MENTAL HOSPITALS OF THE DOMINION (REPORT ON) FOR 1948

Appendix to the Journals of the House of Representatives, 1949 Session I, H-07

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1949 NEW ZEALAND

MENTAL HOSPITALS OF THE DOMINION (REPORT ON) FOR 1948

Presented to Both Houses of the General Assembly Pursuant to Section 79 of the Mental Defectives Act, 1911

The Hon. M. B. Howard, Minister in Charge of Mental Hospitals, Wellington. Madam, — 16th June, 1949. I have the honour to present my annual report upon the work of the Mental Hygiene Division of the Health Department for the year ended 31st December, 1948. Statistical At the end of the year there were 9,270 names of persons upon the registers of the Division, including 67 patients at Ashburn Hall private licensed institution and 855 patients who were absent on probation in the care of their relatives and friends. In actual residence in Government hospitals on 31st December there were 8,352 persons, an increase of 85 as compared with a year before, and of this number 7,905 were subject to a reception order and 373 were voluntary boarders. Admissions for the first time of patients and boarders totalled 1,709, a decrease of 38 compared with the previous year. It has continued to occur that voluntary boarders form an increasing proportion of total admissions to our hospitals. Of all classes of admissions, 1,536 were discharged, or 67-37 per cent, calculated on the number admitted. Although impossible to consider that all persons discharged were fully recovered, it is considered that 4649 had so recovered. The fact that a good proportion of persons are discharged " relieved " indicates the willingness of medical officers to allow their patients to return to the care of relatives and friends when they can be cared for by them.

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Voluntary Boarders

Reports of Medical Superintendents It will be seen in tlie reports from the various hospitals that there are two matters which are seriously holding up progress in the Division : (а) Overcrotvding.—There are at the end of the year 1,000 patients in excess of the accommodation considered to be necessary for their care. Much of this deficiency has been due to the lack of building during the war years, but an accelerated public-works programme in the immediate future, is necessary if the position is not to deteriorate. Many old buildings of wooden construction have reached a stage when it is difficult to continue their occupation by patients, although everything is done to maintain them in as good condition as possible. Considerable progress has been made in adding minor facilities to wards, but many improvements in older wards which are envisaged, and which would improve the nursing and treatment facilities and also the general hygiene and comfort of the patients, cannot be. proceeded with as they would entail further loss of sleeping accommodation. (б) Shortage of Staff. —There continues to be a shortage of medical and female nursing staff in the Division.

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Year. First Admission. Not First j Admission. Total Admissions. Transferred to Register of Patients. Died. Discharged. | Remaining on 31st December. M. F. T. M. p. T. M. F. T. M. F. T. M. F. T. M. F. T. M. F. T. 1912 6 17 23 0 0 0 6 17 23 1 3 4 0 0 0 4 3 7 1 11 12 1913 18 19 37 0 2 2 18 21 39 2 5 7 0 1 1 12 12 24 5 14 19 1914 17 19 36 3 2 5 20 21 41 7 5 12 1 1 2 11 15 26 6 14 ?0 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 39 61 5 11 16 •28 49 77 1 4 5 2 2 4 15 30 45 19 32 51 1919 31 38 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 1.60 284 130 156 286 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 1947 233 301 534 83 122 205 316 423 739 7 2 9 12 12 24 321 383 704 172 232 404 1948 290 288 578 109 161 270 399 449 848 6 5 11 9 13 22 363 418 781 193 245 438

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A depleted medical staff means that not as much individual treatment can be given to patients as is so necessary in the acute stages of mental illness. To some extent this has been lessened in its effect by the curtailment of the time given at clinics in general hospitals, &c. It is considered that advice given to mentally sick people at these clinics and to persons approaching medical officers for advice in other ways is most valuable and has been the means of preventing more serious breakdowns in many cases. Advice given to parents of mentally handicapped children is' frequently sufficient to enable parents to continue to look after them in their own homes. An extension of the " preventive " side of the work of this Division is our aim, and this applies also to child guidance, but the first duty of the medical staff is towards those whose mental illness has necessitated their admission to hospital. I am appreciative of the desire of the medical staff not to curtail their assistance given as indicated any more than has been absolutely necessary. The shortage of female nursing staff continues to be a problem of considerable difficulty. Improvement in the situation has occurred spasmodically, but in effect the position at the end of the year remains little better than at the beginning. The male staff have assisted where possible and have been caring for mentally deficient male children, and have done so very well in the emergency. It is hoped that female nursing staff will be offering to give female nursing attention to these male children and to reintroduce female nurses into male wards, where their influence can be of great benefit to a large proportion of cases. It must be kept in mind that with all the shortage of staff in mental hospitals in New Zealand there is no accommodation kept vacant because of such shortage —a position which has occurred in Great Britain, and which has. occurred in general hospitals in New Zealand. This has only been possible because of the loyal and uncomplaining service given by the staff generally. I sincerely trust that it may never become necessary to refuse admission of voluntary boarders because of any such shortage, which refusal has been occurring in some other countries. Admissions of Elderly Infirm Persons My remarks concerning the above in my report to you of last year are even more applicable now. There has been a further increase in the number of patients of both sexes over seventy years of age in our hospitals —a total now of over 1,000. There has been evidence, however, during the year of an increasing interest in this problem by social and Church agencies in New Zealand, and it is hoped that adequate provision will be made for the aged in suitable homes apart from mental hospitals. The experience and advice of the medical and nursing staff of this Division would be available to such homes when completed if desired and requested. Even the most difficult of senile cases can be managed and directed into a more orderly and amenable way of life, and the staff of the Division would, I consider, be able to give valuable assistance. Occupational Therapy For the first time it is possible to report that there is now a trained Occupational Therapist on the staff of each hospital. The view that occupational therapy plays an important part in treatment in every kind of hospital has- become an accepted one, and it will be further extended as the staff become available after training. During the year it has been possible to initiate short courses in occupational therapy at the Occupational Therapy School attached to Auckland Mental Hospital for suitable and interested male nursing staff from all hospitals. These courses have been a decided success in increasing the scope and assistance in the work at hospitals .and will be continued.

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Dietary, Clothing, and Furnishings The improvements foreshadowed in last year's report have been carried out to an appreciable degree. Much remains to be done and extension of these improvements will be carried out. Already the patients have been benefited in personal comfort, but more important in self-esteem and consequently self-confidence. Psychiatric Social Workers Four female social workers have been appointed and are attached to the hospitals at Auckland, Porirua, Sunnyside, and Seacliff. These officers visit the homes of patients admitted to hospital and form a contact between the patient and his or her home when necessary. They can obtain useful information which can be of benefit in treatment, and when the patient recovers contact can be retained and help given. They are able to give and arrange services for patients which do not and cannot be carried out by nursing staff, and particularly a depleted one. Their usefulness to patients and to the staff generally has been made so obvious in a short time that extension will be made to all hospitals. Building Programme Unfortunately the serious shortage of labour »and materials has continued to prevail during the year. Plans are well advanced for many major works and it is hoped that next year will see many of these under construction. Considerable progress has been made at all institutions towards improving existing conditions for patients and staff. Installation of refrigerators, provision of improved kitchen and ward facilities, extending and improving fire services, &c., have received attention. Alterations, Additions, and Improvements Capital expenditure on new works during the year amounted to £187,022, and the following summary shows the principal items and hospitals at which the expenditure was incurred : (1) Auckland (£1,974). —Alterations to Male 9 Ward have been started. These will provide improved kitchen facilities, store and clinical examination room. Additional tar-sealing of roads has been carried out. (2) Kingseat (£12,977). —Six staff residences have been completed. Refrigerators have been installed in several villas. Additional roading has been tar-sealed. (3) Tokanui (£4,884). —A start has been made on the erection of twenty-one staff residences. A hairdresser's salon and two buildings for occupational therapy have been completed. (4) Lake Alice (£67,749). —Development work of roading, fencing, tree-planting, water-supply, &c., has proceeded, as has the erection of villas. (5) Levin Farm (£2,019). —A large residence has been converted to provide two flats for married staff. Additional laundry equipment has been purchased. Alterations have been made to existing buildings to meet requirements. (6) Porirtia (£61,671). —Two villas have been completed and a third is nearing completion. Laundry machinery is still being installed. A building for occupational therapy has been started. Fire-protection services have been extended and roading has been done. (7) Nelson (£2,190). —Two mattress-sheds have been erected at Ngawhatu villas. Refrigerators have been installed and roading extended.

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(8) Christchurch (£2,530). —Additions to offices and nurses' home have been completed. A small laundry has been provided at the junior nurses' home. Refrigerators have been installed and a garage erected at Tenyoleton Farm. (9) Seacliff (£30,348). —New ward for female patients has been completed. Heating of nurses' home is nearly finished. Renewal of sewerage system at Waitati is in hand. Roading, water-supply, &c., at Cherry Farm is proceeding. Registration of State Psychiatric Nurses The following passed the State Examinations for Psychiatric Nurses, held in June and December, and thereby qualified for State registration : Passed top for Dominion — June : Nurse W. C. Edwards (Auckland). December : Nurse T. Burke (Seacliff). Auckland — Attendant : E. E. Bo vis. Nurses : A. H. G. Lynch, N. D. Bolton, M. L. Curtis, T. Moore, M. J. Turner. Kingseat— Nurses : V. L. Wright, D. J. McKeown, P. M. Williams. Tokanui— Nurses : S. Bristowe, I. N. Champion. Porirua — Attendant : R. J. P. Tabb. Nurses : M. L. Dick, H. M. J. Dillon, N. H. Grantham, I. E. Harvey, F. L. McKendry, P. M. Prior. Nelson — Attendant: D. A. Anderson. Nurse : E. Byrne. Seaview — Nurse : S. M. Connelly. Sunnyside— Attendant : J. Ryley. Nurses : K. A. Feather, N. Flannigan, L. A. Johnston. Seacliff— Nurses : M. E. Ellwood, K. E. Fitzpatrick, J. McCulloch, M. M. E. Walker, W. E. Chapman. Partial pass---Nurse : H. Y. A. Lovell (Auckland). Appreciation I wish to express my gratitude to the staff of Btead Office for their loyal and willing assistance, and to all officers on the staff of hospitals for their keenness to carry out and ■extend at all times any improvement which is possible in the care and treatment of the mentally sick. J. Russell, Director.

