1 9 ~ 4.

VICTOHIA.

HOSPITALS FOil THE INSANE.

REPORT OJ.' 'I'HE

INSPEC'J10 R-G~JNERAL ()_F THE INSA~rE

FOR THE YF:AR ENDED 31sT DECEYIREH,

19 2 3.

PRESENTED '1'0 R0'1'H HtH.JiH£S OF PARLIA~IF.NT PURRlJAt\'1' TO AC'l' 6 GEO. V., ~o. 268i, 8EG'T10N 19.

~tl ,S..utiHrit!_!:

H, J, GREE~~, t'JOVF.RXliEST PRI~TF,R1 11ELB0URNK..

No. 1.-[le. Su.].-!<ZO.

•

REPOT1'T.

LUNACY DBI'ART:\IJ<:NT,

J nspector-General' s Office, l llrl Tr<>asury Buildings, Spring-street,

:\felh01trne, 27th August, 1924.

To the llonomlile the Chi~!' /:ir,crettu;f.

Sm, 1 have the honour to present i;he ;\.m,ual Heport of this Department for the

vcar 1923. ' In contra-distinction to the previous year, there l1as heen a very small addition to the numbers of registered insane in this Rtate; indeed, there is actually a diminution in the numbers nnder eare in the Hospitals for Illl!ane, resulting in a satisfactory improvement in the ratio of the insane to the population of the State. This ratio is now one insane person to every 265 of tlw ;;reneral population. At the encf of 1911, the ratio was as high as one to 245 · 3.

There are now in the State HospitalH 5.:341 persons, a8 against 5,386 last year, i.e., a decrease of 45, of whom 38 are male and 7 female. On the other hand, there ,ue 551 patients ont on trial leave, 134 are hoarde<l out, 81 arc in Private Licensed Houses. 16 being out on trial leave from the lat.ter lnstitlltions, so that the total number of the ·registered insane is now 6,12:1 an increase of 22 on last year's return. H must also be remembered that th<'re are voluntary boarcler patients and .Military Mental cases to be taken into consideration, hut these are not included amongst the returns of the registered civilian insane. There were 53 voiLmtary boarder patients and 127 :\iilitary Ment.al cases under cam, also 81 patients re.sidcnt in the various Receiving Houses on 31st December, 1923.

The diminution in the number resident at the end. oi the year is attributable to the following causes :-Slightly lower admission rates to both Hospitals and Heceiving Houses; an improved discharge rate; ami an increased death rate. These factors will he referred to more fully elsewhere in this Report.

The past year is distinguished by certain events, important as far as this Department is concerned. lt has been recognized that new buildings providing additional accommodation for patients are very necessary, and the principle. has been accepted that such works should he paid for out of loan moneys. At Mont Park the first N ur,es' Home has been established. giving quarters for the female nursing staff entirely separate from the wards. The ultimate retiring age for employees has been made uniform with that in other branches of the Public Service. An increase in the salaries and wages of practically all officers has been granted, as well as an increase in the leave scale. Authority was given for the appointment of a full-time qualified dentist to certain of the metropolitan hospitals. Further funds were provided for the full equipment of t.he new Tnstitution at l\lont Park, hut a rat.ification of a tentative agreement between .Federal and State Govermnents, whereby the immediate care of the Military i\[ental cases would pass into the hands of the bma(Oy Department, had not beeu read1ed, tlwreby mwcssitating a further postponement of the evacuation of Yarra Bend.

Jt has further been accepted as a principle that a new State Hospital should be provided to serve the Gippsland area in the immediate future. Provision has also been made. for an increased expendit-ure on the Repnir Vol'e, and this will require to be renewed for some years to come.

1 have the honour to be, Sir~

Y ou1· obt'dient servant,

\V. ERJ:.i"EST JONES, Inspector-General of the llll!!l.lle.

TADLK I.-Showing tlle Distribution of the Insan~ on 3 I at December, 192 3·

Resident in tJw Ilospitaf for the Inanntt at-

Ynrrn Bend ... ... .. . Kew ... ... ... .. . Kew Idiot. Asylum ... ... ... Anmt ... ... .. ... He€-chworth ... ... ... Sun bury ... ... ... ... Bnllaral. ... ... ... Hoyal I-> ark ... ... .. . Mont Park .. ... ..

