3

H.—7

Admissions. Exclusive of 148 patients (m., 135 ; f., 13) transferred from one institution to another, the admissions numbered 839 (m., 458 ; f., 381), as against 765 (m., 448 ; f., 317) in the previous year, an increase of 74. Of the 839, those admitted for the first time numbered 694 (m,., 402 ; f., 292), the remainder 145 (m., 56 ; f., 89), representing patients who had been in one or other of the mental hospitals. To the first admissions 14 immigrants, who became insane within a year of landing here, contributed. Of this number, 3 men and 4 women came from the United Kingdom, of whom 1 man and 1 woman had had previous attacks of insanity, and 2 men came from the Commonwealth. In addition, 4 NewZealanders (2 men and 2 women), of whom 1 man and 1 woman had had previous attacks of insanity, were admitted shortly after their return from residence abroad. One [man was admitted from Raro tonga. Ratio of Admissions to Population. Excluding the Native race (12 male and 5 female patients) and all transfers, the proportion'of admissions (whether first or not) and first admissions to the estimated general population at the end of the year stands respectively at 7-91 and 6-52 per 10,000 ; or, in other words, every 1,264 persons in the general population contributed an admission, and every 1,535 a first admission.

W As a measure of the increase of patients under the Act in relation to the increase in the poputable is more accurate than figures detailing the proportion of total mentally defective to the population. The first division in each section deals with all patients placed on the register, during the periods ; the second separates from the first patients whose names were placed on the register for the first time. As one attack of insanity predisposes to another, the return of many patients after a period of freedom is not surprising, but an increase in the ratio of first admissions is of more serious import. During the last thirty-seven years there has been 1 readmission among every 4-64 admissions, or 1 relapse of a patient discharged recovered or return of 1 discharged unrecovered for every 2-69 discharges —that is, cases discharged, not persons, for persons labouring under the recurrent forms of disorder will have been discharged and readmitted more than once. The general tendency, as demonstrated by the proportions at the quinquennia, indicates an increase, of occurring insanity in excess of the increase in the population. It should be remembered, however, that our population is materially augmented by ready-made adults, persons no longer immune by age, who have during their period of immunity diluted, so to speak, the statistics of some other country. It should also be pointed out that the Mental Defectives Act, 1911, spreads its net wider than the Lunatics Act, and even during the year under review the difference is appreciable in the larger admission rate of persons mentally infirm through age or the decay of their faculties. In this connection the following excerpt from the Official Year-book for 1912 is interesting : " The declining proportions at the earlier ages 0-19 years may be ascribed to a falling birth-rate, while the increase at the higher ages is due to the advanced age of the then mostly adult immigrants introduced during the early stages of settlement. These form the greater proportion of the groups sixty years and over, numbering 70, 741 persons in 1911, of whom only 3,862 were New-Zealand-born. The latter element in the population is assuming larger proportions each year, while the influence of the numbers recruited from abroad on the age constitution is gradually waning." The last paragraph is hopeful as indicating an approach to a relatively more normal distribution of the population at different ages. With regard to our admissions, we are actually dealing with small numbers to which the addition of a few from any cause, such as an influx of adults and the advancing age of earlier settlers, makes a material difference. In England and Wales during 1910, every 10,000 of the general population contributed 5 first admissions and 6-04 total admissions. Discharges and Deaths. Omitting transfers, where discharge from one institution is coincident with admission into another, the number of cases discharged from the mental hospitals was 402 (m,., 212 ; f., 190), and the deaths numbered 280 (m., 193 ; f., 87). The total number under care during the year, deducting transfers, was 4,595 (m., 2,678 ; f., 1,917). The corresponding figures for the previous year were 376, 303,

Ratio to 10,000 of Population of Number of Persons in Population contributing Year, Admissions. First Admissions. One Admission. One First Admission. ! Quinquennial average. 1902-1906 Quinquennial average, 1907-1911 Jecennial average, 1902-1911 6-86 7-33 5-59 5 93 1,459 1,364 1,788 1,688 7-11 5-77 1,407 1,733 .912 7 91 6-52 1,264 1,535