments. The percentages in regard to occupational therapy based on the total patient population may not appear as great as one would have hoped, but it must be borne in mind that this population has been greatly swollen by the increasing admission rate -of senile cases. The work programme has been slow, as is the case everywhere else. In spite of grants being made, the shortage of material and labour has had this effect. Among the most important works done and now under way are renovations to lavatories, roading repairs, and the formation of a sports-ground. The opening of a canteen has proved a great boon to patients and staff, besides being a financial success, which helps to swell the Patients' Recreation Fund. We are greatly indebted to the following committees, associations, and clubs, and to them I wash to extend my grateful thanks and put on record my obligations to them : the Grey Lynn Ladies' Committee, the Mental Hospital Committee of the Hospital Auxiliary, the Returned Soldiers' Association, the 2nd N.Z.E.F. Association, the Joint ■Committee of the Order of St. John and Red Cross Society, the Point Chevalier Happiness Club, various women's Institutes, and the Auckland Transport Board Bowling Club. Besides the above mentioned, there are numerous individuals and groups of people to whom we owe our sincere thanks. As you are aware, the staff shortage has been acute and placed extra strain on those who remain with us, and I am most grateful for the way in which the majority have risen to the occasion and given ungrudgingly of their services. Mrs. Teape and Mrs. Moore have been regular in their duties as Official Visitor, the patients and staff owing much to their interest.

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KINGSEAT MENTAL HOSPITAL Dr. Tothill reports : I have the honour to submit my report for the year ending 31st December, 1946. The total number of cases under care during the year was 993 with a weekly average of 848. Admissions numbered 121, of whom 79 were committed patients, 28 voluntary boarders, and 14 transfers from other mental hospitals. A large number of new admissions were congenital mental defectives and senile cases, and, as they are unrecoverable, the percentage of recoveries does not give a true picture of the recovery rate. Approximately one in every three new admissions has been a voluntary patient. In the past five years the admissions, excluding transfers, have increased fivefold. This indicates a steady development of the hospital in spite of its distance from Auckland and restricted wartime travelling facilities. Discharges numbered 49, 22 being committed patients and 27 voluntary boarders. In addition, 8 patients were transferred to other mental hospitals. There were 38 deaths, a very low death-rate considering the large number of elderly patients. Owing to the increased admissions and relief given to other hospitals, our accommodation has been severely taxed, and overcrowding to the extent of 65 beds is present. No buildings have been erected since 1940, the war of necessity causing a cessation of the building programme. However I feel the hospital should be completed to full maturity as soon as possible not only to relieve overcrowding, but to provide better facilities for the treatment of infirm patients, occupational therapy, recreation, and administration. During the six months of 1945 that I was in charge of the weekly clinic at the Auckland Hospital 367 consultations were given. The out-patient treatment at Kingseat has considerably increased, but the distance from Auckland is a disadvantage. A large number of examinations, reports, and treatments have been arranged for the Child Welfare Department. Child psychiatry in Auckland has almost reached the stage where a full-time psychiatrist in charge of a child-guidance clinic is necessary. I am sure that this would not only help the educational authorities to sort out the subnormal child attending school so that appropriate training could be given, but also by solving environmental difficulties and mental conflicts, problem children could be more adequately catered for, and perhaps future mental breakdowns prevented. All the modern forms of treatment have been carried out at this hospital, and, though physical methods are spectacular and have been much publicized, it is my opinion that, without psycho-therapy and treating the patient as a whole, permanent recovery is unlikely. The principle of maximum freedom with safety has been followed to the full, and most of the villas are open. In consequence, the majority of the patients have considerable liberty and, apart from enjoying out-door recreation, derive much benefit from fishing expeditions, picnics, visits to town and pictures, &c. It is hoped to erect a seaside cottage where suitable patients-can have a holiday and change from institutional life. Our occupational classes have made good progress, but the desired expansion cannot take place until suitable buildings are available. The present arrangements are makeshift, and day-room accommodation has had to be sacrificed to enable the classes to be carried on. Apart from general maintenance, minor alterations, and the erection of two cottages, no constructional change has taken place during the past year. Tenders have been called for the building of more staff cottages at the settlement, but no finality has been reached yet. General improvements have been made on the farm, the milk-cans are all steamsterilized, and our herd is free of tuberculosis. Apart from regular tuberculin tests, blood tests for all suspect undulant fever carriers are done, and injections given for mammitis. Sea erosion of part of the farm is taking place, and flood-gates will probably be necessary to stop this. Staff shortages, especially female, have been serious during the year, and, although overtime has been worked ungrudgingly, tired nurses cannot do their work properly, and this in turn must reflect on the efficiency of the staff and welfare of the patients.

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A hall for recreational purposes and our own transport service are absolutely necessary if we are to get and retain staff. The location of this hospital places our staff at a definite disadvantage when compared with the mental hospitals near a city. Many organizations and individuals have helped our patients by giving entertainment and donations. I am most grateful for their generosity, and would like to see the community take greater interest in our activities, as I am sure it would not only add to its own enlightenment, but would also keep the patients in closer contact with civilian life and make rehabilitation easier when they are ready for discharge. In conclusion, I tender my sincere thanks to all members of the staff for the good work they have done during the year. TOKANUI MENTAL HOSPITAL Dr. Hunter reports : I have the honour to submit my annual report for the year ending 31st December, 1946. The total number of cases under care during the year has been 1,152, with a weekly average of 910. The admissions were 121 (52 men, 69 women). Of these, 105 (45 men and 60 women) were admitted for the first time, being a decrease of 4 under those of the previous year. The general health of the hospital has been very good, deaths totalling 49 (18 men and 31 women) the majority being elderly people. Discharges numbered 48 (19 men and 29 women). Transfers numbered 245 (14 men and 231 women). Voluntary boarders treated during the year were 66 (22 men and 44 women), 12 men and 12 women being new admissions. Voluntary boarders discharged numbered 33 (5 men and 28 women). The use of the electric convulsive therapy has shortened the time in hospital, especially the involutional melancholic type of mental disorder. During February the forest fires in the Taupo district necessitated the transferring of our women patients at Wairakei to Raventhorpe, and the administration of Raventhorpe was later in the year taken over by Kingseat Mental Hospital. For most of the year the staff shortage has continued to be serious, but was improved somewhat by the arrival of a party of nurses from Great Britain. The staffing position on the male side has not improved, mainly due to the lack of housing for married staff. A site near the hospital has been acquired, and we hope to see some progress being made in the near future with the resultant increase in staff, as a good type of applicant is offering, but will not take a position as there is no accommodation for their families. Occupational therapy continues to play a great part in the improvement of our patients, but we are handicapped by lack" of suitable buildings. Although these have been sanctioned for the last two years, little progress has been made in erecting them. The fire-fighting services of the hospital are being improved, an automatic firealarm system is being installed in addition to our present manual system. An up-to-date fire-fighting engine is on order. A new laundry and boiler-house on a new site are proposed, as the old laundry has, for many years, proved too small for the number of patients and staff it is required to cater for. This will necessitate the provision of separate kitchens and bathrooms for men's wards, A, C, and H, and a separate staff kitchen, to cater for the attendant staff. The provision of these amenities will make each ward self-contained. The clinic at the Hamilton Hospital continues to serve a useful purpose and is appreciated by the hospital authorities, and many early cases are referred for opinion and suggested treatment. Amusement and recreation has been catered for as usual. -Weekly dances, pictures, some concerts, and visits by bands and orchestra. I would like to thank the Te Awamutu Rotary Club for much appreciated interest in providing entertainment for the patients and for the many picture parties that they have provided during the year. In conclusion, I want to express my thanks to all members of the staff for their help and co-operation in the work of the hospital.