Out on trial leave ftom the H0.a:p!tal for Insane at-

Yu.rra Bend ... Kew "" ... Kew hliot A:sy!11u1 ... Arul'a.t ... ... Beechworlh ... Sunlmry ... ... Bn.llarat ... ... Hoyal Park ... :Mont Pn.rk ...

Bollrded out from t-he Ho::;pital

Yarra :BenU 1\ew ... Kcw Idiot Asylum An1rat ... Beech worth Sunbury .BaUarn.t Boyal Park Mont Par·k

...

...

...

...

... "" ... .. . ... ... .. .

. . ... ... .. .

... ... ... .. ... ...

li:n· Insane nt-

Total number ofregistel'<'tl Jutmtic~:~ 011

the books of tl1e PuJ1Hc Hospi!al? for the Insane . . . . ..

Retsident in the Licensed Hou~c-

St,. Helen~ .. . Mount ldn. .. . :Merton Gfen Holme The Tofts ...

Ont on trial letn·e from tl:e Lieensed House-

St. Helf'nS .•. >tonot hla Marton Glen Holme The Tofts •..

Total number of registered lunatiel!l in tbe State

I I I

I

l{Q\4;!&,

----·

!SJ +96 18z Hl J68 474 219

39 z88

J2

57 19 4 7

54 22

tS

59

5~

9

!2

4

2

Female~.

----·

377 39' ljf

'56 272

sz• 47• ss

2Jl

41 66 ll

; '7 JS JO 53 !8

3 2

J I 29

10

12

20

19

I

+ --i ...

I 3 l 5 2

'£olal.

;6o 888 35l 599 640 995 690

97 519

73 123

JO 9

24 92 ;z 71 7i

3 3 ...

... I

22

t6 20

'9 +

2

4 3 5 2 r-.. -.

I

Male~. Females.

•

2,)92 2·749

2{1 2 79

68 66

2.,93 2

t6 6· '

J I J ----2,951 3, I]Z

"-~-·---- ·---------··~-···

Excluding Volnutary Boarders (19 malee. and 44 females) and Soldiers (127).

""'

;.341

551

I

13f

6,oz6

81

!6

6,123

5

TABU£ !I.-Showing dte Admi..;:stons, lW-<ldmi&."iuns~ Discharges, and Den.th~ •iuring the Yenr en.Iad JUt December, 192 J·

Males.

1-·-In the Hoiipitnls, 1:-;t January, On trial Hoarded out

'9"~:: I Total Humber 011 hoQks1 tst:

tTa.nunry, 192:3 . Cases u.dmitterl~

First admisBiOD8 3 7 9 •Not first admission~ 91

E8C'apeJ pa.tiellts retaken ...

Tota.l case}! adrrtiLh..·d ,[uriug the year

Tolul case::. under can· dnrin:,r the year

Cases discharged-· Re(•overed ... Relieved

tNot improvoJ Died ...

Tot.al C[t.ij(JS discho.rged died du1•ing the year

Remaining in the 1-lo.!ipital::1

December, 1923 .Patients ou Je~we ...

" bou.ni ed out ... ,

Total number oo hook~:~, 3 1 bt : Deeernber, 192 3

Average uutnbet· resi1leut duJ·i11g the ycn.r

Persona uude1· care dm·ing the year Penuniio N.1lmittcd 1-'ersons recovered Transferred from one HcspitHI fur

Insane to anot.her

i<'emu.le~.!

; Z,iS6 ' z6o

7"

+70 I 357 66

2!592 2 ·749 27:2 279 6s 66

• lr1cluding ~ransfers from lkensed housn.

1 Jndudln;c tJ·J.nsfers to :icensed hon~e~.

536 i j6t 898 ---1-······-,---

z,6t6 1~ '7)0 5d76 3.l75 M43 6,8!8

46R J"" )i gz5 106 98 Z04

JOJ 8-I J90

T A.HLE 111.-:Showing the PreviQus Attacks among Peri'!QUB Admitt-ed dtwing the Year 19:t 3

Person&.

