7

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December there were ],102 patients (647 males, 455 females) remaining in the institution. The average number resident during the year was 1,086 (619 males, 467 females). Fifty-three patients were discharged recovered, so the recovery-rate was only 21-6 of the number admitted. This is, no doubt, partly due to the fact that a great many of those admitted were incurable, and that a, certain number of those on probation failed to report themselves, and had to be recorded as " discharged unrecovered "in accordance with the Act; but a good many of those admitted towards the latter part of the year are convalescent, and will be discharged some time during the coming year, and. I fully anticipate that out- recovery-rate will be considerably higher in 1921. During the year 28 voluntary boarders (15 males and 13 females) were admitted, and at present there are 8 males and 14 females remaining. It is satisfactory to note that those who have once been here as voluntary boarders are always ready to come back when they fear a return of their trouble. Seventy-seven patients died. The chief causes of death were- senile decay, 17 ; and general paralysis, 15. The general health of the patients has been satisfactory, but there have been several cases of typhoid fever on the female side, with one death. I have little doubt that this outbreak has been due to a carrier, but so far we have not been successful in discovering who it is. The shortage in the nursing staff on the female side has been very acute during the year, and this has entailed considerable hardship on the responsible officers and, in fact, on all the staff. In September 50 female patients were transferred to Tokanui. This considerably relieved the congestion, but if the present rate of admission continues these numbers will be made up in the course of a few months, and something more will have been done to relieve the congestion. It is to be hoped that your suggestion to utilize the present engine-room block for kitchen, sculleries, &c, will be carried out in the near future ; we could then provide a suitable mess-room and recreation-room for the male attendants in the upstairs portion. This will, of course, involve the reorganization of the whole of the steam, plant, which is quite inadequate for present requirements. The engine originally built for a sawmill is totally unsuitable for electric-lighting work, and was in fact condemned years ago. It is now practically worn out, and is a constant source of worry and anxiety to the engine-room staff. This work must be regarded as one of urgent necessity. Although the initial expenditure must of necessity be heavy, a new and up-to-date plant will result in a material reduction in running-costs. I regret to record, the death of Mrs. Schoch, who was an Official Visitor for many years, and always took such an interest in the patients. Mr. Arnold, now a veteran, still manages to visit the institution from time to time, and shows as keen an interest in the welfare of patients as when I first knew him fifteen years ago. Mr. Bothamley has already shown himself to be a most conscientious Official Visitor, and I desire to record my appreciation of his assistance. The religious services have been well attended, and both the Anglican and Roman Catholic clergy visit the patients regularly. I much regretted losing the able assistance of my colleague Dr. Macpherson, who was transferred to Tokanui, but was fortunate in securing the services of Dr. Monaghan and later Dr. Blair. I have to thank Dr. Prins and other officers for their assistance. SUNNYSIDE MENTAL HOSPITAL. Dr. Crosby reports : — % I. have the honour to forward the following statistics in connection with the Christchurch Mental Hospital for the year 1920, during the latter eight months of which I was here. At the beginning of the year the number of patients on our books was 780, and at the end the number had risen to 788. The latter included 41 of those who had been allowed out on trial. The number of admissions for 1920 was 161, of which there were 63 men and 66 women admitted for the first time. The remainder of the admissions were either those who had suffered relapses or who had been transferred here from other institutions. The most prominent predisposing causes of insanity amongst the .161 admitted during the year 1920 were senility, heredity, ill health, and warstrain. As it is usual to find a low death-rate in one year followed by a high rate in the next, so it proved to be the case in 1.920. Of the 75 deaths that took place, 32 were due to senile decay; general paralysis of the insane, tuberculosis, and chest troubles were the chief cause of the balance. The total number of patients under care during the year was 941, the average number resident being 752. A good deal of illness was experienced throughout the year, more particularly in the female division. An outbreak of influenza at the beginning of winter was followed by cases of measles among the patients and nurses, continuing until well on into summer. The shortage of nurses during this time was much felt, so that the fact of the ordinary routine of the institution being kept going with fair efficiency reflects considerable credit on the Matron and nursing staff. On arriving here in May, 1920, I found the ward stock and patients' clothing in the male division to be in good order and sufficient quantity. In the female division this was not the case : therefore a considerable expenditure had to be incurred, which will be reflected by a rise in the maintenance rate for 1920. The interior of the main institution showed the great difficulty experienced during the war in getting ordinary repairs effected. Practically the whole of the male division requires replastering and repainting. On returning to Sunnyside after an absence of sixteen years one noted with, interest the progress and expansion that has taken place in that time, and one cordially acknowledges the wisdom of one's predecessors in this connection. Possibly the most vivid contrast to other days is to be found in the electric lighting of the institution. When one compares the dim illumination of former times with the brilliant flood of light obtainable now, one realizes how valuable an asset