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PORIRUA MENTAL HOSPITAL Dr. Hart reports : I have the honour to submit my report for the year ending 31st December, 1946. The total number of cases under care during the year was 1,816, of which 1,492 were committed patients, 319 voluntary boarders, and 5 persons were remanded for psychiatric observation. Admissions for the year totalled 587, of which 217 were admitted as .voluntary boarders. Over 38 per cent, of the persons admitted during the year voluntarily applied for admission and treatment in this hospital. During the year 381 cases were discharged and 105 deaths occurred. The admissions each year tend to show a progressive increase in the number of persons suffering from senile mental disorders. During the year 124 persons were admitted suffering from mental abnormalities associated with old age. Of these, 43 were between the ages of seventy and eighty years and 17 were between the ages of eighty and ninety years. As the expectancy of life increases, these figures have and will continue to increase. Although some senile cases must continue to be admitted to mental hospitals, the time appears to be overdue when New Zealand should make some provision for people suffering from mental infirmities, other than certification and admission to a mental hospital. During the year extra mural psychiatric work has continued with wards and clinics at the Wellington and Palmerston North Hospitals. An additional psychiatric clinic has been opened this year at the Wanganui Public Hospital. Psychiatric clinic work has so extended and increased that we are finding it increasingly difficult to give adequate time to this important community service. Regarding specialized treatment such as sub-coma insulin, electroplexy and electric narcosis have been used extensively during the year. Our results with the first series of cases treated with electric narcosis have recently been published. The therapeutic results obtained with a group of relatively early paranoid schizophrenics were considerably better than had previously been obtained with other forms of treatment. In other psychoses we found that the results of electric narcosis treatment were no better than those obtained with electric convulsive therapy. Continued progress is being made with the building programme. Villas 4 and 5 were occupied during the year ; the increased accommodation available has reduced the overcrowding. The number has now been reduced to 263 patients resident over and above the authorized accommodation. The construction of Villas 6, 7, and 8 has commenced, and there is every prospect of Villas 7 and 8 being occupied during 1947. With the exception of the old laundry block and F Ward, the demolition of the old main block has been completed. The new laundry block has been finished, but, owing to lack of machinery, it is not in use. It is hoped that this machinery will soon be available as the restricted facilities and inconveniences associated with the old laundry make it very difficult to cope with hospital washing. Last year the Public Works Department took over the responsibility of the maintenance of the hospital buildings, but, owing to a lack of materials and labour, the overcoming of the arrears in building maintenance which arose during the war has not made much progress, although some contracts have been let. Some interior renovations of buildings have been carried out by our staff and patient labour, but progress has been somewhat restricted due to lack of materials. During the year additional provision for the segregation of male T.B. patients was made at Kaumatua Villa. Satisfactory segregation for both male and female is provided and should be quite adequate, pending the construction of the T.B. wing, which will be built along with the main hospital block which has next priority.

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The demolition of a large section of the hospital and rebuilding has called for additional roads, paths, and repairing of existing roads. After a delay the expenditure for roading has been authorized, and I trust that the Public Works Department will complete this work without further delay. Several oil-fuel ranges were installed during the year with success, and in part alleviated the difficulties associated with the acute shortage of coal. Our experience is that this type of range is well adapted to mental hospital cooking, and it is recommended that favourable consideration be given to the installation of oil-fuel ranges in some of the proposed villas. The electric-power cuts naturally caused difficulties in the administration of the hospital. The consequent interruptions in treatment were in the main overcome by the use of the new steam-generators. Considerable attention has been given to fire protection during the year. Contract has been let for the installation of an automatic fire-alarm completely covering all buildings on the estate, and a sprinkler system is being installed in the lower buildings, which are our greatest fire risk. Water-pressure has been improved and additional hoses have been installed where necessary. During the year the Post and Telegraph Department has replaced the old telephones connected with the internal hospital system with some improvement. The very scattered nature of the hospital demands an efficient service, and I am afraid that the internal telephone system will not be entirely satisfactory until the old exchange is replaced with more modern equipment and housed in a satisfactory building. The two town telephone numbers are insufficient to cope with the demand and are a constant source of complaint, but at present there are technical difficulties which prevent the Post and Telegraph Department from giving us additional numbers. Replacement of power-lines was carried out during the year. A new 11,000 v. high-tension transmission-line from the Titahi Bay road was erected, replacing the 6,600 v. line coming in at the southern end .of the estate. The new line has reduced interruptions formerly occurring with the old line in association with storms, fallen trees, &c. Staff shortages remain, and, naturally, vary somewhat from time to time. The shortage at 31st December, 1946, was 31 nurses and 30 attendants. The staff has been augmented by student trainees from the British Isles. Of the 35 who commenced duty here, 27 remain, and their services are a valuable contribution towards relieving the acute staff shortage. Some progress has been made with occupational therapy, but the work is still somewhat hampered by the lack of suitable accommodation. The hospital is in the process of rebuilding, and at the same time has to cope with the largest mental hospital admission rate in New Zealand. Obviously inconveniences and difficulties exist for both patients and staff on account of this, and the work of all branches of the hospital is more difficult than it would be were the hospital completed and fully established. I must thank the staff for the good work which has been maintained under the above-mentioned difficulties. NELSON MENTAL HOSPITAL Dr. Williams reports : I have the honour to present my annual report for the year ended 31st December, 1946. The number of patients under care during this period was 1,178 ; 1,132 were admissions under reception order and 46 were voluntary boarders. Admissions totalling 141, included 4 transferred from other mental hospitals, 39 under section 8 of the Amendment of the Act, and 22 voluntary boarders. During the year, 47, including 25 voluntary boarders were discharged; 13 were transferred to other mental hospitals. Deaths totalled 54.

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The general health of the patients has been good, though there was a moderately severe epidemic of gastro-enteritis among the children. All the latter were immunized against diphtheria and whooping-cough. Eighty per cent, bread was introduced during the year, but has had no noticeable beneficial effect therapeutically. Post-war disorganization of trained labour and material continue to delay needed additions and improvements, and little more than maintenance work has been possible. Roads have been tar-sealed ; the painting party has been kept busy, as, indeed, has the artisan staff generally in attempting to keep abreast of necessary repairs. The building of two cottages for Assistant Medical Officers was begun some months ago ; but shortage of materials still delays their completion. A new staff kitchen is being installed in Dunoon, but it, too, perforce, proceeds slowly. Authority was obtained for the installation of a cinema plant at Ngawhatu, but the Building Controller, although sympathetic, ruled that this could not proceed meanwhile because of its low priority in the matter of urgency. This is a great pity, as facilities for patients' recreation are not good in Nelson, and particularly at Ngawhatu. Thanks iin this respect are due to the Young People's Choir for concerts ; to the Church of Christ for arranging picnics ; and particularly to Mr. Croucher for his evergenerous provision of buses for outings and pictures, though even with his help only a small proportion can benefit regularly. Many firms and societies have been generous, too, with donations in cash and kind for patients' benefit. Staff shortages have continued, though only on the female nursing and domestic side, so that difficulties have been buffered somewhat by extending the duties of the men, who have done very well indeed, I think, in much work to which they are normally unaccustomed. The addition of one, or preferably two trained occupational therapists would assist very much, and I understand this is being arranged as soon as possible. A new lecture-room with annexes has been installed in the old nurses' home, and it is pleasing to record that the staff are very keen on their training, and most have done very well in their examinations, intra and extramural. Sister McEwan has contributed much towards this by her capability and her infectious enthusiasm. There are exceptions, of course, as always, but, generally speaking, the spirit of the staff has been excellent, and their co-operation and assistance has been of inestimable value. For the sake of interest, I ascertained the causes of leaving among the nurses since the war ended. Of a total of 102, 44 left to be married ; 16 were recalled home to look after sick parents, or to assist otherwise in the house or on farm because of shortage of help there. Some of these have been able to return. A number were not suited temperamentally and otherwise, but very few indeed —only 6 I could ascertain — left because they could not cope with conditions. Sixteen went to other mental hospitals on promotion or transfer. The number of men leaving because of conditions extant were negligible. A telephone has been installed in the nurses' home, where, too, there has been established by keen members a very good circulating library, augmented by assistance from the Country Library ServiceFarm activities have continued reasonably satisfactorily with buoyant revenue. Vegetable production has not been of the best, but measures in train should improve this. Water has been laid on to further paddocks, which will give better grazing and increased milk-supply. Mr. Devine, the Farm-manager, retired after almost thirty-five years' service, and best wishes are extended to him and Mrs. Devine for their future. The power-house has been handicapped by further deterioration in the boilers, and replacement of these is urgently required. The Committee of Inquiry visited us, in common with other mental hospitals, during the year, and made a number of helpful recommendations. To the staff generally for their assistance and co-operation I have to offer my sincere thanks.

