H.—7

14

Ashburn Hall Licensed Mental Hospital. 23rd April, 1910. I visited this Mental Hospital on the 18th and 22nd, on the second date examining the candidates for registration as mental nurses. number of patients on the 18th was 51 (males, 27; females, 24), of which number 9 (m., 2; f., 7) were voluntary boarders. I spoke to all, and became the recipient of numerous expressions of good will towards the staff and management. No rational complaint was made. Indeed, the homelike aspect of the different units which compose the Hospital was intensified by the complete absence of noisiness and obtrusive supervision. I came upon little groups doing needlework, playing games, reading, writing, or otherwise occupied, with the supervising members of the staff taking part in the social life. This is a tribute to the example and administration of Dr. Alexander and Mrs. Milne, the Matron. The buildings were neat, clean, well furnished, and in excellent order, and the beautiful grounds continue to be well kept. At each visit one finds pieces of furniture replaced, buildings repainted, rooms repapered, and additions made for the comfort and convenience of the patients, giving evidence of a desire on the part of the proprietors to anticipate recommendations. The outdoor occupations and recreations are well considered. Quite a number of the patients play golf, tennis, and croquet. The value of fresh air in treatment is appreciated by keeping the patients out-of-doors as long as possible, and by having the living and bed rooms well ventilated. The food inspected was of good quality and was well served. As serving to show that refinements do not escape attention, in order that the breakfast bacon may be palatably thin a proper cutting-machine has been installed. Of matters, since the last visit, calling for report, such as casualties, the use of restraint, &c, history has been uneventful. The case-books continue to demonstrate the scientific manner in which treatment is carried out, and these and the other statutory books and registers are well kept and up to date.

MEDICAL SUPERINTENDENTS' REPORTS. AUCKLAND MENTAL HOSPITAL. Sir, — 1 have the honour to submit my report for 1909. Our population has increased during the year by 10 only. This was due chiefly to the decreased admissions, which totalled 155, of whom 102 were males and 53 females. It is fortunate that the number of admissions was so much reduced. It is not to be expected, however, that this lessened rate will be repeated during the coming year. I desire to draw your attention to the large numbers of both male and female refractory patients in this Hospital, and the necessity for "more adequate accommodation for this class. In this connection, too, I trust that at some early date an institution will be established fairly contiguous to our mental hospitals and under the same control where the mentally infirm and others less actively insane can be placed. We have a number of patients permanently resident, some hovering on the border-line, some subject to frequent relapses, and, while under institutional care, apparently normal between their attacks, but all of whom are incapable of earning their own livelihood beyond the reach of sympathetic and often expert supervision. These patients could be managed in a simpler institution, where there could be a general relaxation of that supervision and discipline which must necessarily be associated with a mental hospital, and where they would, under proper guidance, contribute largely towards their own support, On retrogression, or relapse, such patients could be replaced without formality in the mental hospitals, with which all along they would be nominally associated. I am convinced that such an institution would fill a want and lead to economy in administration. The chief contributing causes of the year's insanity were heredity (284 per cent.), alcoholism (142 per cent. —only 2 females), senility (B'4 per cent.), and epilepsy (sB per cent.). Of the males admitted, 29 were labourers, 9 were gum-diggers, 9 of no occupation, and 8 farmers. The other trades and occupations contributed only in units. Of the 53 females admitted, 49 were engaged in domestic duties. Of the males, 35 were married and 59 single. Of the females, 29 were married and 15 single. Deaths. —Males, 42; females, 17: an average on the number resident of S'OI per cent. The chief causes were senile decay, 10; tuberculosis, 9; general paralysis, 7. One death was due to typhoid fever. For some years past we have had one or two cases of typhoid in each year. The disease, however, has never assumed even a mild epidemic form. Recoveries. —Males, 50-9 per cent, ; females, 604 per cent: an average total of 543 per cent. There have been some serious accidents during the year, but no fatalities as a consequence. The usual outdoor work has been carried on successfully. Next year the Wolfe Home will engage a good deal of my attention. The staff has worked harmoniously and well. I gratefully acknowledge the help received from the Deputy-Inspector and Official Visitors, and also from the higher officers of the staff.