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AUCKLAND MENTAL HOSPITAL I have the honour to present my. annual report for the year ended 31st December, 1948. The total number of cases under care was 1,985 and the average weekly number resident 1,333, an increase of 49 and 22 respectively. The shortage in staff continues and naturally affects the scope of treatment. The fact that senile cases constitute a large percentage of our admissions aggravates the position. Physical treatment of patients proves itself of worth both in respect to leucotomy and electro convulsive therapy. Of the former, eleven cases have been treated, and the results are in a few dramatic, in others less so, but in nearly all there is an alleviation of symptoms. There is, of course, still expectations of further improvement at later dates. Electro convulsive therapy is invaluable not only for its curative properties in conjunction with psychological treatment, but also as a restraining factor in hitherto recalcitrant and difficult cases. After all the years electro convulsive therapy has been done here, predicted dire results have not transpired. Our contact with the public in extra-mural work still demands a great part of our time. It is obvious that if shortage of medical officers persists, services in this respect will need, curtailment. Public hospital clinics are held and pension examinations are made twice weekly. There is also an increasing demand from the Courts for reports on accused men and prisoners. The Psychological Clinic with our new Welfare Officer does most useful work. Many cases are referred to it by the Courts and the Education Department. The Welfare Officer has proved herself of worth in investigating home backgrounds not only of children, but of patients in the mental hospital. Occupational therapy continues to expand.* The number of new patients attending classes was 199. Those discharged direct numbered 116, whilst 94 patients were transferred from class-rooms to utility work within the hospital. The training of 7 attendants from other mental hospitals for three months should be of benefit to the Department. These trainees showed a keen interest and appreciation of the value of the work. The main public works that have been done or are now under way : Refrigerators to all kitchens ; painting the exterior and interior of several wards ; commencing alterations to Male 9 Admission Ward. Like ourselves, the Ministry of Works suffers from shortage of labour, and this is reflected in the difficulty of overtaking many of our shortcomings. Good work has been done in refurnishing of wards on both sides of the institution — this has been done on a generous scale and is appreciated by every one. While it is impossible to mention all the many individuals and organizations who have taken an active interest in the patients' welfare and to whom our thanks are due, I would like to acknowledge our indebtedness for the unfailing assistance of the Mental Hospital Committee of the Hospital Auxiliary, the Grey Lynn Ladies Committee, New Zealand Red Cross Society, and the Returned Services Association. To finish, I would like to record my very great appreciation of the work and cooperation the staff has given me throughout the year. It has helped greatly to ameliorate difficult times. H. M. Buchanan, Medical Superintendent.

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KINGSEAT HOSPITAL I have the honour to present the annual report for the year ended December, 1948. The total number of cases under care during the year was 1,019 ; of these, 951 were subjects of a reception order and 68 were voluntary boarders. The weekly average number resident during the year was 846. The admissions totalled 148 ; 110 were certified patients of whom 31 were transfers from other institutions, and 38 were voluntary boarders. Sixty-one were discharged during the year and 29 were transferred to other institutions. At the end of the year 51 persons were well enough to be on probation in the care of relatives or friends. Fifty persons died during the year. In spite of the ageing population and the tendency for a considerable portion of our admissions to be seniles, the health of the patients has been remarkably good. We have been free from any epidemic. The improvement in the clinical equipment of the villas has continued. As far as is practicable we are endeavouring to have the simpler types of illness nursed in the individual villas rather than have them all brought to the hospital admission block. Your policy of brightening the furnishings of the villas and improving the general standard of variety in the clothing of patients is making itself apparent throughout the hospital. The Comforts Fund for patients continues to be a marked success. Much of the money paid to patients is spent in the canteen, the turnover of which has increased considerably. The patients benefit by the profits going to their own Recreation Fund. No patient who is capable of appreciating comforts is now without them. Every villa has been equipped during the year with a refrigerator. This is a great boon. A hairdresser has been appointed during the year, and whilst awaiting the building of a salon makeshift accommodation is being used. We now have a 16 mm. sound-film projector. There is a programme each week. As we lack a recreation-hall and have no suitable place for showing films, a patient's dining-room has to be cleared out for each film. This restricts the number of patients who can attend and necessitates the showing of films on alternate weeks to the male and female sides respectively. This form of entertainment is greatly appreciated by the patients. Occupational therapy has been carried on in the wards, but the building of an occupational block has not yet been commenced. In the latter part of the year we were without the services of a Tutor Sister ; however, with the help of the Tutor Sister from Raventhorpe and with extra work being carried out by our own staff, the training of our nursing staff was maintained, and over all there has been an improvement in the standard. The staff shortage on the male side has not been so acute, and on the female side, although acute, the number of applications indicate a. slight improvement in the interest in psychiatric nursing. Although the numerical strength of the female staff is much the same as last year, the solidity and quality has improved. Farming operations have been carried on as usual. The flower-gardens, orchard, and vegetable-gardens have now been put under the control of a Head Gardener; this should improve efficiency. During the year we had a visit from the Minister of Health, the Hon. Miss Howard. Patients and staff greatly appreciated her interest. Miss C. Jenkins, Assistant Matron, retired on superannuation during the year after many years service. It is with regret that I have to record the death during the year of Dr. E. K. Mulinder, Assistant Medical Officer. His passing has been a distinct loss to the hospital, and the sympathy of all the patients and the whole staff goes out to Mrs! Mulinder and her four young children.

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The Official Visitors have taken regular interest in the patients and the hospital; their visits are very much appreciated. On behalf of our patients I wish to thank our many benefactors for gifts of money, books, &c., bringing sports teams to our hospital, and for showing hospitality in inviting our patients to visit them. The patients appreciate the visits of the clergy and the services which they conduct. In conclusion, I wish to express my thanks to all members of the staff for the help and co-operation in the work at the hospital and for the good work they have done during the year. R. G. T. Lewis, Medical Superintendent.

TOKANUI HOSPITAL I have the honour to submit my annual report for the year ended 31st December, 1948. The total number of cases under care during the year has been 931, with a weekly average of 764. The admissions were 127 (54 men, 73 women). Of these, 94 (48 men, 46 women) were admitted for the first time, a decrease of 16 over those of the previous year. Discharges numbered 65 (20 men, 45 women), while there were 39 (19 men, 20 women) on probation, and the number of transfers totalled 20 (6 men, 14 women). Voluntary boarders treated were 78 (40 men and 38 women), an increase of 11. Of these, 38 (17 men, 21 women) were first admissions, and discharges numbered 47 (24 men, 23 women). The general health of the patients has been good, deaths totalling 56 (32 men, 24 women), most of these occurring among our elderly patients. The number of elderly patients being admitted is increasing, and their care and supervision, with the present staff shortage and lack of accommodation, is maintained only with the greatest difficulty, with increasing strain upon the medical and nursing staff. The female nursing staff is very short, being 29 nurses only, instead of a normal establishment of 73. The male nursing position has improved slightly, there being 50 instead of 78. The male patients' accommodation is overcrowded to the extent of 100 patients—that is, two villas—while the women's side is overcrowded to the extent of one villa (40 patients). Since last report the " Camp Property," 168 acres, on the Waikeria Road, was transferred to the Lands Development Department in October, 1948, to be divided into two units for settlement of returned servicemen. A start has been made to build twenty-one staff houses near the Main South Road on the hospital property. When these are completed, the staffing position on the male side should improve. The patients' allowance has proved a popular and beneficial addition to their welfare and happiness. A 16 mm. sound projector has been added to the equipment -for staff training and has been useful in the teaching of the various subjects for the State examinations. The appointment of a Dental Officer is necessary for the care and attention required for patients' teeth, dental repairs, and the manufacture of dentures ; all are essential to the general health of the patient. The Minister of Health, the Hon. Miss Mabel Howard, visited the hospital in June, 1948.

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The new cow-byres and the two small laundries, one at the nurses' home and one for the women's villas, although authorized, as yet have not been commenced, the main difficulty being shortage of labour and materials. Authority has also been given for the installation of the automatic telephones to replace the old manual type of telephone system. Badly-needed additional office accommodation has also been authorized and the matter is in the hands of the Works Department. Plans are completed for the provision of a kitchen and bathroom for C Ward (male). There is as yet no word of the replacement of the laundry, butcher's shop, bakehouse, and engine-room, which have become inadequate for the work required of them, and require new modern up-to-date equipment for the efficient working of the hospital. The nurses' home and several residences have been painted, and the interior decoration of the villas, especially on the women's side, has been continued throughout the year. Amusements and recreation have been catered for as usual. Weekly dances, picture and picnic parties, and church services by various denominational ministers have been appreciated. The Te Awamutu Rotary Club continues to take an active interest in the welfare of the hospital, arranging picture parties to the various theatres, and this is appreciated very much by both patients and staff. In conclusion, I wish to express my thanks to all members of the staff for their help and co-operation in the work of the hospital, in maintaining a high standard of service, both medical and nursing, despite staff shortage difficulties. J. D. Hunter, Medical Superintendent.