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HOKITIKA MENTAL HOSPITAL Dr. Childs reports : I have the honour to submit my report for the year ending 31st December, 1946. The number of cases under care during the year was 562 (276 males and 286 females.) The admissions numbered 18 (11 males and 7 females), there were 34 transfers (23 males and 11 females), and 6 voluntary boarders (5 males and 1 female). Patients discharged were 8 (5 males and 3 females), voluntary boarders 5 (4 males and 1 female), while there was 1 transfer, a male. There were 34 deaths (10 males and 24 females). At the end of the year 6 males and 4 females remained on probation. The health of the patients generally has been satisfactory. Dr. Hay was in charge of the hospital during the month of January. The Grey River Hospital clinic has been held monthly, visits have been paid to the Westland Hospital, and consultations held here. There has been an acute shortage of staff on the female side, and this has curtailed the activities of the patients in various ways. Occupational therapy, outings for the patients, social activities, and supervision generally have all been interfered with to some extent. The clergy have made frequent visits and held regular services. Mrs. Fane is a most helpful Official Visitor. The usual routine of farming and gardening has been carried on in the usual satisfactory manner. Maintenance work has been in progress during the year, but, owing to the shortage of artisan staff and difficulty in obtaining material, maintenance is in arrears. A new lavatory has been added to the day-room of " Tui " and " Temaire." The Medical Officers' cottage, started on 11th June, 1946, is not yet completed. As usual, recreations and amusements have played as prominent a part in hospital life as possible. Thanks are due to the various local societies, especially the Hokitika Band (which played for the dances), for entertaining the patients, and also the racing club and the various ladies' committees, who invited the patients to outside functions. Mr. Atkinson, who has given long and efficient service as Farm-manager, retired at the end of the year. He deserves a well-earned retirement. I wish to thank the members of the staff generally for their co-operation and good work during the year. SUNNYSIDE MENTAL HOSPITAL Dr. McKillop reports : I have the honour to forward my report for the year ending 31st December, 1946. The total number of cases under care during the year was 1,671 (858 men and 813 women). During 1946, 214 patients (97 men and 117 women) were admitted, and 10 men and 6 women were transferred from other institutions. Forty-one men and 60 women were discharged, 65 patients were transferred, and at the end of the year 738 males and 698 females (inclusive of 198 patients absent on probation) remained in the hospital. In addition, 233 voluntary boarders (122 men and 111 women) were treated, 158 (83 men and 75 women) being admitted in 1946. One hundred and forty-five voluntary boarders (79 men and 66 women) were discharged, 2 women were committed as ordinary patients, and 6 (4 men and 2 women) died, leaving 80 (39 men and 41 women) receiving treatment at the end of the year.

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The death-rate was comparatively low. There were 69 deaths (33 men and 36 women, inclusive of 3 men and 2 women who died on probation). As usual, the chief cause of death was senile decay. The results of electric shock therapy have again been very satisfactory, 170 patients were treated and 122 were discharged fit to resume their normal occupations. Occupational therapy is being carried out on a gradually increasing scale. The occupational block has been added to and will shortly be in use. The usual maintenance work has been carried out. Villas at Templeton and villas and wards at Sunnyside are being renovated yearly in rotation. A larger dining-room and a side room for the nursing staff at the nurses' home is in course of construction, and, with the proposed extension of the main home, should greatly improve the livingconditions of the nursing staff. It is hoped in 1947 to commence the following major works : (1) tuberculosis block; (2) admission block; (3) female villa, to permit of better classification in the main building; and (4) nurses' home at Templeton. Work has already commenced in connection with office accommodation at Sunnyside and a granary at Templeton. The farms and gardens have had a very successful year, and present indications are that the production of vegetables will be the best for many years. Clinics have been held twice weekly at Christchurch Hospital and once a month at Timaru Hospital. The attendances have been well maintained ; there were 1,550 consultations at Christchurch and 313 at Timaru. Several outside associations have taken an increasing interest in the well-being of our patients. The National Council of Women and the Justices of the Peace Associations may be mentioned particularly in this respect. The Official Visitors and the chaplains of various denominations have paid regular visits and have helped in many ways to brighten the lives of our inmates. Special mention must be made of the work of Canon Hevell and of the Rev. Tennant, who both recently retired. Canon Revell was a visiting chaplain when I was appointed to Sunnyside in 1925. The Rev. Tennant came out of retirement to help during the war years. They carried out their duties here in a pleasant and efficient manner. Our nursing difficulties will be eased considerably by the nurses who recently arrived from England. Our nurses have had a very trying year. They have worked very long hours without complaint and have made the care and treatment of their patients the first consideration. SEACLIFF MENTAL HOSPITAL Dr. Brown reports : I have the honour to submit my report for the year ending 31st December, 1946. During the year there were 1,194 persons (684 men and 510 women) under care. In that period 178 patients were admitted, 100 discharged, and 7 transferred to other hospitals. In addition to these patients, 79 voluntary boarders were admitted, and 33 remain under treatment at the end of the year. The number of deaths was 69, and in 43 of these the cause of death was senile decay. The new villa at Waitati was occupied early in the year, and it provides modern and very comfortable accommodation for a number of elderly male patients. The contractors have completed the demolition of the tower, but work is still proceeding on the new fire-escapes.

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The maintenance staffs have been fully occupied with the necessary repairs. During the last six months the slipping nature of the country has been more in evidence than ever. Its effects are well seen on the female side and in certain of the residences, and the constantly recurring breaks in water-mains and sewers due to it are a source of considerable worry. Garden and farming activities have been carried on as usual and call for no special comment. The general health of the patients has been good. Electric convulsive treatment continues to show its value, particularly in depressed cases. Mr. M. A. Falconer, the Neuro-surgeon, performed leucotomy in three cases in which all other forms of treatment had failed. One of these is discharged and very well, and another is still in the hospital and has shown a marked improvement; the third case was transferred to another hospital, and I do not know the ultimate result in that case. Mrs. R. E. S. Reeves and Mr. A. Steven, the Official Visitors, have visited frequently and have been very helpful. To the latter and to the Patients' and Prisoners Aid Society, of which he is the chaplain, I am very grateful for several entertainments which have been provided for the patients both at Seacliff and Waitati. Mr. C. B. Barrowclough, the District Inspector, having returned from service overseas, has resumed his duties, and to him I have to express my thanks. Once again I have to record my gratitude to various members of the staffs of the Medical School and the public hospital for their help and assistance with clinical investigations. Sir Charles Hercus and Professor D'Ath have been particularly helpful. At the end of the year a number of nursing trainees from Great Britain joined the nursing staff, and their advent afforded some measure of relief to the harassed nursing staff. During the year Dr. R. T. Hay left to go to Queen Mary Hospital, Hanmer, and his position as Deputy Superintendent was filled later in the year by the appointment of Dr. D. G. McLachlan. Dr. H. R. Bennett joined the staff, and is stationed at Waitati. I have to offer my thanks to the staff generally for their loyal co-operation. Table I. —Showing the Admissions, Readmissions, Discharges, and Deaths in Mental Hospitals during the Year 1946 M. F. T. In mental hospitals, Ist January, 1946 .. .. .. .. 4,470 3,934 8,404 M. F. T. Admitted for the first time .. .. 544 621 1,165\ aA ~ 7sa , Readmitted .. .. .. ..101 167 268/ Total under care during the year .. .. .. 5,115 4,722 9,837 Discharged and died— Recovered .. .. .. .. 183 270 453 Not recovered .. .. .. 107 125 232 Died .. .. .. .. 269 281 550 559 676 1,235 (Not including transfers ; Males, 114 ; females, 296.) Remaining in mental hospitals, 31st December, 1946 .. .. 4,556 4,046 8,602 Increase on 31st December, 1945 .. .. .. 86 112 198 Average number resident during the year .. .. .. .. 4,266 3,706 7,972

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Table II. —Admissions, Discharges, and Deaths with the Mean Annual Mortality and Proportion of Recoveries, Etc., per Cent. on the Admissions during the Year 1946

