H.—7.

Weekly Conjoint Out-patient Clinics for Nervous Cases at the General Hospitals. Nothing but good has come of the weekly " Out-patient Clinics for Nervous Affections " which we commenced some two years ago at and in conjunction with the main General Hospitals. As might have been expected, the benefit has proved to be proportionate to the encouragement and support given to this work by the respective Hospital Authorities at the four centres. The Mental Hospitals Department greatly appreciates the frank and friendly spirit of professional co-operation in which their representatives attending the clinics have been received and welcomed at the General Hospitals. The following letters need no explanation : — Auckland General Hospital, 26th May, 1027. The Director-General of Mental Hospitals, Wellington. Dear Sir, — A Psychiatric Clinic has been in operation for some time at the Auckland Hospital, and is proving of considerable service to the community. Tn my last annual report I drew the attention of my Board to the good work that is being done. It is now a matter of general knowledge that such a clinic is being held; and the service is taken advantage of not only by members of the medical profession, but by people who come of their own accord. Parents with mentally defective children are particularly anxious to obtain advice at this clinic. Tn dealing with returned soldiers afflcted with various forms of psychic disorder the clinic is extremely useful, and is a means of keeping in touch with these sad cases, who require specially skilled and sympathetic direction. As regards the Hospital, we find the advice of Dr. Prins (Medical Superintendent, Auckland Mental Hospital) a great help in the elucidation of some of the knotty problems associated with patients who may be mentally abnormal. Dr. Prins is, by his tact and sound judgment, doing us a great service, and there is no doubt that the Psychiatric Clinic is a potent factor for good. Yours faithfully, C. E. Maocttre, Medical Superintendent. Waikato Hospital Board, Box 14, Hamilton, 20th May, 1927. The Inspector-General, Mental Defectives, Wellington. Dear Sir,— I am instructed to ask if your Department will consent to Dr. Macpherson, the Medical Superintendent of the Mental Hospital, Tokanui, consulting, when required, with the Board's Medical Superintendent on border-line cases, &c., at the Waikato Hospital. Such an arrangement would be very much appreciated by Dr. Gower and his staff, and would materially strengthen their hands in dealing with doubtful mental cases. The Board, of course, will undertake to pay the necessary travelling-expenses incurred. Yours faithfully, G. W. Johnson, Secretary. Provision for Temporary Lodgment of Alleged Mental Patients in Special Quarters in General Hospitals, pending Examination and Decision. It is to be regretted that, so far, nothing adequate has resulted from the efforts of the Department to ensure suitable provision in the General Hospitals for the temporary lodgment and accommodation of persons alleged to be insane, pending examination by the appointed judicial and medical authorities. This beneficient provision, it is earnestly hoped, will be made during the current year, along with radical improvement in the whole arrangements for dealing with patients prior to their admission to our mental hospitals, so as to prevent completely the unfortunate impression and suggestion of delinquency or criminality. It is, of course, obvious that persons suffering from mental impairment, or so-called " nervous breakdown," should be carefully screened from anything seeming to imply or suggest moral degeneracy or depravity. In the above matter we have been assured of the sympathy and hearty co-operation of the Commissioner of Police. It has long been the official instruction that police officers occupied in escorting mental patients do not wear uniforms, and the use of police vans has been exceptional. However, it is now arranged that even where a patient is refractory or difficult to manage, the Mental Hospitals Department will meet the cost of conveyance by taxi, thus completely doing away with the use of police vans. Degenerates and Sexual Offenders. As my colleague Dr. Theodore Gray (Deputy Inspector-General) has been earnestly engaged for nearly a year making investigations at Home and abroad into the practical problems which concern not only the care and treatment of the insane, but which bear also on the best practical means of dealing with people on the border-land between insanity and mere degeneracy or delinquency, I am glad to insert here the following short summary which he has kindly written in response to my request for an interim report: — Dr. Theodore Gray's Interim Summary Report. " During my recent tour of the United States, Canada, Great Britain, and the Continent of Europe my inquiries were directed towards two main fields—the Problem of the Feeble-minded, and the Care and Treatment of the Insane. " I am engaged in compiling a special report on these matters to the Hon. the Minister, but in the meantime I may briefly indicate some of the broad conclusions at which I have arrived. " (a) Throughout the world there is no known method of successfully treating or curing insane people which is not already being practised in our own mental hospitals. " I visited thirteen countries and almost one hundred institutions, and discussed this question with many leading alienists. I studied treatment in all its various phases and fashions, including hydro-therapy, so-called " occupational-therapy," and the use of electricity, ultra-violet rays,

2