PORIRUA HOSPITAL I have to submit my report for the year ended 31st December, 1948. The total number of cases under care in the hospital during the year was 2,020, of which 1,655 were committed patients, 354 voluntary boarders, and 11 persons were remanded for psychiatric observation. Admissions for the year numbered 652, of which total 248 persons entered hospital as voluntary boarders. During the year 461 persons (patients and boarders) were discharged, 104 died, and 83 patients were transferred to other psychiatric hospitals within the Division. Of the deaths occurring within the year, 69 per cent, occurred in people of the age of sixty-five years and over. At the close of the year 104 patients were absent from the hospital on probationary leave to the care of relatives or friends. Owing to medical staff shortage there has been some reduction in the amount of extra-mural psychiatric work carried out during the year. .. Psychiatric out-patient clinics at Napier, Wanganui, and Palmerston North Hospitals have only been held at irregular intervals. The bi-weekly psychiatric clinics at the Wellington Hospital and a weekly clinic for psychoneurotic ex-servicemen have been maintained. The number of in-patients under observation or treatment in the psychiatric wards, Wellington Hospital, numbered 461, whilst 1,384 consultations were dealt with at the various out-patient clinics. The shortage of medical and nursing staff personnel continues and made for very real administrative difficulties during the year. The part-time employment of married ex-nurses lessened the burden somewhat on the female side. We are grateful for the help these people have given.

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The modern active psychiatric treatments such as electric convulsive therapy, electric narcosis, and sub-coma insulin have continued to be used as routine. Our successes with these treatments have continued, and one important factor brought about by these therapies has been the reduction in the period of hospitalization now required for the recoverable cases. The rebuilding progresses slowly and the overcrowding figure at the end of the year was 352 patients. Villas 7 and 8 were completed and occupied during the year, whilst Villa 6 should be ready for occupation early in the New Year. The sewing-room female occupational therapy block is in the process of construction, whilst another year closes with the new laundry block still not in use owing to theincomplete installation of machinery. Next major work to commence is the male admission and treatment block, which, when completed and occupied, will permit reorganization of the Rauta Block for female patients only. The plans for the administrative block have been finalized, and although a commencement as soon as possible of the work is desired it is appreciated that buildings for patient accommodation and overcoming overcrowding in wards has the definite priority. The male staff shortage in recent years has enabled us to house the reduced number of staff living in, but if staff become available in any way approaching the normal staff establishment additional provision will have to be made for male staff accommodation. Provision should be made for an attendants' home as soon as building-materials and available labour will permit. The general appearance of the hospital was improved during 1948 by the painting of various buildings. In addition, much needed equipment, hospital and domestic, has been installed, and the refurnishing of the older wards has continued. Considerable attention has been given to fire protection. Sprinkler systems have been installed in F Ward and a portion of the Lower Buildings. It is anticipated that the remaining wards will be provided with this system during the coming year. The automatic alarm system has also been extended. Much progress has been made with our road-sealing programme, but there is still a good deal to be done in grading and sealing of the surrounds of the new villas. I hope that the Ministry of Works will find it possible to complete this at an early date. Occupational-therapy work has been extended, and we have now four Occupational Therapists attached to the staff. Our farm and gardening activities have produced satisfactory results. The hospital has been fortunate in the sustained interest displayed by individuals and organizations in making provision for entertainment and extra comforts for the patients. It is not possible to name all these, but I particularly desire to thank the Joint Council of the Order of St. John and New Zealand Red .Cross Society for the very keen interest taken in the welfare of ex-servicemen patients. • Recreation and entertainment for patients has been well catered for. Picnics, dances r visits to theatres, bus drives, &c., have been provided for and much appreciated. In addition, a considerable sum has been made available through the Comforts Fund topatients for personal spending. The staff as a whole is to be commended for the good work done during the year,, in many cases under difficulties which are inevitably associated with the rebuilding of a large institution such as this. B. D. Hart, Medical Superintendent.

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NELSON MENTAL HOSPITAL I have the honour to present my annual report for the year ended 31st December, 1948. The number of patients under care during thjs period was 1,185. Of these, 1,126 were admissions under reception -orders and 59 were voluntary boarders. Admissions totalling 157 included 47 transferred from other mental hospitals, 46 under section 8 of the amendment of the Act, and 38 voluntary boarders. Sixty-five, including 37 voluntary boarders, were discharged during the year. Twenty-one were transferred to other mental hospitals. Deaths totalled 36. The health of the patients has been, on the whole, good ; as is reflected in the low death-rate. Building difficulties persist, as is the case elsewhere, but nevertheless a good deal of maintenance, a number of improvements, and some new works have been completed. At Nelson, kitchenettes have been completed in El Nido and F Ward and washingmachines installed. The office has been enlarged and rearranged to give more efficiency. Renovations have been made to Hospital Ward and routine painting continued. At Ngawhatu a hairdressing-salon has been erected, also a pavilion on the bowlinggreen. Storerooms in the female villas have been enlarged ; mattress-rooms are in the course of building. The kitchen in main building has been remodelled. New roads have been made on the farm and old ones repaired. Painting and maintenance is catching up, and, all in all, progress is more satisfactory than it has been for a number of years. The Hospital Ward has been transferred from two-floored Yiewmont to single-storied Kinross. This makes nursing much easier and enables the elderly and the frail to have much more time in the sun now that there are no stairs to surmount. The non-replacement of worn-out boilers has been a serious handicap to the laundry, and some urgency must be given this. The non-sealing of Polstead Road has evoked continued complaint also, but arrangements are in train apparently to remedy this. A 16 mm. film projector has been purchased for the dual purpose of staff instructionand patients' entertainment, and it serves these purposes very well. The acquisition of a station-wagon is an amenity which has been of much use to patients, staff, and the hospital generally. An agreement has been reached with the Fire Board whereby the alarm siren at Ngawhatu is now connected with the Nelson City Fire Brigade Station ; connection from the Nelson branch has, of course, been in existence for some years. The recently appointed Fire Captain is undergoing a special one month's course of training at the city brigade. Farm activities have proceeded satisfactorily, and returns have been adequate. Staffing conditions have been somewhat easier too. Repairs to the farm buildings are proceeding at present. Patients' amusements have been on a better basis than ever previously, I should think, largely due to the acquisition of the picture projector, but helped very much also by concert parties who have visited regularly, and by the continuing of fortnightly dances, regular picnics, and so on. Mr. Croucher, of the Suburban Bus Service, is in particular to be thanked for his continued kindness in supplying buses for the taking of patients to various places of entertainment and for transporting concert parties without charge. He has been most generous. Turning for a moment from the particular to the general, I think it opportune here to mention that the present policy of modern furnishing for the villas, modern clothing for the patients, and a more liberal and a more hospital-like outlook generally is a great improvement and makes conditions vastly more congenial for every one.

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In conclusion, I wish to express my appreciation to the various branches of religion for their work here, and also to the staff generally for their continued loyal help and co-operation. J. U. Williams, Medical Superintendent.

SEAVIEW HOSPITAL I have the honour to submit my report for the year ended 1948. The number of cases under care during the year was 552 (273 males and 279 females). The admissions numbered 20 (9 males and 11 females). There were 8 transfers (5 males and 3 females), and 13 voluntary boarders (7 males and 6 females). Patients discharged were 17 (12 males and 5 females), voluntary boarders 14 (7 males and 7 females), while there were 10 transfers (8 males and 2 females). There were 20 deaths (9 males and 11 females). At the end of the year 5 males and 6 females were on probation. The general health of the patients has been good, but a large number of our patients are now getting into the aged group, only about one-third being under fifty. Dr. W. O'Reilly was appointed to the staff on 2nd July, 1948, and his willing co-operation and assistance has been appreciated. Clinics have been held monthly at the Grey River Hospital and occasional visits made to the Westland Hospital. Co-operation with the Westland Hospital continues, and I am indebted to Mr. Smart, Surgeon-Superintendent, for giving the patients the benefit of his advice, hospital investigation, and treatment. Mr. Pready attended a course of instruction in occupational therapy at Avondale, and since his return successful occupational-therapy classes have been instituted, one of the older, smaller buildings on the male side, being converted for this purpose. As yet no Occupational Therapist has been appointed. Electro convulsive therapy has been carried out on suitable patients. Mr. Robinson took up his duties as Head Attendant on 4th February, 1948, and is installed in the new cottage which was finished about the end of February. In keeping with the Department's policy, the patients are now wearing more varied and better types of clothing, and the wards of the hospital are being partly refurnished and renovated and better equipped. The sound projector has been useful in implementing the work of teaching. The usual routine of farming and gardening has been carried out satisfactorily and maintenance work done as far as possible, but prolonged sickness has affected one member of the artisan staff. Recreation and amusement has been carried on as usual. The local societies have given help in various ways, and thanks are due to the Hokitika Band, the Racing Club, and the various ladies' committees for assisting at or providing for local functions both at and away from the hospital. The clergy make frequent visits, hold regular services, and take an interest in the patients generally. The water-supply has been unsatisfactory and we have to constantly call on the borough for relief. The hospital generally is badly in need of painting, and the plumbing is in bad state. It is hoped that this will be soon remedied as labour and supplies become more plentiful. There is still an acute shortage of staff on the female side, and they ably do much extra work to overcome this disability. I wish to thank the staff generally for their help during the year. T. W. J. Childs, Medical Superintendent.