14

Mental Hospitals. In Mental Hospitals on 1st January, 1946. Admissions in 1946. Total Number of Patients under Care. Admitted for the First Time. Not First Admissions. Transfers. Auckland Kingseat Raventhorpe Tokanui Levin Farm .. Porirua Nelson Hokitika Christchurch Seacliff Ashburn Hall* Totals .. M. F. . T. 713 621 1,334 440 403 843 414 (H7 1,031 52 .. 52 654 475 1,129 581 432 1,013 242 268 510 751 690 1,441 610 406 1,016 13 22 35 M. F. T. 121 145 266 35 37 72 45 60 105 19 .. 19 104 150 254 62 47 109 8 6 14 82 93 175 62 81 143 6 2 8 M. F. T. 34 51 85 2 5 7 .. 2 2 4 8 12 34 57 91 3 2 5 3 1 4 15 24 39 6 17 23 M. F. T. 14 18 32 6 8 14 9 237 246 3 1 4 28 .. 28 11 7 18 3 2 5 23 11 34 10 6 16 6 6 12 1 .. 1 M. F. T. 882 835 1,717 483 453 936 9 239 248 466 686 1,152 qq qq 803 689 1,492 649 483 1,132 276 286 562 858 813 1,671 684 510 1,194 20 24 44 4,470 3,934 8,404 544 621 1,165 101 167 268 114 296 410 5,229 5,018 10,247 Mental Hospitals. Discharged recovered. Patients discharged, transferred, and died. Discharged not recovered. Transferred. Died. Total discharged, transferred, and died. Auckland Kingseat Raventhorpe Tokanui Levin Farm Porirua Nelson Hokitika Christchurch Seacliff Ashburn Hall* Totals M. F. T. 38 66 104 2 8 10 17 23 40 55 89 144 7 12 19 3 2 5 27 38 65 34 32 66 M. F. T. 45 42 87 2 10 12 2 *6 8 4 4 23 22 45 >213 2 13 > 14 22 36 i 13 21 34 M. F. T. 14 17 31 2 6 8 7 7 14 231 245 22 7 29 10 3 13 O 1 o 46 19 65 3 4 7 112 M. F. T. 63 72 135 16 22 38 4 4 18 31 49 56 43 99 31 19 50 10 24 34 33 36 69 42 27 69 3 3 M. F. T. 160 197 357 22 46 68 ..11 11 51 291 342 4 4 156 161 317 50 35 85 17 28 45 120 115 235 92 84 176 1 4 5 183 270 453 1107 125 232 114 296 410 269 281 550 673 972 1,645 Mental Hospitals. In Mental Hospitals on 31st December, 1946. Average Number resident during the Year. Percentage of Recoveries on Admissions during the Year. Percentage of Deaths on Average Number resident during the Year. Auckland Kingseat Raventhorpe Tokanui Levin Farm Porirua Nelson Hokitika Christchurch Seacliff Ashburn Hall* .. Totals M. i*. T. 722 638 1,360 461 407 868 9 228 237 415 395 810 95 .. 95 647 528 1,175 599 448 1,047 259 258 517 738 698 1,436 592 426 1,018 19 20 39 M. F. T. 667 557 1,224 439 385 824 2 65 67 401 532 933 61 .. 61 616 455 1,071 567 409 976 252 261 513 677 639 1,316 567 382 949 17 21 38 M. F. T. 24-52 33-67 29-63 5-41 19-05 12-66 34-69 33-82 34-19 39-86 43-00 41-74 10-77 24-49 16-67 27-27 28-57 27-78 27-84 32-48 30-37 50-00 32-65 39-75 M. F. T. 9-45 12-93 11-03 3-64 5-71 4-61 6-15 5-97 4-49 5-83 5-25 9-09 9-45 9-24 5-47 4-65 5-12 3-97 9-20 6-63 4-87 5-63 5-24 7-41 7-07 7-27 .. 14-29 7-89 4,556 4,046 8,602. £,266 3,706 7,972 28-37 34-26 31-61 6-31 7-58 6-90 * Private mental hospital.

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Table III. —Native Countries

Table IV.—Ages of Patients on 31st December, 1946

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Countries. Auckland. Kingseat. Ilaventhorpe. Tokanui. Levin Parm. Porirua. England and Wales Scotland Ireland New Zealand Australian States France .. Oermany Austria Norway Sweden Denmark Italy China Maoris Other countries Unknown Totals M. F. T. 81 60 141 18 10 28 17 12 29 470 476 946 29 12 41 1 . . 1 12 3 5 1 6 1 . . 1 2 1 3 2 i 3 2 1 3 35 21 56 43 22 65 15 19 34 M. F. T. 72 54 126 14 11 25 20 18 38 290 290 580 15 11 26 7 7 4 4 2 13 1 i 2 2 .. 2 14 9 23 20 12 32 M F. T. 1 24 25 . . 8 8 17 8 7 170 177 ..13 13 .. i" 1 5 5 M. F. T. 47 46 93 14 10 24 17 14 31 281 275 556 7 13 20 1 .. 1 112 2 2 3 i 4 1 .. 1 2 2 27 29 56 12 6 18 M. F. T. 1 .. 1 2 .. 2 87 !! 87 2 .. 2 3 .. 3 M. F. T. 78 52 130 24 14 38 21 16 37 446 398 844 25 10 35 1 i' 2 1 I 2 2 12 3 32 22 54 16 13 29 722 638 1,360 461 407 868 9 228 237 415 395 810 95 .. 95 647 528 1,175 Countries. Nelson. Hokitika. Christchurch. Seaciff. Ashburn Hall (Private Mental Hospital). Totals. England and Wales Scotland Ireland New Zealand Australian States .. Prance Germany Austria Norway Sweden Denmark Italy China Maoris Other countries Unknown Totals M. F. T. 38 37 75 21 8 29 8 4 12 479 367 846 9 8 17 1 1 2 2 1 4 I .. 1 II 2 17 14 31 3 1 4 15 8 23 M. F. T. 24 20 44 8 4 12 11 4 15 185 189 374 6 10 16 . . i 1 1 !! 1 1 .. 1 2 2 i !! I 15 30 45 M. F. T. 35 60 95 21 11 32 11 8 19 645 576 1,221 10 14 24 2 2 1 .' 1 6 11 17 7 18 25 M. F. T. 35 20 55 32 24 56 19 10 29 470 356 826 13 5 18 1 1 2 2 1 .. 1 4 2 6 15 9 24 M. F. T. 1 1 2 2 16 i9 35 1 .. 1 M. F. T. 412 374 786 156 100 256 125 93 218 3,376 3,116 6,492 117 96 213 2 2 6 4 10 15 2 17 7 7 7 2 9 10 1 11 9 2 11 9 5 14 135 106 241 110 79 189 60 66 126 599 448 1,047 259 258 517 738 698 1,436 592 426 1,018 19 20 39 4,556 4,046 8,602

Ages. Auckland. Kingseat. Raventhorpe. 1 Tokanui. Levin Farm. Porirua. From 1 to 5 years „ 5 „ 10 „ „ 10 „ 15 „ „ 15 „ 20 „ „ 20 „ 30 „ „ 30 „ 40 „ „ 40 „ 50 „ „ 50 „ 60 „ „ 60 „ 70 „ „ 70 „ 80 „ • .. „ 80 „ 90 „ Upwards of 90 Unknown Totals M. F! T. 3 i' 4 7 2 9 22 17 39 105 90 195 150 117 267 151 114 265 106 154 260 115 91 206 46 34 80 8 8 16 9 l6" 19 M. P. T. 1 .. 1 2 2 4 4 4 8 19 5 24 28 31 59 68 52 120 77 77 154 98 84 182 102 99 201 56 38 94 6 15 21 M. E. T. i' i . . & 8 .. 17 17 3 42 45 4 60 64 . . 65 65 2 31 33 .. 2 2 .. 2 2 11. E. T. 112 5 7 12 6 7 13 10 6 16 57 54 111 80 70 150 68 79 147 58 79 137 83 55 138 37 26 63 5 8 13 5 3 8 M. E. T. i !! i 17 .. 17 27 .. 27 42 .. 42 8 .. 8 M. E. T. 16 7 18 9 20 22 42 73 71 144 147 97 244 116 102 218 127 91 218 103 81 184 54 39 93 5 11 16 722 638 1,360 461 407 868 9 228 237 415 395 810 95 .. 95 647 528 1,175

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Table IV. —Ages of Patients on 31st December, 1946 —continued

