H.—7

14

Since February of last year the percentage of suicidal patients has risen from 2"3 to 49, adding largely to the anxieties of management. As many as 43 patients (19 males, 24 females) are under special-observation notices. Thirty-three patients (27 m., 6 f.) are detained under the section of the Act relating to criminals of unsound mind. I have before pointed out that these figures are deceptive, because of inaccuracy in the Act which makes it far-reaching, and does not alter the status after expiry of sentence. There are only 6 patients (1 in., 5 f.) confined to bed—one on account of her mental state, the others for physical ailments, which are being appropriately treated. There are no bed-sores. As against the above groups of patients who are either the subject of more or less anxiety or the object of nursing attentions, 90 men at Seaclili' and 7 at Waitati—that is, 216 per cent. —are allowed to go about unattended. The following return of employment is taken from the weekly journal:— Males. Females. Total. Farm ... ... ... ... ... 99 ... 99 Garden ... ... ... ... ... 86 ... 86 Workshops ... ... ... ... ... 22 ... 22 Wards ... ... ... ... ... 84 86 170 Kitchen ... ... ... ... 34 34 Laundry ... ... ... ... 23 23 Domestic duties ... ... ... 5 5 Needlework ... ... ... ... 19 19 Various employments, chiefly on the estate at Waitati 38 ... 38 Total employed ... ... ... 329 167 496 Unemployed ... ... ... 119 115 234 448 282 730 The records show that there have been the usual recreations on a liberal scale—picnics, dances, sports, boating, &c, visits to the theatre and circus in Dunedin; and 32 patients (20 m., 12 f.) visited the Christchurcli Exhibition in April last. One of these patients, telling me his experiences, spoke not of " Wonderland," but of the British Section, and the exhibits of the Mines and Agricultural Departments. He is incurably insane, but who can tell how much that excursion, which at this length of time can be intelligently recollected, has contributed to his contentment! The average number joining in active recreations is 241 (121 m., 120 f.). Though still disproportionate to these, the average attending divine service has doubled, and stands at 139 (83 m., 56 f.). The percentage of deaths on the total number under care is 65 (in., 74; f., so). The deaths were due to natural causes, save in the instances hereunder detailed. Two fatalities occurred in the case of men who had each spent over twenty years in the institution, and who had been trusted with liberty on parole for the last fifteen years. In one of these cases the patient was in the habit of fishing from a rock on the coast, where he was accidentally drowned. The other patient committed suicide by drowning. A recent case, described in the admission-papers as neither suicidal nor dangerous, was kept as a matter of treatment in the library ward with the best-behaved and most sensitive patients —the usual course with such patients. He seized a table-knife on sudden impulse and severed the carotids, the wound being immediately fatal. A quarrel between two patients resulted in one having his skull fractured. Secondary symptoms set in a fortnight later, and he died at the end of about three weeks. lam satisfied that in none of these cases could the event have been anticipated. The nursing staff consists of 55 attendants and 39 nurses, of whom 14 and 6, respectively, have been in the service for five years and upwards. Forty-five were eligible to enter for the Examination for the Registration of Mental Nurses, having served for a period of three years and upwards—32 being attendants and 13 nurses—of whom 14 (8 attendants, 6 nurses) submitted themselves for examination. During this inspection Dr. King and I conducted the viva voce part of the examination. The replies in some cases were disappointing, but the general average was good. Omitting deductions for absence on leave, the following are the relative numbers of the full nursing staff to patients: — Seacliff. Waitati. Day attendants ... ... ... ... Ito 9"9 Ito 4"6 Night attendants ... ... ... ... 1 to 101-5 1 to 42 Day nurses ... ... ■•• ••• ... Ito 7 - 8 Night nurses ... ... ... ... ... 1 to 94 Many works have been carried out and are in progress which will be recorded in the annual report. Future needs point to the development of the Waitati Estate and the reclamation of the tidal flat as an essential. With the large water-power at our disposal taken advantage of, the working-expenses of the institution will be reduced, and the establishment of a brick and tile industry will reduce the capital cost of buildings on the estate. These matters require to be gone into as soon as possible. The value of the fish caught during the year is £400-odd. The farm returns are excellent, and will be commented upon in the annual report. Nurse McDougall has received well-deserved promotion by being appointed Matron of Mount View Mental Hospital, and Nurse Sutherland has re-entered the service as Assistant Matron. One cannot fail to appreciate Dr. King's enthusiasm for the welfare of the institution in the best interests of the patients, or the service which such euthusiasm inspires.