EL—7.

Roentgen rays, and. drugs. Concerning the use of drugs, I may say at once that nothing struck me more forcibly throughout the whole course of my investigations, both in the New and Old Worlds, than the excessive resort to sedative and hypnotic drugs for inducing rest and sleep, where we in New Zealand have been in the habit not of repressing but of rather giving fair play to normal activities, and thus aiding nature to restore the normal balance and re-establish health of body and mind. " I paid visits of inspection to every class of institution for the prevention of insanity, and for the care and treatment of the insane in all stages, including Behaviour Clinics, Psychopathic Hospitals and other such institutions ; and, while one recognizes that most methods have something to recommend them, I am more convinced than ever that in New Zealand our main resources for treatment are to be found in full facilities for ensuring the primary essentials— namely, fresh air, sunshine, hydro-therapy in its broadest sense, suitable diet, exercise, recreation, rest, and. sleep —everything, indeed, conducive to the establishment of active regular daily habits and the restoration of full enjoyment of the daytime—thus inclining the organism to the normal reaction of sound, refreshing sleep at night. " (b) It would be utterly futile and impracticable to adopt slavishly and blindly any of the various systems of dealing with mental disease followed in other countries. No two countries are alike in detail, and each has of necessity evolved, in this as in other matters, more or less in accordance with its own geographical, climatic, social, racial, and economic circumstances. " I have fully discussed with many of the leading alienists throughout the world the scheme outlined by yourself (as Inspector-General) in your reports for 1925 and 1926, and now being carried into effect, and they expressed general approval of the proposals as being on sound, progressive lines, and, in their opinion, admirably adapted to ensure the best results under our favourable New Zealand conditions. " (c) It is imperatively necessary that some provision be made in connection with our General Hospitals —particularly in the main centres —for the immediate reception, detention, and, when necessary, the certification of mental cases in the early stages. In many countries large so-called " Psychopathic Hospitals " have been established in order to meet this need —as well as to avoid the need of resorting to certification, when safely avoidable, and to afford teaching facilities for students. However, on the whole, my impression of these places was not favourable. They are extremely expensive to erect and to administer ; and in practically every instance their proper function, as hospitals designed to benefit the patients, appeared to me to have been almost lost sight of in the endeavour io facilitate the teaching of students. It was interesting to learn from the Directors of most of these Hospitals that they find themselves already faced with the question of ' stigma,' which by the very creation of these separate and specially named institutions (namely, ' Psychopathic Hospitals ') they had hoped to avoid. " I am satisfied that our requirements in this direction can be best met by the erection at the General Hospitals, in the main centres, of small detached blocks to accommodate, say, from six to twelve patients and staff. The smaller provision would certainly suffice in the meantime, and it would soon be seen what number of beds would be needed in each centre. " Admission to these quarters should be by provisional order or voluntary request, and the Magistrate could' visit, say, once or twice a week, or oftener, to certify when necessary. Personally, I should prefer, if practicable, to introduce the Canadian system —i.e., certification by doctors, and no judicial intervention ; but it is'doubtful if public opinion has yet reached the stage to enable this to be done in New Zealand. " (d) The ' Villa System 'of mental hospitals, with its large measure of freedom to patients (on parole), and the abolition of all yards and enclosed spaces, is gradually being recognized as likely to afford the greatest comfort to patients, and to promote their contentment and well-being by facilitating proper classification, &c. " A system of classification which has proved ideal in some respects is in vogue at Gheel in Belgium and at Lier in Norway. Here patients do not enter a mental hospital unless they become so acute as to be unmanageable. They reside in groups of twos and threes with families in the neighbourhood. I visited both Gheel and Lier and was greatly impressed with the obvious advantages both to the patients and the ratepayers; but the system is unsuited to our conditions here, and I feel that we must be content with the next best—viz., the ' Villa System.' " Comment on Dr. Grays Interim Report. It was fortunate indeed that Dr. Gray returned just in time to enable the above summary to be included in the present Annual Report. The mission with which he was sent out last August, by the Government, was to make a world-wide, practical investigation and research into what was being done elsewhere to cope with the growing manifestations of lack of control and breakdown (on mental, emotional, and moral planes) due to the increasing artificialities, stress, and complexities of modern ]jf e manifestations of weakness and failure which embrace consideration not only of everything appertaining to the prevention and practical care and treatment of neurasthenia and insanity in general, but also the still more difficult problems inquired into and reported on in 1924 by the New Zealand " Committee of Inquiry into Mental Defectives and Sexual Offenders." Dr. Gray's special qualifications for undertaking the highly responsible task with which he was entrusted when he set out were unquestionable, and this, of course, makes his present more matured opinions and conclusions peculiarly valuable. It would be out of place for me to. anticipate, in any way, what he may have to say in his full report, especially that portion of his report which will deal with the problem of sexual offenders, and procreation of degenerates.

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