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Seacliff (£6,526) The water-supply has been improved. The erection of a new villa at Waitati should be completed at an early date. Marion (£6,680) Roading, water-supply, and drainage work have been carried out. It is expected that the building programme will soon be commenced. The Training of Psychiatric Nurses The passing of the Nurses and Midwives Registration Amendment Act, 1944, recognizes the status which is due to those who train to b .come proficient in nursing the mentally afflicted. The Department has provided courses of lectures, tuition, and training since 1907 on a progressively higher standard, but it has been felt that to attach to the diploma the status which it merits we should come into line with other branches of nursing and vest the conduct of the examination in the Nurses and Midwives Registration Board. With the introduction of the more recent methods of treatment, including the various forms of shock therapy and the spread of occupational therapy, throughout our hospitals, there has been instituted a greater individualization of treatment and a corresponding requirement of more knowledge on the part of the nurse, but in this, as, indeed, in all forms of social service the work becomes more congenial and easier in proportion to the intellectual as well as the humanitarian interest which can be brought to bear on it. It is essential for the proper training of nursing staff that our Matrons should hold the double general and psychiatric nursing qualification, and every encouragement is given to our nurses to take further training in the hope that they will return to fill the higher positions in our hospitals. We have, of course, to consider the claims of those of our staff who have given long and faithful service to the Department, but at several of our hospitals we already have doubly trained Matrons and many of our nurses are on special leave for general training. Conversely, with the wider recognition of the psychological aspects of physical illness, no nurse can be described as fully qualified unless she has spent at least some time in nursing psychiatric cases, and the logical result of the recent legislation should be the institution of some means whereby such training can be made available to all nurses. Shortage of Nurses I regret to say that there has been no material change from last year so far as staff shortage is concerned, and the main body of our nurses have to carry an undue burden. I have been greatly impressed upon my visits of inspection by the manner in which our nurses carry out their duties, and this I have pleasure in putting upon record. Service Patients The forecast made in my report of four years ago that there was " no reason to anticipate anything but a small incidence of mental disorders amongst our soldiers on active service overseas " is amply borne out by the figures compiled up to the end of 1944. The movements of service patients and boarders from the beginning of the war until the end of last year are shown in the following table :— Admitted after Overseas Service. Admitted from Camps, &c, in New Zealand. Admitted .. .. .. .. 190 Admitted .. .. .. .. 167 Discharged recovered .. .. .. 82 Discharged recovered .. .. .. 78 Discharged, not recovered .. .. .. 26 Discharged, not recovered .. .. .. 25 Died .. .. .. .. .. 4 Died .. .. .. .. .. 8 — 112 — 111 Remaining .. .. .. .. 78 Remaining .. .. .. .. 56 Our figures are much in accord with the experiences in Great Britain, where several mental hospitals and homes for defectives were taken over for war hospitals. This caused overcrowding in these institutions, " but, fortunately, the demand for beds for certifiable mental cases tended to diminish rather than to increase " (Mackintosh). These figures, it is true, do not tell the whole story, and there are many cases of psycho neurosis which do not come within the purview of this report, although many of the patients are being seen and treated by officers of this Department, but again in respect of the psycho neuroses there is no need for public uneasiness. The psycho neuroses of war are for the most part reactive in character, their treatment is simpler, and the outlook better than those arising from peacetime conditions. Medical Staff The steadily increasing demands upon the Department for psychiatric service outside our mental hospitals, the institution of newer and more intensive forms of treatment, and the immediate prospect of new mental hospitals and institutions for defective children make it necessary for me to ask that attention be given to the need for increasing our medical staff which is at present hopelessly inadequate to maintain a proper standard of treatment and care.

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