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SUNNYSIDE HOSPITAL I have the honour to forward my report for the year ended 31st December, 1948. The number of cases under care during the year was 1,681 (839 men, 842 women). There were 239 patients committed (93 men, 146 women) and 18 patients were transferred from other institutions. One hundred and four patients (37 men, 67 women) were discharged, leaving 1,457 patients remaining at the end of the year. Of that number, 186 (93 men, 94 women) were absent on probation. Under the voluntary boarder section, 71 men and 76 women were admitted, 66 men and 71 women were discharged following treatment, 2 patients died, and 4 were committed. The total number of voluntary boarders under care during 1948 was 222. There were 90 deaths (47 men, 43 women), (including 2 voluntary boarders), the chief cause being senile decay. Accommodation for patients on the female side is definitely inadequate. An admission block and a villa for female patients are urgently required. The nurses' sick-room is almost completed, the nurses' dining-room has been extended, and an up-to-date kitchen for the female staff has been provided. Although the programme of building for 1948 included a tuberculosis block, a female villa, nurses' home (Templeton), and an admission block, no work has been carried out in connection with any of the buildings mentioned. Authority was given for the extension of the bowling-green, which has been entirely relaid under expert supervision and will be ready for use next season. Most of the wards have been refurnished throughout with modern and comfortable furniture, and several wards have been painted and renovated by our own staff. The weekly allowance granted to patients able to appreciate it has caused much pleasure to them. The entertainment of the patients has been carried out on the usual lines. The Returned Services Association has provided bus drives regularly for ex-servicemen, and the Mental Welfare Society, the National Council of Women, and the Justices of the Peace Association have been of great assistance to us. Concerts, dances, and other entertainments have been given frequently at Sunnyside by Mrs. Pearce's party, the Railway Workshops Band, and Skippers Harmonica Band. Mr. McEldowney, Presbyterian Social Service Association, and the Junior Chamber of Commerce give fortnightly entertainments at Templeton ; the Crichton Cobbers Band and the Rotary Club have also given concerts there. We have deeply appreciated what the various organizations and individuals have done to brighten the lives of our inmates. The staffing question is still very difficult on the female side, both at Sunnyside and Templeton. Our nurses deserve great commendation for the pleasant and efficient way they have carried out their duties. To the Official Visitors, to the chaplains of all denominations, and to the staff generally I tender my thanks for their co-operation. A. C. McKillop, Medical Superintendent.

SEACLIFF HOSPITAL I have the honour to submit my report for the year ended 31st December, 1948. During the year there were 1,176 persons (684 men and 492 women) under care. In that period 158 patients were admitted, 77 discharged, and 7 transferred to other hospitals. In addition to these patients, 76 voluntary boarders were admitted and 83 were discharged. The number of deaths was 58. Towards the end of the year it was possible to get the patients into the new dayroom built for F.2 Ward. Apart from the very much improved amenities which this provides for the patients, it was a great relief to be able to evacuate the old building, which was such a source of worry. It is hoped that the demolition of the old, unsafe structure will be done speedily.

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In last year's report I commented on the fact tliat on the male side there was cause for apprehension because of the damage being done to the structure because of the slipping ground, and the position there has deteriorated. There is one large crack in particular which seems to have widened much further, and at the roof-level there is a considerable gap. There have been the usual troubles with the water-mains and the sewers. The provision of a new main sewer running above ground is proposed, and this should be a great help from the point of view of sanitation and from the saving in labour. The farm and garden have had a satisfactory year and the provision of more mechanized equipment has been a great help. The treatment of patients with electro shock in new and recent cases has now become almost common-place, but the extension of it to patients whose illnesses have been of long standing has shown gratifying results. While it does not and cannot be expected to effect cures in the ordinary sense of the word, it has a very distinct effect on behaviour disorders and allows many patients to lead happier and more useful institutional lives. Further leucotomy operations have been performed by Mr. Murray Falconer, and it is hoped later to present you with a report on the results obtained in his first forty case's. I am happy to report that the recreational facilities for the patients have been greatly improved, particularly in the matter of outings. This year marked the centennial of this province, and to every one of the public functions and celebrations parties of patients were sent, usually by bus. At the beginning of the summer it was possible to hire two buses each Sunday to take parties to the beaches and the other picnic spots in the district; this is Qontinuing. A canteen has been opened at the Orokonui Home, and it appears to be greatly appreciated. The usual clinics in Dunedin Hospital and in the outlying towns were conducted by the medical staff. I have to thank many organizations who gave concerts and entertainments, and express my gratitude to Mr. A. Steven, who organized most of them. The Official Visitors and chaplains from the various churches have paid regular visits and have been very helpful indeed. I wish to thank all members of the staff for the work they have done, despite many difficulties. Malcolm Brown, Medical Superintendent.

Table I —Showing the Admissions, Readmissions, Discharges, and Deaths in Mental Hospitals During the Year 1948 M. F. T. In mental hospitals, Ist Janaury, 1948 .. .. .. .. 4,567 4,141 8,708 M. ¥. T. Admitted for the first time .. .. .. 524 607 1,131\ AR£) 7Qn , , Q!) Readmitted .. 128 173 301/ b6/ /8U Total under care during the year .. .. .. .. 5,219 4,921 10,140 Discharged and died — Recovered . . .. .. . . 210 325 535 Not recovered .. .. .. .. 118 102 220 Died .. .. .. .. ..279 274 553 607 701 1,308 (Not including transfers : males, 134 ; females, 117.) Remaining in mental hospitals, 31st December, 1948 .. ~ .. 4,612 4,220 8,832 Increase on 31st December, 1947 . . . .. .. .. 45 79 124 Average number resident during the year .. .. .. .. 4,339 3,806 8,145

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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 1948

15

Hospitals. Ia Hospitals on 1st January, 1948. Admissions in 1948. Total Number of Patients Under Care, Admitted for the First Time. Not First Admissions. Transfers. Auckland Kingseat Raventhorpe Tokanui LevinFarm .. Porirua Nelson Seaview Sunnyside SeaclifF Ashburn Hall* Totals M. F. T. 737 665 1,402 442 399 841 9 217 226 424 380 804 135 38 173 640 611 1,251 574 433 1,007 259 265 524 736 6881,424 597 421 1,018 14 24 38 M. F. T. 135 132 267 33 34 67 48 46 94 49 27 76 101 147 248 25 34 59 8 8 16 66 118 184 56 57 113 3 4 7 M. F. T. 22 32 54 5 7 12 3 io 13 46 71 117 2 11 13 2 2 4 27 28 55 21 12 33 M. F. T. 11 17 28 10 21 31 .. 28 28 3 17 20 15 2 17 22 17 39 47 .. 47 4 4 8 10 8 18 10 2 12 2 1 3 M. F. T. 905 846 1,751 490 461 951 9 245 254 478 453 931 199 67 266 809 846 1,655 648 478 1,126 273 279 552 839 842 1,681 684 492 1,176 19 29 48 4,567 4,141 8,708 524 607 1,131 128 173 301 134 117 251 5,353 5,038 10,391 Hospitals. Discharged Recovered. Patients Discharged, Transferred, and Died. Discharged not Recovered. Transferred. Total Discharged, Died. Transferred, and Died. Auckland Kingseat Raventhorpe Tokanui Levin Farm Porirua Nelson Seaview Sunnyside SeaclifF Ashburn Hall* Totals M. F. T. 48 63 111 5 14 19 1 2 3 16 34 50 77 lie 193 8 14 22 7 2 9 25 43 68 20 31 51 3 6 9 M. F. T. 44 24 68 8 6 14 1 .. 1 1 • 4 11 15 8 1 9 ; 17 16 33 !. 5 1 6 i 5 3 8 ; 12 24 36 13 13 26 >2 2 4' M. F. T. 15 13 28 5 24 29 4 13 17 6 14 20 2 2 54 29 83 17 4 ' 21 8 2 10 16 16 32 6 1 7 1 12 M. F. T. 75 64 139 25 23' 48 6 6 31 24 55 4 1 5 31 63 • 94 20 15 35 9 11 20 48 41 89 34 24 58 2-2 4 M. F. T. 182 164 346 43 67 110 5 22 27 57 83 140 14 2 16 179 224 403 50 34 84 29 18 47 101 124 225 73 69 142 8 11 19 210 325 535 ; 118 102 220134 117 251 279 274 553 741 818 1,559 Hospitals. In Hospitals on 31st December, 1947. Average Number Resident During the Year. 1 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 Seaview Sunnyside SeaclifF Ashburn Hall* Totals M. F. T. 723 682 1,405 447 394 841 4 223 227 421 370 791 185 65 250 630 622 1,252 598 444 1,042 244 261 505 738 718 1,456 611 423 1,034 11 18 29 M. F. T. 671 570 1,241 438 376 814 7 214 221 415 349 764 146 50 196 586 563 1,149 568 400 968 245 253 498 679 626 1,305 571 384 955 13 21 34 M. F. T. 30-57 38-41 34-58 13-16 3415 24-05 100-00 200-00 300-00 31-37 60-71 46-73 52-38 53-21 52-88 29-63 31-11 30-56 70-00 20-00 45-00 26-88 29-45 28-45 25-97 44-93 34-93 100-00 150-00 128-57 M. F. T. 11-18 11-23 11-20 5-71 6-12 5-90 2-80 2-71 7-47 6-87 7-20 2-75 2-00 2-55 5-29 11-19 8-15 3-52 3-75 3-62 3-67 4-35 4-02 7-07 6-55 6-82 5-95 6-25 6-07 15-38 9-52 11-76 4,612 4,220 8,832^ £,339 3,806 8,145 32-21 41-67 37-36 6-43 7-20 6-79 * Private mental hospital.