Have lHtd one attnek ... 88 7' •;9 Have had two attu.cks Zl 10 J I Have bad three attacks l 6 9 Have had fonr n.ttaeks + i Have bad five attackB or over t l

----

'LH~LE l V. -Showiuu Insn!ll:" un the BookR of the 1-'uhlie SoMlers \.r€ated nndet· the Jleutul Treatment

Books of the Pnblie Hosnitali-< for the Iu~ane arH!

for !Ju~ lnn::me aad the Pdvate Licensed IloHse;; at the end of each veat from 5· tiw Number of Pn1ionts in tbo Recdving Houses nwl V.-"'"anls, amf ahw the

Lil~nnsetl HouliCS at th(• e1Hl of each Year.

1900

l9CJJ

1902

f903 I ')Of

~190=' 1906

ti907 1905 1909 1910 19 I I

1912

'9' 3 !r914 §1911

19I6 1917 l9t8 1919 19".?.0

1921

1922

'9 2 3

Ye:tl'.

TI.vgln!ered lnil:llltt.

l j[{l~pi~.d- I> 'I ~I-f 111"111' \"111 .\Tt li•, u-•·1! ! 1'•11-(·~.

8oldleri>.

I \Inn.,.._~ ,,,,;

\\":ad~

1.f\uml>er.j ·rot..ll ,,r I

Rl·;..·i~t.et·ed llhT~,\-1.'. ' "'"' ~~ I

i Ul'l'llW 1 ]\,<;•n•:l-'o:',

I • ~! .\liol•.'..;,

2,2 ;;;(}

?,~o;

2,1q 2,3~ 1

2 •. ~

'·48+ z,_qs 2 ~5 57 z,6t <.

2 16 ~ 5 2t68 t

2,~82

Fl'HH](·<

2.!! 5 z. 19+ 2,19.1

"·'99 2~2·t9 2,)32 2!)89 7 -F3 2,4)/ 2, .. 1 S:; 2,~ K6 2,659 2); I 2

2,j92

z,8+3 z,SS; 2~911

TH:J]

+·399 h;::>J

"·5·;:· 4

+·I {,87 J f•90 I ~,o1 + s,oC); ;;z+ 1

S~lF..I s,.; ;u ;,6)1 5·72 9 5,767

IJ ZJ

22

JO JC 25 10

12

IZ

" I I

5 I -c

75

Sf 89 93 R6 Ro 79

1 ()+ 91 97

103 108 zcy 109

!05

9>' 95

+,39~"l

i,;oJ {·5+;

+·77' 4·93i ; ~ :::-5 z j.J I I

;,zoo 5,J49 ~t449 5,)79 ~~7 )6 ~~827 5,R6z

:,932 s,l:-l3J '' I 7+ l "o i 5,919 ~,026 5,915 T.i 1 71 1 85 J 6,ooo

,,85) 2,991 ;,8j6 16 91 5,937 z,888 z,:J+Z 1 5,83o I7 95 5,925 z,86g 2,973 f ;,84z Ii 99 5·"1f+' z,qo9 3,o8H i ;,997 2f So tc.~ 6~101

I 6,o26 1 -s ')7 6,121

--~.,

2

2

6

'T'>tll l.

3 3 6

+ lOZ

+ +2.l +;z

+ t ZQ

2 z I + + r60 1 ; z +II5l••· f! !+

+59 "' ... 12 IJ + 89 ... ... 19 22

+I+tJ ... I 2z z; +loo '9 r7 +r3o ...... 'z; zg +t;; ... . .. 1 .ib 25

+91 ... ... I 27 'l + .35 ~ .. . ! 29 29 +::u 16 +I! 1 20 31

+ 84 +68 21 J I + l 110 + z6 30

6.~ l20 +10

2

2

+ +7 JG

[

;o ~X

5 I 52 f;o

12 91 + 16 83

+ 160 87 +:t:J. 1? 81

.. Priv:lt(' T.il'f'H~NI U•~ll"E~ !'<'f'I}£\'H)!:"'" + lie<·('i\irti:. llou,e, lloy!:tl P::wk, nJ,e!U'I! Rrpknil><'r, 1907. t \"nhttil~n·l\,.,m••l•·r \:·1. 1n fr>L'!'I' Cl••JulJL~r. llJl+.