Table V. —Length of Residence of Patients discharged "Recovered" during 1946

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Ages. Nelson. Hokitika. Christchurch. Seacliff. Ashburn Hall (Private Mental Hospital). Totals. M. F. T. M. F: T. M. F. T. M. F. T. M. F. T. M. F. T. From 1 to 5 years 34 20 54 7 3 10 1 1 2 44 25 69* „ 5 „ 10 „ 49 38 87 23 14 37 5 2 7 89 70 159 „ 10 „ 15 ■„ 53 32 85 1 '2 3 52 20 72 2 8 10 143 84 227 „ 15 „ 20 „ 36 25 61 4 4 8 60 54 114 13 12 25 211 145 356 „ 20 „ 30 „ 68 50 118 15 13 28 169 143 312 71 35 106 4 2' 6 632 497 1,129= „ 30 „ 40 „ 105 56 161 42 31 73 108 109 217 114 63 177 1 1 823 612 1,435. „ 40 „ 50 „ 73 55 128 43 45 88 114 85 199 134 62 196 2 2 781 661 1,442' „ 50 „ 60 „ 71 70 141 59 65 124 81 95 176 106 84 190 3 '2 5 713 784 1,497 „ 60 „ 70 „ 65 61 126 67 67 134 80 102 182 91 92 183 3 7 10 709 720 1,429 „ 70 „ 80 „ 31 33 64 24 22 46 39 50 89 44 50 94 3 7 10 336 330 666 „ 80 „ 90 „ 7 6 13 2 4 6 5 17 22 10 15 25 3 2 5 51 88 139 Upwards of 90 1 1 4 4 1 1 6 6 Unknown 7 1 8 2 5 7 2 2 i 1 2 '24 24 48Totals 599 448 1,047 259 258 517 738 698 1,436 592 426 1 ,018 19 20 39 4,556 4,046 8,602:

Length of Residence. Auckland. Kingseat. Raventhorpe. Tokanui. Levin Farm. Porirua. U»der 1 month From 1 to 3 months 3 „ 6 „ „ 6 „ 9 „ „ 9 „ 12 „ 1 „ 2 years „ 2 „ 3 „ „ 3 „ 5 „ „ 5 „ 7 „ 7 „ 10 „ „ 10 „ 12 „ „ 12 „ 15 „ Over 15 years Totals M. F. T. 5 4 9 3 8 11 4 7 11 10 16 26 4 13 17 5 8 13 5 3 8 2 3 5. .. 2 2 .. i 1 1 1 M. F. T. ..3 3 112 .. 2 2 112 .. 1 1 M. F. T. M. F. T. 1 1 16 7 3 2 5 3 3 6 8 6 14 .. 2 2 12 3 .. 2 2 M. F. T. M. F. T. 2 2 10 26 36 18 21 39 7 14 21 6 6 12 7 13 20 2 4 6 3 3 6 1 ! 1 1 !! 1 38 66 104 2 8 10 17 23 40 55 89 144 Length of Residence. Nelson. Hokitika. Christchurch. Seacliff. Ashburn Hall (Private Mental Hospital). Totals. Under 1 month From 1 to 3 months „ 3 „ 6 „ „ 6 „ 9 „ „ 9 „ 12 „ 1 „ 2 years .. 2 „ 3 „ .. 3 „ 5 „ „ 5 „ 7 „ .. „ 7 „ 10 „ 10 „ 12 „ .. „ 12 „ 15 „ Over 15 years Totals M. F. T. 1 .. 1 i i 2 1 .. 1 .. 3 3 13 4 2 2 .. 2 2 2 2 112 M. P. T. .. i l I ;; i 112 1 1 M. F. T. 1 1 1 .. 1 6 3 9 3 11 14 5 8 13 7 7 14 3 3 2 4 6 2 2 112 M. F. T. 5 6 11 7 4 11 5 6 11 6 4 10 8 8 16 2 2 4 1 .. 1 .. 1 1 .. i l M. F. T. M. F. T. 6 7 13 20 43 63 38 44 82 29 51 80 26 38 64 37 47 84 9 16 25 10 14 24 2 3 5 2 3 5 2 "l 3 2 3 5 7 12 19 3 2 5 27 38 65 34 32 66 183 270 453

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Table VI. —Causes of Death, 1946

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Causes. Auckland. Kingseat. Ilaventhorpe. Tokanui. Levin Farm. Porirua. I— General Diseases Tuberculosis— General Lungs Meningitis Hydatid cyst Cancer Toxaemia Septicemia Acute yellow atrophy of liver Congenital debility M. 2 2 2 F. 1 2 T. 6 4 2 M. 1 F. 3 2 i T. 1 3 2 1 M. F. ®. .. i l M. F. T. . . 5 5 .. r 2 M. F. T. M. 6 1 F. T. 'i 10 'i 2 II. —Diseases of the Nervous System Exhaustion Exhaustion of mania Exhaustion of melancholia General paralysis of the insane Cerebral haemorrhage Cerebral thrombosis Cerebral tumour Cerebral oedema Epilepsy Organic brain disease 6 2 4 "i 5 i 10 7 4 1 1 1 i "i l 1 2 2 1 3 2 3 i 2 !! 3 1 3 2 5 1, 1 1 1 III. —Diseases of the Respiratory System Pneumonia — Broncho Hypostatic Lobar Bronchitis Pulmonary— (Edema Embolism Thrombosis Pleurisy Lung abscess 6 1 4 10 1 1 l 2 2 .. 'i l 3 7 10 1 .. 1 14 1 1 1 9 23 2 3 1 2 'i 1 !! 1 IV. —Diseases of the Circulatory System Heart-disease Arterio-sclerosis 30 45 1 75 1 6 3 9 12 10 22 15 1 13 28 1 V.—Diseases of the Digestive System Enteritis Gastric ulcer Peritonitis Liver abscess Coeliac disease 2 1 i 1 2 1 3 1 2 5 1 VI.—Diseases of the Urinary System Uraemia Nephritis Pyonephrosis 1 1 2 1 2 1 VII—OLD AGE Senile decay 2 2 4 4 .. 2 2 2 5 7 VIII. —External Causes Exposure Asphyxia Suicide Injury to central nervous system 1 1 1 1 2 1 1 2 .. '2 2 1 !' 1 IX.-—Died whilst on probation .. 1 5 6 2 4 6 Totals 63 72 135 16 22 38 .. 4 4 18 31 49 56 43 99

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Table VI.—Causes of Death, 1946 —continued

18

Causes. Nelson. Hokitika. Christchurch. Seacliff. Ashburn Hall (Private Mental Hospital). Total. I.—General Diseases Tuberculosis— M. F. T. M. E. T. M. F. T. M. F. T. M. F. T. M. F. T. General 1 1 1 1 1 1 2 2 4 Lungs 3 3 'i 4 5 4 3 7 1 2 19 21 40 Meningitis 1 i 2 1 1 2 Hydatid cyst 1 1 1 1 Cancer 2 '2 4 'i 1 1 2 4 '8 12 Toxaemia 2 7 9 Septicaemia 2 2 Acute yellow atrophy of liver i 1 Congenital debility i 1 1 1 II.—Diseases of the Nervous System Exhaustion 1 1 2 1 3 2 2 4 Exhaustion of mania 1 1 2 Exhaustion of melancholia 1 1 1 1 2 General paralysis of the insane 1 1 4 4 Cerebral haemorrhage 1 i 2 1 2 10 io 20 Cerebral thrombosis '2 2 1 1 9 8 17 Cerebral tumour 1 1 Cerebral oedema 1 1 Epilepsy 4 'i 5 1 1 9 1 10 Organic brain disease 1 1 III.—Diseases op the Respiratory System Pneumonia— Broncho 2 2 1 1 3 1 4 2 1 3 31 24 55 Hypostatic 3 3 2 2 8 8 Lobar 1 1 i 3 4 Bronchitis 1 1 2 Pulmonary— (Edema 1 Embolism i Thrombosis 1 1 Pleurisy .. .. i Lung abscess 1 IV. —Diseases of the Circulatory System Heart-disease 3 1 4 4 12 16 5 6 11 6 1 7 .. 2 2 81 93 174 Arterio-sclerosis 1 1 2 V. —Diseases of the Digestive System Enteritis 2 1 3 1 1 5 4 9 Gastric ulcer 1 1 1 1 2 2 4 Peritonitis 2 2 Liver abscess 1 1 Coeliac disease 2 2 2 2 VI. —Diseases or the Urinary System Ureemia 3 3 1 1 3 3 6 Nephritis 1 1 Pyonephrosis "i 1 VII. —Old Age Senile decay 10 9 19 1 1 11 17 28 26 17 43 .. 1 1 52 55 107 * VIII.—External Causes Exposure .. .. 1 1 Asphyxia 2 2 Suicide .. .. 1 1 2 2 4 Injury to central nervous system 2 2 IX.—Died whilst on probation .. 1 1 2 1 1 2 3 2 5 1 2 3 9 15 24 Totals 31 19 50 10 24 34 33 36 69 42 27 69 .. 3 3 269 281 550