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Table III—Native Countries

Table IV—Ages of Patients on 31st December, 1948

16

Countries. Auckland. 1 Kingseat. 1 Raventhorpe. Tokanui. Levin Farm. Porirua. England and Wales Scotland Ireland Hew Zealand Australian States Prance Germany Austria Norway Sweden Denmark Italy China Maoris Other countries Unknown Totals M. P. T. 85 56 141 14 7 21 11 12 23 476 516 992 27 19 46 1 . . 1 1 1 4 4 1 . . 1 11 2 2 2 4 1 5 31 20 51 40 19 59 26 30 56 M. F. T. 62 49 111 11 ir 22 18 14 32 291 277 568 15 12 27 i:: 4 4 2 . • 2 1 i 2 112 6 13 19 30 16 46 M. F. T. .. 20 20 .. 10 10 i 164 168 . . 11 11 7" 7 4 4 M. F. T. 40 43 83 15 8 23 17 14 31 299 252 551 11 11 22 1 . . 1 1 1 2 2 1 '! 1 1 .. 1 2 .. 2 23 22 45 9 19 28 M. F. T. 13 4 2 .. 2 175 57 232 2 13 4 2 6 1 .. 1 .. 2 2 M. F. T. 69 77 146 25 18 43 18 18 36 441 451 892 20 15 35 1 1 3 . . 3 4 2 6 37 27 64, 12 14 26 723 682 1,405 44f 394 841 4 223 227 421 370 791 185 65 250 630 622 1,252 Countries. Nelson. Sea view, i Sunnyside. Seaciff. j Ashburn Hall (Private Mental Hospital). Totals. England and Wales Scotland Ireland New Zealand Australian States .. France Germany Austria Norway Sweden Denmark Italy China Maoris Other countries Unknown Totals M. 3?. T. 42 28 70 21 12 33 10 3 13 459 365 824 13 8 21 1 i' 2 1 .. 1 I . . 1 3 3 II 2 1 .. 1 17 15 32 8 2 10 20 9 29 M. F. T. 23 21 44 9 3 12 8 6 14 171 190 361 8 7 15 1 1 1 . . 1 2 2 1 1 20 34 54 31. F. T. 27 56 83 19 13 32 13 6 19 658 621 1,279 9 13 22 1 1 1 .• ' 1 6 5 11 4 4 8 sr. p. t. 34 25 59 30 24 54 19 9 28 492 351 843 14 5 19> 1 " 1 2 2 1 1 3 i' 4 15 8 23 M. F. T. 1 . . 1 1 . . 1 8 18' 26 1 . . 1 M. F. T. 384 378 762: 147 106 253 114 89 203. 3,474 3,262 6,736 120 102 222 2 .. 2 4 3 7 12 . . 12 6 . . 6 6 17 7 . . 7 10 2 12: 13 4 17 125 104 229127 116 243 1 61 53 114 598 444 1,042 244 261 505 738 718 1,456 6y 423 1,034 11 18 29 4,612 4,220 8,832

Ages. Auckland. Kings eat. Raventhorpe. Tokanui. Levin Farm. Porirua. M. F. T. M. F. T. M. F. T. M. F. T. M. F. T. M. F. T. Prom 1 to 5 years 2 1 3 1 1 2 16 8 24 1 1 „ 5 „ 10 „ 1 1 2 2 4 4 8 41 15 56 2 6 ' '8 „ 10 „ 15 „ 7 3 10 6 5 11 5 9 14 24 10 34 1 7 8 » 15 » 20 „ 30 13 43 22 11 33 i 1 16 8 24 41 12 53 13 32 45 „ 20 „ 30 „ 92 78 170 28 37 65 1 2 3 52 40 92 48 16 64 77 77 154 % 30 „ 40 „ 157 128 285 57 45 102 .. 23 23 88 67 155 15 3 18 164 106 270 „ 40 „ 50 „ 144 129 273 73 84 157 .. 36 36 62 70 132 1 1 118 111 229 „ 50 „ 60 „ 111 153 264 91 82 173 3 62 65 63 67 130 117 107 224 „ 60 „ 70 „ 100 108 208 95 79 174 .. 59 59 62 67 129 87 91 178 :i 70 „ 80 „ 55 46 101 57 38 95 .. 31 31 57 28 85 44 67 111 „ 80 „ 90 „ 13 14 27 10 11 21 . . 6 6 7 7 14 6 17 23 Upwards of 90 years 1 1 1 1 Unknown 13 io 23 4 i •4^ .. 3' 3 3 *2 5 Totals 723 682 1 ,405 447 394 841 4 223 227 421 370 791 185 65 250 630 622 1,252

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Table IV—Ages of Patients on 31st December, 1948—continued

Table V—Length of Residence of Patients Discharged "Recovered" During 1948

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17

Ages. Nelson. Sea view. Sunnyside. Seacliff. Ashburn Hall (Private Mental Hospital). Totals. M. jr. T. jr. F. T. H. F. T. M. F. T. M. • F. T. M. F. T. From 1 to 5 years 18 10 28 13 13 - 26 2 2 53 33 86 „ 5 „ 10 „ 42 30 72 1 1 33 23 56 6 i 7 132 79 211 „ 10 „ 15 „ 55 36 91 1 i 2 42 28 70 1 2 3 142 101 243 „ 15 „ 20 „ 38 31 69 1 2 3 71 43 114 13 9 ' 22 245 162 407 „ 20 „ 30 „ 63 45 108 7 14 21 151 104 255 68 38 106 4 4 591 451 1,042 , „ 30 „ 40 „ 98 50 148 32 25 57 124 122 246 110 56 166 1 3 846 627 1,473 „ 40 „ 50 „ 76 61 137 49 44 93 109 100 209 136 66 202 1 1 768 702 1,470 „ 50 „ 60 „ 73 64 137 56 63 119 82 99 181 109 83 192 1 1 706 780 1,486 „ 60 „ 70 „ 71 70 141 68 73 141 74 108 182 101 89 190 2 7 9 660 751 1,411 » 70 „ 80 „ 46 31 77 21 29 50 33 59 92 51 60 111 1 6 7 365 395 770 „ 80 „ 90 „ 9 12 21 6 6 12 5 14 19 14 17 31 1 2 3 71 106 177 Upwards of 90 years 2 3 5 1 1 2 2 1 1 3 8 11 Unknown 7 1 8 2 i 6 "i 4 5 30 25 55 Totals 598 444 1,042 244 261 505 738 718 1 ,456 611 I 423 1 ,034 11 18 29 4,612 4,220 8,832

Length of Residence. Auckland. Kingseat. Raventhorpe. Tokanui. Levin Farm. Porirua. Under 1 month From 1 to 3 months .. >, 3 „ 6 „ „ 6 „ 9 „ .. „ .9 „ 12 „ ,, 1 to 2 years ■ 2 „ 3 „ 3 „ 5 „ » 5 .. 7 » 7 „ 10 „ » 10 „ 12 „ „ 12 „ 15 „ Over 15 years Totals M. F. T. 2 13 10 12 22 7 3 10 .. 2 2 3 5 8 19 26 45 3 9 12 2 4 6 112 1 .. 1 M. F. T. 1 1 1 .. 1 2 4 6 12 3 1 1 5 5 112 m. r. t. 112 1 1 M. P. T. 112 .. 3 3 3 3 5 2 7 5 11 16 5 10 15 1 1 I 1 II 1 1 m. F. a?. M. v. T. 6 3 9 28 34 62 20 33 53 5 14 19 3 11 14 8 12 20 3 4 7 13 4 112 1 1 1 .. 1 1 .. 1 48 63 111 5 14 19 12 3 16 34 50 77 116 193 Length of Residence. Nelson. Sea view. Sunny side. Seacliif. Ashburn Hall (Private Mental Hospital). Totals. Under 1 month From 1 to 3 months .. „ 3 „ 6 ..„ „ 6 „ 9 „ „ 9 „ 12 ■ „ ,, 1 to 2 years „ 2 „ 3. „ 3 „ 5 „ „ 5 „ 7 „ „ 7 „ 10 „ „ 10 „ 12 „ 12 „ 15 Over 15 years Total M. F. T. 1 .. 1 3 3 14 5 112 12 3 2 2 2 2 2 13 1 1 m. jr. t. 1 .. 1 1 .. 1 1 .. 1 112 2 13 1 .. 1 M. F. T. 2 2 4 112 4 23 27 4 6 10 13 4 5 3 8 4 3 7 2 2 4 1 .. 1 1 .. 1 M. F. T. 5 5 io 2 4 6 2 8 10 3 5 8 4 4 8 .. 3 3 3 14 1 1 1 .. 1 M. F. T. !! i i I I 3 14 .. 3 3 M. P. X. 11 8 19 47 56 103 36 71 107 21 38 59 16 43 59 43 62 105 14 24 38 11 12 23 3 6 9 2 3 5 1 .. 1 112 4 15 8 14 22 7 2 9 25 43 68 20 31 51 3 6 9 210 325 535

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Table VI—Causes of Death, 1948

18

Causes. Auckland. Kingseat. Raventhorpe. Tokanui. Levin Farm. Porirua. I —General Diseases M. F. T. M. F. T. M. F. T. M. F. T. M. F. T-. M. F. T. Tuberculosis — General 112 1 .. 1 Lungs 5 3 8 1 .. 1 4 4 Cancer .. .. 2 13 4 4 1 .. 1 1 . . 1 Toxaemia 1 1 Septicaemia Diabetes 1 1 Congenital debility i ! I Gangren i Malaria I .. I Hydrocephalus 1 .. 1 Splenic anaemia 1 1 Cholecystitis .. .. « 1 1 Henock's purpura Bacillary dysentery II—Diseases of the Nervous System Exhaustion Exhaustion of mania .. i i 1 1 Exhaustion of melancholia 1 1 1 1 General paralysis of the insane .. 2 2 Cerebral haemorrhage 14 5 4 1 5 12a Cerebral thrombosis 1 1 3 3 6 .. 2 2 1 1 Cerebral tumour Organic brain-disease 1 1 Epilepsy 1 ! 1 2 2 4r Neuro-syphilis 1 . . 1 Locomotor ataxia III —Diseases of the Respiratory System Pneumonia — 4 2 6 Broncho 15 18 33 2 2 4 7 4 11 Hypostatic 3 12 15 2 2 Lobar 1 1 1 1 1 1 Pulmonary— (Edema 1 1 ! Embolism IV —Diseases of the Circulatory System 5 11 16 Heart-disease 39 9 48 12 9 21 2 2 3 7 10 Arterio-sclerosis .. 2 2 2 2 2 7 9 V —Diseases of the Digestive System Peritonitis 1 .. 1 VI—Diseases of the Urinary System Uraemia 2 2 .. i l Nephritis 1 1 VII—OLD AGE 11 32 43 Senile decay 3 2 5 .. 1 1 9 8 17 VIII—External Causes Chronic morphinism 1 1 1 ! 1 Suicide 1 . . 1 Asphyxia by drowning .. i i Respiratory obstruction 1 1 Head injury IX —Died Whilst on 3 3 Probation 4 7 11 1 . . 1 1 . . 1 2 2 Totals 75 64 139 25 23 48 6 6 31 24 55 4 15 31 63 94

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Table VI—Causes of Death, 1948 —continued