Voluut.arr Bon:rdtrs.

I

JTosvit.als tor thP lrmanr. l'riv~tl;' Liccn~td !IOtl~(·~. j Total.

-----1 _ .. , ~~:~ka. ' Fe-utala.l TotaL

I I

,. I " I 28 I t6 8 .•

: J I [ .j. .

rii ~

[ 2

+ 6

IJ I J 18 ['

' 'J [0

10 12

10 17 17 I J 3 4. Zl +4 ·Jl ... 5 5 .j-6 + 2 5 '9 . I 4 5 H -12 ~6 ... 8 8 5t + 20

26 2 'I r7 43 '' 23 7 2[ 28 51 + 8 26 5 21 z6j;z +1 18 + 28 12 .;o --~

'+ 1 , 2 19 I s1 +, ~ W;~r :\1\·nt:~\ Tn'alm' nt _Ay1 \11 (fl:l'i'eAUf...'"1mt. 10,1~

c:

.e ., c 0

·;;: .2: E .;: J! ~

< ..: f " z "-<

,!; ~ > c

~ ~ c

" -~ ~ g-:t ., i 0

==· "' -;;; >, s " ~ :'! ~

' -'"'":::-1i

~ ~

-5 " !l " :si " " -5

·;::

2 ~ " 3~ ~ ~ t •

~ " • " ~

• .;:

" "' ~ ~ ;,:;;; ~

£ = c ·;;: .?t

:;; " £ !;(

" " 0 -" -'XI

I > ~ ... ~ .. ,..

7

t".O orN C..O':C'-0 •rN +0 t--.t'I"'>N Q\'l;; ........ u:; QC....::; 0" ["' ?" U'"l\0 - ......., 0 00 (-_, ~~~?c I· i" f-~% 00 j, ~~~ (:t,;X: ~00

f'-.,....,O~J:;-- -!"--<0\C C\ 0"-- lf'l t--.. ~ '"'" - "'", +'<0 Q'\ N

0..00 (.,,'l:, h-.o if., c.. c-. o- (:;.. 0..

'J: 1 :::;-. ""' t'" n :xJ ,,.. .,.., t~ 0; :<; <D ~ v-.,.. -+V·· r-.. '" 0 r-..... =::. '?'t~ _,;~ :.-.oy :-9 :-7' ;:: !" ~~? :""":~!" -'f:''P % -+'N ('--'"·'' '-'.,C- N..Q -r-N',l·'C'C +0 a•,-..;; +-...,.. ~~•-~m~•m••••••••••••••

- l . 0 ry-;x.- :r,_ 0 ,.., .::: 0 \C ..... ..,:: o-,'0 0 '.h X- + '"' N ..., -

;.-, ~'"' i ,~ 0...;,.., + -t- N N :.r -<---'~< --~~~:!"~~:-..:::-.._~~~-~ -"~''-'"""'-"~''"--'

'1JJHI( ! I

N ~~- ><":>t<", '9 -OCN ...,. ....

'L I l- l"­+ ...--, ....... _.,...,

!I'''"'·..,,,,.-,.,;; -t:! X ~r-::;- 'X-'"' C'<t-.. 0 --:-r-.'-0 u- 1'l x~ + '"' - - ,..-,cr. + ,.... + ...,-,;..:, 00 o ~ ~ l

-r '~ < ~ ""· ~ l .<1~~ S' q" V -~ - , , , ~. ....-; <>-. + '"t'-,- +-,- + + '"t' + '" Jr or u-, >r, ''~'· !r <r o~. >r.

c>e """· ..... o ''"'"'"·+""""+:..,""v; "'0'>- o-.r,o-.O>'::: •-o •r 7 J • 0 14> 0 1'1 t.r l ~ 0 <.;;;; 0 +>C V -r ....--. f"'< ,'X; X -r N "''<