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Table VII.—Principal Assigned Causes of Insanity, 1946

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Causes. Auckland. Kingseat. Raventhorpe. Tokanui. Levin Farm. Porirua. M. F. T. M. F. T. M. F. T. M. F. T. M. F. T. M. F. T. Alcohol 7 3 10 2 13 Arterio-sclerosis 16 8 24 1 1 6 i 7 13 4 Congenital 17 11 28 15 's 23 3 8 11 19 ! 19 8 11 19 Climacteric Constitutional 29 33 62 7 ii 21 12 20 32 40 '61 101 Encephalitis . . 1 1 Epilepsy1 'i 5 2 i 3 2 'i 3 5 1 6 Exhaustion 1 1 Heredity--2 2 2 i 3 1 '2 3 .. "8 8 Ill health 5 S 8 Involution .. 22 22 1 '7 8 1 "i3 14 Meningitis Mental stress 11 i.6 27 1 "e 7 7 '6 13 9 io 19 Organic brain disease 2 6 8 3 3 13 4 Previous attack 37 52 89 2 5 7 2 3 '2 5 34 57 91 Puberty or adolescence 1 1 Puerperal 4 4 4 4 . . "3 3 Senility i9 32 51 5 "n 12 io 17 27 34 33 67 Syphilis 9 9 1 1 3 2 5 Toxic "i 1 1 1 Transfers ii 18 32 6 '8 14 9 237 246 3 i 4 28 !! : 28 11 "7 18 Totals, 169 214 383 43 50 93 9 239 248 52 69 121 47 . . 47 149 214'363 Ashburn Hall Causes. Nelson. Hokitika. Christchurch. Seacliff. (Private Totals. Mental Hospital). M. F. T. ffi. F. T. M. F. T. M. F. T. M. F. T. M. F. T. Alcohol 1 1 2 2 12 : 4 16 Arterio-sclerosis 3 ft 9 27 18 45 Congenital 29 | 19 48 1 3 29 15 44 7 ' io 17 128 ; 84 212 Climacteric .. 2 2 1 1 3 3 Constitutional 4 .. 4 is i 24 42 31 .. 31 2 ; 'i 3 143 153 296 Encephalitis 1 1 Epilepsy 1 7 2 9 2 1 '2 4 1 - ! 1 20 1 12 32 Exhaustion.. 1 1 Heredity 16 6 22 i 1 2i 18 39 111 health 1 5 4 9 Involution 1 '4 4 2 47 49 Meningitis .. : i 1 1 1 Mental stress 4 3 7 7 is 22 8 1 44 52 47 100 147 Organic brain disease 2 ; !! 2 8* 9 17 Previous attack 1 6 7 4 5 15 24 39 6 ■ i7 28 102 166 268 Puberty or adolescence 2 : 2 4 3 2 5 Puerperal 1 1 i 1 13 13 Senility 12 ; 9 21 3 4 is 24 42 11 22 33 1 'i 2 li3 146 259 Syphilis 1 1 13 3 16 Toxic i 2 3 2 3 5 ( Transfers 3 ; 2 5 22 ii 33 10 '6 16 6 6 12 1 . !! 1 113 296 409 Totals 68 51 119 34 : 18 52 107 123 230 74 : 104 178 7 2 9 759 CO 00 00 0

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Table YIII. —Showing the Admissions, Discharges, and Deaths from Ist January, 1876, to 31st December, 1946 (excluding Transfers) M. I". T. In hospital, 31st December, 1875 .. .. .. . . . . 482 254 736 Admissions .. .. .. .. .. .. .. 28,905 23,983 52,888 29,387 24,237 53,624 m. f. t. Recovered .. .. .. .. 9,666 9,204 18,870 Not recovered .. .. .. 3,513 3,227 6,740 Died .. .. .. .. .. 11,652 7,760 19,412 —— 24,831 20,191 45,022 ' Remaining on 31st December, 1946 ... .. .. .. 4,556 4,046 8,602

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

20

' Males. Females. Both Sexes. Recovered " 32-89 37-98 35-19 Unrecovered 11-96 13-31 12-57 Died 39-65 32-02 36-20 Remaining 15-50 16-69 16-04 100-00 100-00 100-00

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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, 1905

21

_ Discharged. Remaining —Percentage of Percentage of Year. Admitted. Died. 31st December waifWt * Recoveries on Deaths on Average Recovered. Relieved. Improved in each Year. ■ Admissions. Numbers resident. M. F. T. M. F. T. M. F. T. M. J?. T. M. T. M. F. T. M. F. T. M. F T M F T • 1905 360 251 6ll 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-i8 5-44 ?■ 07 1906 395 264 659 157 126 283 28 22 50 . . 1 1 146 85 231 1,900 1,306 3,206 1,823M,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 1,900 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 19 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 27 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 9 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 37-74 8-99 5-61 7-57 1913 466 318 784 175 162 337 35 48 83 1 5 6 196 HI 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 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 7-28 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 33-73 10-53- 9-16 9-95 1919 512 371 883 190 147 337 37 44 81 9 13 22 212 130 342 2,667 1,980 4,647 2,620 1,907 4,527 37-11 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 35-22 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 2<i-18 30-75 29-67 6-16 6-42 6-77 1927 533/ 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 20 30 59 221 199 420 3,753 2,908 6,661 3,503 2,696 6,199 21-64 25-21 23-37 6-31 7-39 6-76 1932 587 484 1,071 141 160 301 39 42 81 38 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 fi-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 £-72 fi-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 fi-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 fi-35 7-21 fi-73 1938 527 575 1,102 170 210 380 140 135 275 273 274 547 4,296 3,501 7,979 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 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 fi-74 fi-28 fi-53 1941 605 637 1,242 128 186 314 130 130 260 297 260 557 4,404 3,738 8,142 4,192 3,474 7 666' 21-12 29-09 25-20 7-08 7-48 7-27 ' 1942 563 648 1,211 146 197 343 126 152 278 313 343 656 4,383 3,693 8,076 4,189 3,498 7,687 25-09 30-56 28-41 7-47 q-81 8-53 1943 550 658- 1,208 138 223 361 138 119 257 281 263 544 4,376 3,746 8,122 4,181 3,513 7,694 25-09 33-89 29-88 6-72 7-49 7-07 1944 600 763 1,363 137 218 355 101 90 191 327 249 576 4,411 3,952 8,363 4 231 3 640 7 871 22-83 28-57 26-05 7-73 6-84 7-32 1945 657 715 1,372 165 295 460 106 118 224 327 320 647 4,470 3,934 8,404 4,229 3 689 7 918 25-11 41-26 33-53 7-73 8-67 8-17 1946 645 788 1,433 18S 270 453 107 125 232 269 281 550 4,556 4,046 8,602 4,266 3,706 7,972 28-37 34-26 31-61 6-31 7-58 6-90 21,332 19,109 40,441 6,536 6.881 13,417 2,318 2,307 4,625 .• 9,385 6,800 16,185 ' Excluding transfers between institutions —3,875 males, 3,506 females.