19

Causes. Nelson. Sea view. Sunnyside. Seacliff. Ashburn Hall (Private Mental Hospital). Total. I —General Diseases Tuberculosis — General Lungs Cancer Toxaemia Septicaemia Diabetes Congenital debility Gangrene Malaria Hydrocephalus Splenic anaemia Cholecystitis Henock's purpura Bacillary dysentery M. i 1 E. T. i l 1 2 !! I i l M. 3 F. T. i 4 1 1 1 1 M. F. T. 5 i 6 i !! I M. 1 1 1 2 F. | T. 2 1 1 M. E. T. M. 2 15 6 1 1 i 1 1 1 1 *2 F. 1 11 7 i i 1 T. 26 13 3 1 1 1 1 1 1 1 1 1 II—Diseases of the Nervous System Exhaustion Exhaustion of mania Exhaustion of melancholia General paralysis of the insane Cerebral haemorrhage Cerebral thrombosis Cerebral tumour Organic brain-disease Epilepsy Neuro-syphilts Locomotor ataxia 3 1 1 ;! 3 *2 3 1 3 3 4 '2 6 1 !1 .. "i 1 i ! 'i '4 i 1 4 1 1 2 3 13 4 1 1 5 1 1 2 2 i.3 7 i 6 3 2 2 26 11 1 2 11 1 1 III—Diseases oe the Respiratory System Pneumonia — Broncho Hypostatic .. .1 Lobar Pulmonary— (Edema Embolism 2 2 4 1 1 2 9 5 14 1 12 13 1 .. 1 1 1 1 1 41 6 2 34 24 2 2 75 30 4 2 IV —Diseases of the Circulatory System Heart-disease Arterio-sclerosis 4 1 5 4 4 8 15 14 29 1 . . 1 5 6 2 13 7 89 10 63 11 152 21 V —Diseases oe the Digestive System Peritonitis 1 1 VI—Diseases oe the Urinary System Uraemia Nephritis 3 14 5 1 2 6 2 VII —Old Age Senile decay 7 6 13 1 3 4 14 5 8 8 16 2 2 4 42 66 108 VIII —External Causes Chronic morphinism Suicide Asphyxia by drowning Respiratory obstruction Head injury 1 1 1 1 i 1 1 1 1 1 IX—Died Whilst on Probation 1 1 3 14 5 5 17 11 28 Tbtals 20 15 35 9 11 20 48 41 89 34 24 58 2 2 4 279 274 553

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Table VII—Principal Assigned Causes of Insanity, 1948

20

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 2 2 1 1 3 3 Arterio-sclerosis 6 3 9 i 1 1 . . 1 Congenital 16 10 26 3 5 8 8 14 49 27 76 8 3 11 Constitutional 49 40 89 13 15 28 11 14 25 57 66 123 Drug addiction 1 2 3 Encephalitis i 1 Epilepsy 1 1 1 i 2 i 1 2 15 6 Heredity i 1 2 2 1 .. 1 111 health 5 1 6 10 18 .. 1 1 Involution 1 1 3 3 1 3 4 2 12 14 Mental stress 3 14 17 i 1 1 14 15 Organic brain-disease 1 3 4 3 14 Previous attack 22 32 54 5 7 12 3 io 13 46 71 117 Puerperal 6 6 2 3 3 Senility 46 48 94 , 8 io 18 13 10 23 20 39 59 Spastic paralysis .. 1 1 Syphilis 5 i 6 1 i 2 1 1 Toxic 1 1 1 1 3 i 4 2 13 Trauma 1 1 2 2 Transfers 11 i7 28 10 21 31 28 28 3 17 20 15 2 17 22 17 39 Totals 168 181 349 48 62 110 28 28 54 73 127 64 29 93 169 235 404 1 Ashburn Hall Causes. . Nelson,. Seaview. Sunny side. Seacliff. (Private Totals. Mental Hospital). 31. F. T. M. F. T. M. F. T. >r. F. T. 31. F. T. M. F. T. Alcohol 2 2 1 1 ■> 2 11 11 Arterio-sclerosis 5 7 12 12 11 23 Congenital 5 10 15 19 ' 24 43 7 i 8 115 86 201 Constitutional 9 5 20 26 46 20 27 47 ! 3 5 ! 17-4 194 368 Drug addiction 1 2 3 Encephalitis ' 1 1 Epilepsy 1 2 3 1 3 2 2 G . 13 19 Heredity 2 3 5 5 4 9 111 health 15 10 25 Involution i 1 2 ii 11 i 1 6 i 31 37 Mental stress i 8 9 16 22 '9 1 7 16 1 . ! 1 1 21 60 81 Organic brain-disease 1 a 4 9 Previous attack 2 : '9 11 2 3 2 28 55 21 12 33 128 170 298 Puerperal 3 3 1 1 15 15 Senility 11 12 23 3 5 13 31 44 14 16 30 i 1 128 169 297 Spastic paralysis 1 1 Syphilis 1 1 2 2 9 3 12 Toxic 2 *2 4 8 5 13 Trauma 3 ; 3 Transfers 47 .. 47 4 i 8 10 8 18 10 *2 12 2 13 134 117 251 Totals 74 45 119 14 14 28 103 154 257 87 71 158 5 1 5 10 786 897 1,683

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Table VIII Showing the Admissions, Discharges, and Deaths From Ist January, 1876, to 31st December, 1948 (Excluding Transfers) M. F. T. In hospital, 31st December, 1875 .. .. . . .. .. 482 254 736 Admissions .. .. .. .. .. .. .. 30,276 25,553 55,829 30,758 25,807 56,565 Discharged— m. p. t. Recovered .. .. .. .. 10,112 9,854 19,966 Not recovered .. .. .. 3,785 3,452 7,237 Died .. .. .. .. .. 12,249 8,281 20,530 26,146 21,587 47,733 Remaining on 31st December, 1948 .. .. .. .. 4,612 4,220 8,832

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

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21

— Males. Females. Both Sexes. Recovered 32-88 38-18 35-30 Unrecovered 12-31 13-38 12-79 Died 39-82 32-09 36-30 Remaining 14-99 16-35 15-61 100-00 100-00 100-00

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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, 1907

22

Year. Discharged. Died Remaining Average Numbers Resident. Percentage of Percenta«i 3 of Admitted Not prov( 31st December Recoveries 1 on Deaths on Average Numbers Resident. Recovered. Relieved. Im 3d. in Each Year. Admissions. M. F. T. M. F. T. M. F. T. M. F. T. 31. F. T. M. F. T. M. F. T. M. F T - M. F. T. 11)07 359 241 600 160 139 299 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 31 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 38 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 36 186 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 8 41 7-02 8-41 1912 458 381 839 184 141 325 17 44 61 11 5 16 193 87 280 2,273 2,332 1,640 3,913 2,146 1,551 3,697 40 17 37-01 37-74 99 5-61 7-57 1913 466 318 784 175 162 337 35 48 83 1 5 6 196 111 307 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 2,448 1,703 4,111. 2,309 1,641 3,950 40 67 45-12 42-51 8 36 5-36 7-11 6-94 1915 450 361 811 202 157 359 26 32 58 10 11 21 172 112 284 1,752 4,200 2,391 1,703 4,094 44 89 43-21 44-88 7 19 6-58 1916 518 361 879 160 171 331 35 34 69 7 8 . 15 209 80 289 2,555 1,820 4,375 2,483 2,543 1,768 4,251 30 89 47-37 37-66 8 42 06 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 1,825 4,368 36 38 40-64 38-27 8 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 0 53 9-16 9-95 1919 512 371 883 190 147 337 37 44 81 9 13 22 212 130 342 2,667 2,717 1,980 4,647 2,620 1,907 4,527 37 11 39-62 38-17 18 09 6-82 7-55 1920 455 418 873 162 148 310 27 37 64 6 10 16 210 166 376 2,037 4,754 2,674 1,980 4,654 35 63 35-22 35-51 7 85 38 8-40 8-OS 6-69 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 5-76 1922 453 386 839 156 157 313 32 20 52 10 8 18 211 184 395 2,816 2,116 2,157 4,932 2,747 2,062 4,809 34 44 40-67 37-31 i 67 8-92 8-21 1923 442 366 808 168 152 151 319 42 38 80 15 5 20 194 131 325 2,839 4,996 2,789 2,079 4,868 38 00 41-25 39-48 6 95 6-30 6-67 1 921 446 377 823 1-28 280 30 42 72 9 11 20 221 95 316 2,873 2,258 5,131 2,808 2,146 4,953 34 08 33-95 34-02 7 87 4-42 6-37 1925 445 430 . 875 144 175 319 29 37 66 23 17 40 201 123 324 2,921 2,336 5,257 2,830 2,203 5,033 32 36 40-69 36-45 7 45 5 * 57 6-43 1926 508 439 947 136 145 281 27 35 62 15 25 40 207 147 354 3,044 2,423 5,467 2,926 2,287 5,213 26 18 30-75 29-67 6 16 6-42 6-77 1927 531 414 945 157 128 285 40 42 82 14 9 23 217 132 349 3,147 2,526 5,673 3,022 2,373 5,395 29 56 30-91 30-16 17 5-65 6-55 6-47 6-59 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 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 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 51 6-64 7-15 1931 587 476 1,063 127 320 247 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 L ,071 141 160 301 39 42 81 38 41 79 219 169 388 3,903 2,980 3,217 6,883 3,681 2,738 6,419 24 02 33-05 28-10 97 6-17 6-06 1933 563 554 1,117 117 144 261 35 27 62 28 22 50 221 124 345 4,065 4,133 7,282 3,809 2,932 6,741 20 78 25,99 23-36 5 80 4-23 6-68 5-16 1934 479 504 933 114 146 260 64 72 136 233 203 436 3,300 7,433 3,899 3,039 6,938 23 80 28-97 26-45 5 98 6-28 1935 567 502 1,069 117 136 253 72 55 127 229 206 435 4,282 3,405 7,687 4,003 3,111 7,114 20 63 27-09 23 ■ 67 5 72 6-62 6-11 1936 553 556 1,109 121 149 270 105 96 201 252. 213 465 4,357 3,503 7,860 4,093 3,195 7,288 21 88 26-80 26-76 6 18 6-66 6-38 1937 557 567 1,124 180 179 359 121 110 231 261 236 497 4,352 3,545 7,897 4,112 3,272 7,384 32 32 31-57 31 • 94 i 6 6 35 7-21 6-73 1938 527 575 1,102 170 210 380 140 135 275 273 274 547 4,2^6 3,501 7,979 4,129 3,287 7,416 32 26 36-52 34-48 61 8-33 7-38 1939 1 595 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 08 6-28 6-53 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 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 09 30-56 28-41 47 9-81 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 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 73 8-67 8-17 1946 645 788 1,433 183 270 453 107 125 232 269 281 550 4,556 4,046 8,602 4,266 3,706 7,972 28 37 34 • 26 31-61 6 31 7-58 6 -90 1947 719 790 1,509 236 325 561 154 123 277 318 247 565 4,567 4,141 8,708 4,309 3,753 8,062 32 82 41-14 37-18 7 38 6-58 7-01 1948 j 652 780 1,432 210 325 535 118 102 220 279 274 553 4,612 4,220 8,832 4,339 | 3,806 8,145 32 21 41-67 37-36 6 43 7-20 6-79 j21,948 I 20,164 42,112 6,676 1 7,284 '13,960 1 2,533 2,486 5,019 i 9,689 '7,169 1 ! 16,858 .. ■•!•■!•• 1 •• I | Excluding transfers between institutions— -4,077 males, f 5.7S5 females.

