H.—7

25

statements do not apply in order that the majority may be benefited has often been favourably commented upon. There is no doubt that when dealing' with patients not likely to injure themselves or others a brief self-found freedom beyond the gates in a world with which they are unable to adjust themselves is incomparably less unsettling than would be the case were they so kept that means of escape were impossible. There are 142 men and 109 women who do no work, being mentally or physically unfit. All the patients at Orokonui (35) work on the estate, and at Seacliff 182 men arc employed on the farm and gardens, 27 men work at trades, and 81 have ward duties, the remainder being employed in many useful offices. With the women the chief source of employment is in the wards (84), the laundry (24), and the kitchen (36). Though the value of the work done is not to be compared with the product of paid labour, in the aggregate something substantial is accomplished. This is, however, the least important aspect of the matter, the important factor being the tendency of work to subdue morbid manifestations and lead the energies into useful channels. This reaction on the organism is one of the chief therapeutic agencies in promoting the recovery of the recoverable and the contentment of the patients employed. The management of such an institution, were the patients idle, would be very difficult and costly, not because of the value of the work lost, but because the patients would certainly become noisy, complaining, troublesome, and often dangerous, and after allowing for the recovery of those who apparently recover under any circumstances it would be found that there was a larger residuum of chronic cases. This is a sufficient answer to persons who complain that they are charged (always, I may say, a sum within their means) for the maintenance of a relative who is employed. Supplementing treatment by employment there has been the usual round of active amusements. Sports have been held on eight occasions, there have been two dances, one a fancy-dress ball, and two picnics, one, being the big annual function. The record also tells of two house concerts and of parties going to Dunedin to the Agricultural Show, the Caledonian Sports, and a circus. The number attending Divine service (males, 38 ; females, 31) is considerably below the average. The general health of the establishment is good, only 2 patients being confined to bed. Analysing the cause of the 7 deaths which have taken place since the last visit, 3 are recorded as due to cerebral disease, complicated in one case by pneumonia, there are 2 others directly due to pneumonia, 1 to Bright's disease, and Ito cancer. It will be seen that the quota of excess of admissions over discharges and deaths is 11. The inevitable increment is a serious matter when the Hospital is full, and requires to be anticipated, otherwise works not directly associated with sleeping accommodation, but none the less necessary and usually designed to effect economy, have to be deferred. The policy of transferring patients when the accommodation is taxed in one mental hospital to a similar institution where additional accommodation for its particular district has been anticipated is undesirable, save for medical reasons. The newer accommodation will sooner be filled, and the older is relieved only for a short period. Further, there is a decided tendency to the accumulation of a disproportionate number of noisy and troublesome patients in the Hospital that had the excess, because such patients, being usually unfit to travel, are left behind. There has twice been such an exodus from Seacliff, which seems to have left its mark on the women's side. I regret to observe that the dormitory space is being gradually overtaxed, and that there are now 18 men and 22 women in excess of the statutory accommodation. A factor contributing is undoubtedly the larger number of rooms wanted for the additional staff necessitated by the liberal leave-allowance. To meet the immediate difficulty on the women's side, " The Cottage," which was built for and for many years has been used as a " reception house," is to accommodate the overflow of the nursing staff, and the patients will pass to the building known as " The.Retreat " at the auxiliary establishment at Orokonui. The Nurses' Home accommodates 20, 2 are now at the cottage, and not more than 10 are required to be at hand in the main building. The most practical way to me appears to add to the Nurses' Home and to the end of F4 ward. Similarly the excess on the men's side can best be overcome by the addition over the park, to which I alluded in the last report. The building should be in brick. These works once completed, anything in the meantime beyond minor extensions should be carried out at Orokonui, where we have a large estate possessing great potentialities. Concurrently with the difficulty of housing the increasing staff, the nurses' dining-room is now too small for present and future requirements. It is situate next the kitchen, and will conveniently supply pantry and store accommodation (which is much needed) when replaced by a suitable dining-room for the nurses. The best site for this seems, on the whole, to be the south-east corner of the court at the back of Fl ward. A propos of the nurses' dining-room I may here mention that, as usual, I inquired into the nurses' dietary. It may be remembered that towards the end of last session of Parliament a letter was read in the House which stated that the nurses' meals often consisted of only bread and butter, and that meat, when provided, was tough, ill cooked, and in fact unfit for consumption. Of course, nothing need be said to any one knowing the facts, but, lest a false impression may have been made upon persons not knowing the real state of things, I shall copy hereunder the menu for the Sunday before and the week previous to the present visit. I may also add that I have inspected the meals at odd times during this visit, and have always found them of excellent quality and well cooked :—

Usually, once a week, eggs for breakfast; cheese once a fortnight, in addition.

4—H. 7.

Breakfast. Dinner. Tea. Daily .. January 27 28 „ 29 30 „ 31 February 1 2 3 Porridge, tea, toast, &c. Pish Bacon Sausages ChopsJ Bacon 1 . . Chopslj .. „l.-i •• Bacon; Vegetables Roast, pudding Soup, roast, pudding Stew, milk pudding Roast beef, stewed fruit Soup, roast mutton Roast, pudding Soup, roast, pudding Lamb, apple pie .. Tea, toast, &c. Cold meat, scones. Cold meat. Hot meat. Cold meat, jam. Cold meat. 5> Hot meat. Cold meat, scones.