H—7

Table XI.—Debits for the Financial Year 1946-47

22

Ipjfe' Auckland. Kingseat. Raventhorpe. Tokanui. Levin. Porirua. Salaries, including overtime Official visitors Advertising, books, &c. Bacteriological research Bedding and clothing Buildings, including additions, &c. Dental services Farms, maintenance of Fencing, draining, and roading Freight, cartage, and transport Fuel, light, water, &c. Funeral expenses Furniture and fittings Gardens and shrubberies Laundry Machinery repairs and stores Medical fees Motor-vehicles — Maintenance of Purchase of Nursing staff uniforms Office equipment Patients, expenses connected with — Friends Gratuities Recreation Transfer Postages, telegrams, &c. Printing and stationery nations Rents and rates Stores * Surgery and dispensary Telephone services .. Transfer and removal expenses Travelling-allowances Travelling-expenses .. Treatment in general hospitals—Staff .. Compensation under Workers' Compensation Act Payment of monetary equivalent of leave due to deceased officers Grants to widows or relatives of deceased officers Contingencies and miscellaneous Expenses of medical officers and occupational therapists from United Kingdom to New Zealand Removal of offices .. Totals £ s. d. 98,358 15 7 33 3 6 27 3 4 61 18 0 10,390 14 8 798 10 0 8 5 0 1,987 12 9 21 19 4 146 19 0 8,237 4 6 97 10 0 1,044 11 5 205 13 1 276 4 2 223 19 7 814 10 0 100 18 10 690*18 1 53 12 1 1,28515 1 10 12 3 148 15 0 266 12 8 1Q 0 .5 17 4 1,887 7 10 1,808 -0 10 134 19 9 52 13 1 208 5 8 349 10 11 27 9 0 1 17 6 706 13 8 139 13 5 338 .13 4 £ s. d. 53,974 1 10 70 4 6 17 19 6 4,678 13 8 923 4 9 0 15 0 1,332 16 1 19 12 9 861 16 6 4,602 17 1 104 10 0 547 10 4 182 16 10 394 1 5 326 6 5 259 8 2. 321 2 11 297' 6 6 30 5 3 77i" 1 3 100 12 3 118 18 5 13,865 1 3 30o' 0 0 804 13 6 180 11 6 7 15 10 153 3 6 71 11 9 15 3 0 74 11 3 65 4 10 £ s. d. 10,802 4 2 15'19 3 865'18 1 164 11 2 247' 5 4 32 11 0 205 3 0 1,596 8 3 29 0 6 22 8 6 35 14 0 66 5 2 197 0 11 12 4 11 321 0 9 6i' 4 4 54 0 8 119' 3 11 10 7 9 45 9 3 60 2 3 7,527 14 11 205' 8 3 301 12 9 22 7 1 94 5 8 35 19 2 18 16 6 6 7 1 £ s. d. 56,090 12 3 176'10 4 ' 22 8 0 4,736 11 4 ' 790 14 5 0 9 11 5,039 13 0 197 15 1 ,466 4 0 5,320 17 1 103 2 6 1,223 13 6 66 18 0 530 19 4 315 5 10 219 2 2 269 8 9 502'll 9 5 14 6 li'l8 0 753 10 6 102 1 9 149 9 0 196 7 9 8,595 8 3 764 5 6 1,219 4 2 821 18 6 180 14 7 42 13 7 197 10 9 78 11 3 2' 5 0 72- 1 0 586 10 11 £ s. d. 6,251 0 9 i' 0 8 2,004' 9 3 95 3 5 3 2 10 157 12 1 32 18 5 59 9 2 500 1 1 72'16 8 43 0 11 29 0 8 50 0 0 32 5 6 31 8* . 4 92' 8 4 0 3 6 99' 6 0 0 5 6 22 19 0 32 15 11 1,742 6 6 273' 8 4 185 4 1 46 13 0 8 6 3 63' 9 3 2 9 3 £ s. d. 112,961 2 6 10 8 4 13 7 2 285 7 6 18,254 4 9 716 9 7 8 4 2 3,093 13 8 145 13 2 326 12 4 8,163 19 7 88 .0 0 2,009 19 0 169 10 0 267 13 3 315 7 5 905 14 1 357. 9 9 272 1 7 581 4 8 53 10 2 75 4 6 1,388 3 9 34 7 2 259 13 11 214 5 2 24,717 9 _8 3,303' 6 5 1,341 10 1 208 14 8 11 1 10 122 4 3 208 2 3 52 10 0 0 9 0 32 10 5 669 18 5 517 2 4 154,318 10 9 85,473 17 10 23,176 14 7 89,853 2 3 11,933 4 8 182,156 6 6

H—7

Table XI. —Debits for the Financial Year 1946-47—continued

23

• — Nelson. Hokitika. Christchuich. • Seacliff. Head Office. Totals. £ s. d. £ s. d. £ s. d. £ s. d. £ sJ d. £ s. d. Salaries, including overtime 73,147 12 5 42,786 4 1 112,183 10 6 98,023 4 9 13,836 17 4 678,415 6 2 Official visitors 6 6 0 18 17 8 68 15 6 Advertising, books, &c. 5i'l8 S 45~ 3 11 60 0 10 174'18 10 1,305 i4, 8 1,942 2 2 Bacteriological research 21 4 0 0 10 6 15 1 9 8 11 6 433 0 9 Bedding and clothing 6,758 2 1 5,021 17 1 11,151 4 1 11,626 10 3 75,488 5 3 Buildings, including 573 G 2 430 11 8 1,804 6 3 982 2 1 7,279 0 0 additions, <fcc. Dental services 11 18 6 23 15 1 25 15 2 0 13 6 82 19 2 Farms, maintenance of 2,085 17 5 1,200 7 9 1,808 1 7 2,539 17 5 19,492 17 1 Fencing, draining, and TOflrllTlcr 20 1 2 2 5 9 117 9 8 89 1 10 679 8 2 A WctU-lllg Freight, cartage, and 340 11 1 63 12 5 659 6 10 569 17 4 3,699 11 8 transport Fuel, light, water, &c. 7,659 17 6 3,513 12 11 9,518 4 1 7,397 4 7 100 " 9 11 56,610 16 7 Funeral expenses 146 10 0 192 12 3 84 10 0 71 15 0 917 10 3 Furniture and fittings 1,113 16 0 182 9 5 1,888 11 1 1,342 5 0 89 "7 3 9,537 8 2 Gardens and shrubberies 47 9 3 20 6 2 158 10 0 80 19 2 1,010 17 5 Laundry 255 15 493 4 5 1,084 14 3 404 1 1 3,401 19 1 Machinery repairs and stores 232 16 4 77 14 9 820 6 4 391 2 2 2,949 19 9 Medical fees 157 8 6 55 13 0 -562 3 6 411 1 6 53 0 6 3,482 11 10 Motor-vehicles — Maintenance of 208 18 2 * 83 6 6 627 1 7 474 3 9 2,794 19 4 Purchase of 488 8 0 614 4 0 1,374 13 7 Nursing staff uniforms 419'13 6 829' 9 11 791 7 5 431 3 11 4,697 8 5 Office equipment 0 14 6 9 11 1 51 .5 7 49 18 2 12 i7 9 321 13 3 Patients, expenses connected with — Friends 50 0 0 50 0 0 Gratuities 337'15 4 0 9 9 23 2 9 448 10 4 Recreation 1,059 7 6 494 3 7 1,450 4 0 1,575 16 0 8,996 11 7 Transfer 26 13 9 4 15 6 127 9 0 14 6 0 330.18' 8 Postages, telegrams, <fcc. 83 8 4 40 10 7 172 5 9 211 4 7 90"i9 8 1,325 7 4 Printing and stationery 121 7 10 97 9 B 233 6 5 169 10 3 139 3 8 1,650 0 0 Rations 16,867 15 6 9,934 12'10 22,547 1 2 17,766 4 8 146,929 4 9 Rents and rates 11 6 11 520 15 0 28 10 0 408'i4 1 1,739 8 10 Stores 1,459 7 6 428' 3 2 2,518-5 4 2,778 18 5 14,373 9 5 Surgery and dispensary 1,493 4 7 501 7 7 1,746 4 7 763 13 5 9,767 9 11 Telephone services .. 95 5 9 102 6 0 168 18 6 211 2 9 163 "0 0 1,514 13 7 Transfer and removal 45 6 7 2 11 5 173 9 10 254 9 9 147 7 6, 840 1 4 expenses Travelling-allowances 96 13 5 51 15 5 161 10 8 623 2 2 174 16 8 1,825 1 8 Travelling-expenses .. 32 6 10 92 11 5 54 11 7 163 19 0 279 8 0 1,412 18 9 Treatment in general hospitals— Patients 3 12 0 2 5 0 1 19 9 34 15 0 137 13 9 Staff 10 0 2 10 0 8 16 Compensation under 706 13 8 Workers' Compensation Act Payment of monetary 4 8 3 36 18 8 equivalent of leave due to deceased officers Grants to widows or 75 5 0 82 15 0 130 12 -4 288 12 4 relatives of deceased officers Contingencies and 106 3 2 9 8 7 182 13 0 44 0 9 323 13 5 1,630 19 4 miscellaneous Expenses of medical 497 6 6 678 13 9 2,683 11 8 officers and occupational therapists from United Kingdom to New Zealand Removal of offices .. 752 4 10 752 4 10 Totals 115,665 17 1 66,484 0 2 174,657 4 6 150,533 1 11 17,877 15 3 1,072,129 15 6