H—7

Table XI—Payments for the Financial Year 1948-49

23

Head Office, Avondale, Sunnyside, Sea view, Kingseat, Levin Farm, Wellington. Auckland. Christchurch. Hokitika. Papakura. Levin. £ s. d. £ s. d. £ s. d. £ s. d. £ s. d. £ s. d. Salaries, including 12,325 19 0 116,741 3 1 129,641 12 10 47,751 11 8 67,159 9 2 17,287 10 0 overtime Official Visitors 23 2 0 12 12 0 Advertising, books, &c. 1,551 11 8 68 11 10 58 6 7 58 13 11 230' 2 2 25 13 4 Bacteriological research 9 19 0 16 10 0 4 16 6 Bedding and clothing 18,878 14 10 19,769 17 11 9,822 14 10 14,794 19 1 7,98414 11 Buildings, including i' 8 i 3,176 16 0 3,092 6 3 811 12 3 1,483 0 6 292 1 7 additions, Ac. Compensation under 209 9 0 Workers' Compensation Act Dental services 354 ' 8 7 161 8 0 33 4 6 169 9 11 33 4 0 Expenses of officer 903 5 9 travelling overseas Farms, maintenance of 3,145 9 5 174 11 4 2,743 14 7 2,970 6 0 359 7 5 Fencing, draining, and 132 13 9 170 2 6 79 li 10 82 18 10 85 2 2 roading Freight, cartage, and 215 17 8 764 11 3 106 5 10 442 '5 11 81 9 2 transport Fuel, light, water &c. 134 2 3 11,734 0 9 12,541 16 3 3,825 13 8 6,060 6 10 2,744 12 0 Funeral expenses 89 10 0 103 1 0 152 0 0 153 0 0 Furniture and fittings 20 17 0 7,638 14 0 6,889 15 3 1,883 18 3 1,243 11 10 4,69917 2 Gardens and shrubberies 107 7 4 870 6 0 57 19 8 1 4 88 4 4 Grants to— University of Otago 250 0 0 A patient for injuries 1,308 4 0 received in an accident Widows or relatives of deceased officers Laundry 455 1 7 459 17 10 265 8 3 276 16 5 84 10 7 Machinery repairs and 1,515 19 11 1,613 19 3 500 8 6 756 2 6 239 0 5 stores Medical fees 758 10 5 618 2 10 58 9 6 224 11 8 295 15 ' 6 Motor-vehicles-Maintenance of 114 2 6 749 19 2 112 12 1 381 13 8 34 14 4 Purchase of 185 11 6 185 11 7 Nursing staff uniforms 1,419 14 10 1,596 19 8 928 6 6 90i' 0 9 192' 9 3 Office equipment 30i 5 7 45 11 8 84 5 9 135 11 2 72 17 11 32 16 0 Patients, expenses connected with— Comforts 6,950 17 8 7,157 1 1 4,213 6 0 3,923 10 0 1,380 0 0 Gratuities Recreation 1,603' 9 5 1,9li 9 10 804 3 0 1,393' 3 0 51316 10 Transfers 17 16 11 46 13 0 40 0 9 ■ 2 2 8 Payment of monetary 17 4 8 equivalent of leave due to deceased officers Postages, telegrams, &c. 113 0 9 170 8 4 169 8 2 46 6 6 136 15 1 80 9 3 Printing and stationery 107 16 0 521 0 10 421 2 8 325 3 8 361 18 5 150 9 10 Rations 34,361 7 0 28,885 7 9 12,088 3 1 20,265 13 4 6,046 7 9 Rents and rates 381. 10 0 10 10 3 520 15 0 Staff training: expenses 14 6 10 92 1 4 144' 6 9 3018 5 incidental thereto Stores 3,579 1 10 4,318 9 3 1,647 14 11 4,220 4 8 1,594 7 8 Surgery and dispensary 25 11 11 2,669 2 1 2,039 2 6 966 5 7 1,471 3 9 960 2 7 Telephone services .. 200 2 11 149 9 8 203 4 11 86 9 8 160 17 8 37 18 3 Transfer and removal 48 1 4 446 17 0 38 1 7 376 15 4 279 14 0 73 15 7 expenses Travelling-allowances 327 1 0 167 7 6 454 8 10 62 1 5 310 15 2 2 10 10 Travelling-expenses :. 429 1' 6 662 16 1 161 7 3 150 2 8 98 5 5 48 13 9 Contingencies and 198 11 1 41 4 5 23 19 9 43 9 2 22 11 10 miscellaneous Totals 17,120 14 9 218,543 12 2 225,867 3 11 90,488 7 8 131,446 4 8 45,505 7 5

H—7

Table XI—Payments for the Financial Year 1948-49—continued

24

— Nelson. Porirua. Raventhorpe, Papakura. Salaries, including overtime Official Visitors Advertising, books, &c. Bacteriological research Bedding and clothing Buildings, including additions, &c. Compensation under Workers' Compensation Act Dental services Expenses of officer travelling overseas Farms, maintenance of Fencing, draining, and roading Freight, cartage, and transport Fuel, light, water, &c. Funeral expenses Furniture and fittings Gardens and shrubberies Grants to— University of Otago A patient for injuries received in an accident Widows or relatives of deceased officers Laundry Machinery repairs and stores Medical fees Motor-vehicles— Maintenance of Purchase of Nursing staff uniforms Office equipment Patients, expenses connected with — Comforts Gratuities Recreation Transfers Payment of monetary equivalent of leave due to deceased officers Postages, telegrams, <fcc. Printing and stationery Rations .. Rents and rates Staff training: expenses: incidental thereto Stores Surgery and dispensary Telephone services .. Transfer and removal expenses Travelling-allowances Travelling-expenses .. Contingencies and miscellaneous Totals £ s. d. 83.409 0 10 3912 3 5 5 0 21,573 7 9 886 7 4 80 8 4 3,177 10 0 68 16 0 442 6 4 9,883 16 7 151 5 0 3,048 0 0 77 4 11 204 2 2 498 6 10 199 12 8 150 3 7 356 4 3 65 17 5 863 15 10 83 18 0 3,624 0 9 189 6 10 1,009 18 8 45 4 8 7 13 4 82 11 8 314 1 1 23.410 3 10 7* 3 9 2,565*19 9 2,269 11 2 111 8 9 139 2 5 148 2 7 76 15 8 91 5 9 £ s. d. 122,760 0 6 4 3 472 5 11 184 15 0 22,059 10 10 1,127 4 0 891 12 3 93 0 9 5,763 16 11 186 13 1 645 10 8 13,006 10 3 52 12 6 11,838 10 0 151 19 10 136 13 4 845 4 0 1,430 8 8 884 17 6 645 1 6 668 17 7 1,730 9 9 180 10 4 9,457 10 10 2,10215 7 167 13 6 9 12 4 272 19 1 580 11 2 32,233 6 6 87 17 0 5,983 10 7 4,074 0 10 290 14 2 228 9 2 239 11 4 204 17 5 69 17 2 £ s. d. 14,288 16 0 14' 2 6 1,939 15 11 350 18 11 45 4 1 115 19 8 60 1 10 166 0 3 ' 1,818 17 11 20 0 0 580 5 9 59 11 7 660 4 0 287 9 7 144 0 9 124"l2 3 90 2 9 -1,561 15 8 3 10 0 170 15 5 2 10 0 25 0 6 173 1 7 7,314 18 10 1,250 1 2 784 8 6 148 18 4 15 0 0 21 19 5 40 5 11 0 17 6 £ s. d. 111,382 6 4 147' 1 4 0 10 6 18,233 13 6 2,110 9 3 44 0 6 4,958 12 3. 149 3 8 818 3 11 9,793 8 2 64 7 6 5,713 12 7 370 15 1 610 19 9 954 6 9 366 9 4 579 19 10 1,653' 9 11 122 18 7 6,757 14 11 15 11 10 1,756 1 1 0 4 5 19 11 6 233 11 2 408 8 8 25,374 5 5 8 0 0. 172 12 8 3,685 18 5 2,587 3 4 219 18 8 128 11 10 731 8 3 427 6 3 137 8 1 £ s. d. 59,966 18 9 3l ' 9 9 72 12 0 10,544 7 4 1,564 6 9 8,680 14 2 234 4 7 892 13 8 6,130 19 8 117 0 9 1,257 8 5 94 9 1 697 7 5 511 6 5 206 13 10 724 18 3 653' 2 1 73 18 4 3,784 5 5 10 0 983 18 8 16 16 4 146 14 10 264 1 4 11,295 13 6 012 0 3,035 1 10 1,377 11 4 153 2 8 171 3 4 175 11 6 127 17 9 69 1 0 £ s. d. 782,714 8 2 39 17 4 2,297 11 3 294 . 8 0 145,601 16 11 14,896 10 11 1,101. 1 3 1,014 8 8 903 5 9 32,090 1 9 1,249 8 3 4,575 4 8 77,674 4 4 902 16 9 44,814 10 3 1,942 19 2 250 0 0 1,308 4 0 340 15 6 4,853 16 8 8,008 14 8 3,563 14 2 3,843 6 4 1,105 18 1 10,064 0 10 1,223 16 1 48,810 2 "4 209 8 8 12,249 11 6 339 2 3 54 1 10 1,477 5 4 3,627 15 3 201,275 7 0 920 la 3 549 18 9 31,880 10 1 19,224 3 7 1,762 5 8 1,945 11 7 2,640 17 10 2,427 9 8 698 5 9 159,357 11 9 241,363 15 2 32,279 6 7 200,738 5 3 114,057. 2 9 1,476,767 12 1