H—7

Table XIa. —Credits for the Financial Year 1946-47

Table XII.—Average Cost of each Patient per Annum

24

Auckland. Kingseat. Raventhorpe. | Tokanui. Levin. Porirua. Receipts from maintenance* Receipts from farms .. Miscellaneous Totals £ s. d. 1,284 17 0 1,257 8 5 8,854 17 1 £ s. d. 219 6 0 2,389 11 6 5,073 14 7 £ s. d. 5 10 8 1,252 6 6 £ s. d. 344 3 9 4,078 3 0 7,305 18 4 £ s. d. 492'il 4 £ s. d. 559 3 0 2,135 17 0 11,856 19 5 11,397 2 .6 7,682 12 1 1,257 17 2 11,728 5 1 492 11 4 14,55119 5 Nelson. Holritika. Christchurch. Seacliff. Head Office. Total. Receipts from maintenance* Receipts from farms .. Miscellaneous Totals £ s. d. 1,205 5 1 1,483 11 6 7,050 12 0 £ s. d. 130 0 0 811 12 7 3,992 18 6 £ ■ s. d. • 1,157 3 10 3,801 4 4 10,163 14 0 £ s.. d. 3,328 4 2 5,712 0 7 ' 8,356 3 0 £ s. d, 930"i4 6 £ s. d. 8,228 2 10 21,674 19 7 65,390 9 3 9,739 8 7 4,934 11 1 15,122 2 2 17,396 7 9 980 14 6 95,293 11 8 * Outstanding accounts as at 31st March, 1939.

Mental Hospital. Average Number resident (inclusive of Boarders). Salaries. Bedding and Clothing. Buildings and Repairs. Farm. Fuel, Light, Water, and Cleaning. . Provisions Auckland " Kingseat Raventhorpe Tokanui Levin Porirua.. Nelson Hokitika .. .. Christchurch .. .. - SeaclifF Head Office Total average cost 1,310 854 243 793 70 1,188 1,002 516 1,383 984 8,343 £ s. d. 75 1 -8. 63 4 1 44 9 1 70 14 8 89 6 0 95 1 8 73 0 0 82 18 5 81 2 4 99 12 4 1 13 2 £ s. d. 7 18 8, 5 9 7 3 11 3T"' 5 19 6 28 12 8 15 7 4 6 14 11 9 14 8 8 13 11 16 4 £ s. d. 0 12 2 117 0 13 7 .0 19 11 17 2 0 12 1 0 11 5 0 16 8 16 1 10 0 £ s. d. 1 10 <4 1 11 3 10 4 6 7 1 2 5 0 il2 1 2 18 2 6 6 1 6 .2 2 11 7 £ s. d. 6 5 9 5 7 10 6 11 5 6 14 2 7 2 Iff 6 17 5 7 12 11 6 16 2 6 17 8 7 10 4 0 0 3 £ s. d. 17 16 9 16 4 9 30 19 7 10 16 9 24 17 10 20 16 1 16 16 8 19 5 1 16 6 1 18 1 1 8,343 81 6 4 9 10. 0 17 5 2 6~ 9 6 15 9 17 12 3 Surgery and Dispensary. Miscellaneous. Total Cost per Patient (a). Repayments (&). Net Cost per Patient (&)• Net Cost previous Year. Decrease in 1946-47. ( Increase in 1946-47. Auckland Kingseat Raventhorpe Tokanui Levin Porirua Nelson Hokitika Christchurch .. •Seacliff Head Office .. . Total average cost £ s. d. 17 7 0 18 10 1 4 10 10 9 2 12 11 12 7 1 9 10 0 19 5 15 3 0 15 6 £ s. d. 7 3 1 6 3 ,11 6 17 6 10 13 4 14 5 0 10 17 4 7 14 6 0 0 10 1 0 11 12 5 0 9 5 £ s. d. 117 16 0 100 1 10 95 7 7 113 6 2 170 9 5 153 6 7 115 8 9 128 16 11 126 5 10 152 19 7 2 2 10 £ s. d. 7 14 5 8 14 9 5 3 6 14 7 1 7 0 9 11 15 7 8 10 4 9 6 3 10 1 11 14 5 11 0 2 4 £ s. d. 110 1 7 91 7 1 90 4 1 98 19 1 163 8 8 141 11 0 106 18 5 119 10 8 116 3 11 138 13 8 2 0 6 £ 95 12 1 85 16 3 91 6 4 200 16 3 122 8 5 95 5 11 104 16 5 101 4 9 124 4 11 1 16 4 £ s.' d. 37 '7 7 £'' s. d. 14 9 6 5 10 10 7 i.2 9 19 2 7 11 12 6 : 14 14 3 14 19 2 14 8 9 0 4 2 13 5 9 7 4 128 10 2 10 8 9 1 5 104 18 1 13 3 4 Notes. —(a) Cost does not include interest and depreciation on land, buildings, <fec. (6) Receipts from maintenance shown in Table XIA not included.

H—7

Table XIII.—Expenditure of Public Works Fund on Mental Hospital Buildings, etc., during the Financial Year ended 31st March, 1947

25

* Net Expenditure Mental Hospitals. for Year ended 31st March, 1947. £ Auckland 10,972 Christchurch 2,683 Hokitika 1,250 Nelson "and Stoke .. . . 5,840 Porirua .. .. .. 67,503 Kingseat .. .. . . 3,985 Seacliff 16,155 Tokanui .. Nil Marton 48,276 Levin 239 Raventhorpe 107,567 264,470

H—7

Table XIV.—Total Expenditure of Public Works Fund for Building and Equipment at each Mental Hospital from 1st July, 1877, to 31st March, 1947

Approximate Cost of Paper.—Preparation, not given; printing (583 copies), £75.

By Authority: E. V. Paul, Government Printer, Wellington. —1947. Price 9d.~\

26

Mental Hospitals. 1877-1937. 1937-38. 1938-39. 1939-40. 1940-41. 1941-42. £ £ £ £ £ £ Auckland 234,964 5,658 907 7,118 2,659 885 Christchurch 367,283 16,397 6,784 17,252 13,326 6,815 Dunedin (The Camp) 4,891 Hokitika 100,067 2^097 1,14:0 26j 793 10,233 23,944 Hornby .. 11,102 Motuihi Island 561 Napier 147 Nelson and Stoke .. 205,647 2^234 15,458 39j 469 34j 119 ii,957 Puhitahi (Kingseat) 195,228 52,144 71,149 62,896 45,095 25,052 Seacliff 315,106 570 2,527 1,082 707 1,855 Tokanui 258,482 2,855 6,903 9,922 13,662 2,128 Waitati 32,321 Wellington 29,641 Wellington (Porirua) 353,039 20j 502 23,948 10,894 6,843 7,191 Marton Levin Raventliorpe Totals 2,108,479 102,457 128,816 175,426 126,644 79,827 Total Net Expenditure Mental Hospitals. 1942-43. 1943-44. 1944-45. 1945-46. 1946-47. 1st July, 1877, to 31st March, 1947. £ £ £ £ £ £ Auckland 327 1,983 2,504 7,307 10,972 275,284 Christchurch 1,885 2,210 766 701 2,683 436,102 Dunedin (The Camp) 4,891 Hokitika 3,842 125 180 " 43 i^250 169,714 Hornby 11,102 Motuihi Island 561 Napier 147 Nelson and Stoke i^oio 4 37 1 5*840 315,776 Puhitahi (Kingseat) 3,569 637 \ 424 1,487 3,985 461,666 Seacliff 1,301 6,526 24,918 16,155 370,747 Tokanui 112 1 1 1 294,067 Waitati 32,321 Wellington 29,641 Wellington (Porirua) 3 j 485 83 j 253 20,623 45,866 67,503 643,147 Marton 519 6,680 44,696 48,276 100,171 Levin 83,967 239 84,206 Raventhorpe 107,567 107,567 Totals 15,531 88,732 37,741 208,987 264,470 3,337,110