IT—7

Table XIa—Receipts for the Financial Year 1948-49

Notes. —(a) Outstanding accounts as at 31st March, 1939. (6) Exclusive of foodstuffs, &c., grown and consumed in hospitals, value £75,460 6s. sd.

Table XII —Average Cash Cost of Each Patient for Financial Year 1948-49

Notes. —(a) Cost does not include interest and depreciation on land, buildings, &c. (6) Receipts from maintenance shown in Table Xla not included.

25

— Avondale, Auckland. Kingseafc, Papakura. Raventhorpe, Papakura. Tokanui. Te Awamutu. Levin Farm, Levin. Porirua. Receipts from maintenance (a) Receipts from farms (6) Miscellaneous Totals £ s. d. 1.544 12 4 1.545 0 5 730 8 5 £ s. d. 1,211 14 6 3,537 18 8 490 15 1 £ s. d. 226 14 2 £ s. d. 469 15 5 6,191 5 11 757 13 0 £ s. d. 451 "6 11 £ s. d. 1,348 16 6 2,426 0 11 1,785 11 2 3,820 1 2 5,240 8 3 226 14 2 7,418 14 4 451 6 11 ■ 5,560 8 7 Nelson. Sea view, Hokitika. Sunnyside,Christchurch. Seacliff. Head Office, Wellngtoii. Total. Receipts from maintenance (a) Receipts from farms (b) Miscellaneous Totals £ s. d. 736 4 4 2,417 12 7 470 16 5 £ s. d. 1,176 0 0 1,367 16 9 337 10 9 £ s. d. 359 16 2 5,735 8 6 1,853 15 5 1 £ s. d. 1,146 6 10 6,697 6 2 1,262 13 9 £ s. d. 141 3 0 £ s. d. 7,993 6 1 29,918 9 11 8,508 8 1 3,624 13 4 2,881 7 6 7,949 0 1 9,106 6 9 141 3 0 46,420 4 1

Hospital. Average Number Resident (Inclusive of Boarders). Salaries. Bedding and Clothing. Buildings, Equipment, Improvements, Repairs, and Replacements Farm. Fuel, Light, Power, Water, and Cleaning. Rations. Avcmdale (Auckland) Kingseat (Papakura) Raventhorpe (Papakura) Tokanui (Te Awanautu) Levin Farm (Levin) Porirua Nelson Seaview (Hokitika) Sunnyside (Christchurch) . . Seacliff Head Office, Wellington Total average cost 1,332 847 224 793 208 1,255 996 406 1,365 986 8,502 £ s. d. 87 12 10 79 5 0 63 15 9 75 12 5 83 2 3 97 16 4 83 14 10 96 5 6 94 19 6 112 19 3 19 0 £ s. d. 14 3 6 17 9 4 8 13 2 13 5 11 38 7 9 17 11 7 21 13 2 19 16 1 14 9 8 18 9 10 £ s. d. 2 7 8 1 15 0 1 11 4 1 19 5 18 1 0 18 0 0 17 10 1 12 9 2 5 4 2 2 10 £ s. d. 2 7 3 3 10 2 0 10 4 10 18 11 1 14 7 4 11 10 3 3 10 5 10 8 0 2 7 5 0 7 £ s. d. 8 16 2 7 3 1 8 2 5 7 14 8 13 3 11 10 7 3 9 18 6 7 14 3 9 3 9 9 18 8 0 0 4 £ s. d. 25 15 11 23 18 6 32 13 2 14 4 11 29 1 4 25 13 8 23 10 1 24 7 5 21 3 3 25 14 8 8,502 92 1 3 17 2 6 1 15 0 3 15 6 9 2 9 23 13 6 — Surgery and Dispensary. Miscellaneous. Total Cost per Patient («)• Receipts. (b). Met Cost per Patient (6). Net Cost previous Year. Decrease in 1948-49. Increase in 1948-49. Avondale (Auckland) .. Kingseat (Papakura) .. Raventhorpe (Papakura) Tokanui (Te Awamutu) Levin Farm (Levin) Porirua . . Kelson* Seaview (Hokitika) Sunnyside (Christ-church) Seacliff Head Office, Wellington Total average cost . . £ s. d. 2 0 1 1 14 9 3 10 1 1 14 9 4 12 4 3 4' 11 1 18 11 1 9 10 2 12 6 0 0 1 £ s. d. 20 18 0 20 7 2 25 5 10 18 5 7 47 5 3 32 2 10 14 16 2 25 3 2 21 15 6 26 13 5 0 10 11 £ s. d. 164 1 5 155 3 10 144 2 1 143 16 7 218 15 6 192 6 5 160 0 0 182 8 9 165 9 5 203 11 9 2 0 4 £ s. d. 1 14 2 4 15 2 10 3 8 15 3 2 3 5 3 7 1 2 18 0 3 8 9 5 11 2 8 16 0 0 4 4 10 5 £ s. d. 162 7 3 150 8 8 143 1 10 135 1 4 216 12 1 188 19 4 157 2 0 179 0 0 159 18 3 195 10 3 2 0 0 £ s. d. 129 4 5 122 19 9 126 3 4 112 3 1 188 13 5 158 14 0 119 8 10 141 6 9 126 18 1 161 7 5 1 17 3 £ s. d. £ s. d. 33 2 10 27 8 11 16 18 6 22 18 3 27 18 8 30 5 4 37 13 2 37 13 3 33 0 2 34 2 10 0 2 9 2 5 3 23 18 2 173 13 11 169 3 6 137 2 4 32 1 2

H—7

Table XIII— Expenditure by Ministry of Works on Buildings, etc., for the Provision of Mental Hygiene During the Financial Year Ended 31st March, 1949

26

Hospitals. Set Expenditure for Year Ended 31st March, 1949. • Avondale (Auckland) Sunnyside (Christchurch) Seaview (Hokitika) Nelson and Stoke Porirua Kingseat Seacliff Tokanui Marton Levin . . . J . . £ 1,974 2,530 680 2,190 L 61,671 12,977 30,348 4,884 67,749 2,019 «\ 187,022 f

H—7

Table XIV—Total Expenditure by Ministry of Works for Buildings and Equipment at Each Hospital From 1st July, 1877, to 31st March, 1949

Approximate Cost of Paper.—Preparation, not given : printing (693 copies), £9O.

By Authority: R. E. Owen, Government Printer, Wellington.—l 949, Price 9cL.]

27

Hospitals. 1877-1939. 1939-40. . 1940-41. 1941-42. 1942-43. 1943-44. £ £ £ £ £ £ Avondale (Auckland) 241,529 7,118 2,659 885 327 1,983 Sunnyside (Christchurch) 390,464 17,252 13,326 6,815 1,885 2,210 Dunedin (The Camp) 4,891 Seaview (Hokitika) 103,304 26,793 10,233 23,944 3,842 125 Hornby 11,102 Motuihi Island 561 Napier .. 147 Nelson and Stoke 223,339 39,469 34,119 11,957 1,010 4 Kingseat (Puhitahi) 318,521 62,896 45,095 25,052 3,569 637 Seacliff 318,203 1,082 707 1,855 1,301 Tokanui 268,240 9,922 13,662 2,128 112 1 Waitati 32,321 Wellington 29,641 Porirua 397,489 10j 894 6,843 7,191 3,485 83,253 Marton 519 Levin Raventhorpe Totals 2,339,752 175,426 126,644 79,827 15,531 88,732 Total Net Expenditure Hospitals. 1944-45. 1945-46. 1946-47. 1947-48. 1948-49. 1st July, 1877, to 31st ] March, 1949. £ £ 1 £ £ £ £ Avondale (Auckland) 5,504 7,307 10,972 10,938 1,974 288,196 Sunnyside (Christchurch) 766 701 2,683 4,369 2,530 443,001 Dunedin (The Camp) 4,891 Seaview (Hokitika) 180 43 1,250 509 680 170,903 Hornby 11,102 Motuihi Island 561 Napier 147 Nelson and Stoke 37 1 5,840 1,518 2 j 190 319,484 Kingseat (Puhitahi) 424 1,487 3,985 8,936 12,977 483,579 Seacliff 6,526 24,918 16,155 25,752 30,348 426,847 Tokanui .. 1 1 8,065 4,884 307,016 Waitati 32,321 Wellington 29,641 Porirua 20^623 45,866 67,503 58,335 61,671 763,153 Marton 6,680 44,696 48,276 56,007 67,749 223,927 Levin 83,967 239 10,234 2,019 96,459 Raventhorpe 107,567 10,925 118,492 Totals 37,741 208,987 264,470 1 195,588 187,022 3,719,720