~oqo "1 NN ,...,--r--•-'"'*"''"·'.-.U'"l'.r---ct":-•• •••~••~•~~·~••~·r•~~· "~~""~"'-"-

N N 1r >r< + '"•~ n C'<. N ~ C'- •1"- + ~ {-..~ N 00 ,.. ,__.., 0 \() +'-C !·, J ~ Q N -+ :;;:> ! LA N ~Q:. <'l 0 0 - 0. N ,... N "" N N ~ "' <". t<"' ,..., ~<"' • .,.. ...,... + v-. •r •r,•.:; ,:: ~ ,e; >..n-0 \() ""- \()

~ ... ~~~~~~~~~~·~~~~~~~ --"-«~-"'"""·~'!""~ """""

!

J

1.0 r-1<.~:; u, ..... +t""- c o,... o-r-~·"<'\<'"'-"'-D o,.., 1"-'D Q +!"-<..,..\() !~'C- ::J'\"1--,.1-H">N\() 0'<"""-- _,.....-,-,-0'-N ·~ '':'u:'~ 1;-z: c:·q ~ ~ '': -:"'~ 1;-t·;-J;~ c:;::.o~:z:-.~- ~q +-+ + ..r + + -ot-•r '" '-" tn ,_....., ,, ,_...... ~--~ '""' '"'"' -..r.<r.tr, >r\() ''" ____ , --<-

"'''"'"",; I

'j\lj<lJ,

'6~[t!J~

+ ,.-_ ~ 0> N 0'- ....-; J •• -~ 0' N N ,.... lr - ~· '0 .., M ,..-,'.>': '"t' 0' :y.-. C\ ...,... --<..Q ,... .... .L. -,r. .... ,... ;;::-._ + r:f. - ...., (>I c-. + ! ~ C/j -::::"

'"': - ,.. N •::· ":"" '"!';: -r '':_ >C; r::: I.·Y~ :;<?~ '?- :::- 0~ ~ q': C'- ~ ~-NoNNNNNNNNoNNMNNN~NNN~~

0 1'-1 tl .... 0 .... ,et: ()'.- u: "'\() ""' + .... - 0.. 0 :z: -rif: + ...-::, v-,->J ....-::. N ;:-_ N I - {---..<;' 0 00 ::7'% \0 '--"' Q Q'. ..;.. t·- "'!"' t-~~MMMNMMMM~MMM+••M+N~ +

o-, <r ...--.-a e-. 1----. V 1 ,,--:;.c ... ,,. ...,... 0'. 0 N ..,.. <:n '"' H'\ • ..-, <." "7" ,_.., ll') >r. U', l ~ C\ () - - - - ~ - - - - ~

,... (;".. + W;; + '"'00 0 N - (> OC Q'. -f" N ,... '..0 ~NOM-MM-~-~-·-~·~~ - N ~ N N N H • N N ~ N N N N N N

lr- Q ":;:' l'-..tl: N ""I C"':Z: - •i"-; ....-,- U". I ,'.(J N CC I "'-C N •.r-. •r· oL ~r;OO \() 0'- '<'>-..£~ \0 l ~ c;:.u:e C'<:t:, ~ N '"''\0 o. ~;;t:J

-.,::; ! , -T-..;) r-~ t"' ~" . .J - + <..n::C ,.... ...-,I'· Q 0 V, C'< Q 00 Ch -1-_, N N N-. - 4- tr, lr, t.-, + "i'" ,.-, '"t' -1- «", -+ u-,\C 00 Q.'C "'1"

- 'Y:; ["-. ...... N tl <"' N \C if + 0 0 C \0 - <n N j-, N 0 ·::,tj N ,.. N N N N ...,- ...-, -1- •: .,.. N -1- lr; ""t- 11' --t" '""~ \0 \ ~'-0 V\ vt-

0;.00 -,..- t- () t<'1 :;- ~~c.t:- I - -t- C :10 Q :)0 ,,., ....., '--"'· N 1-._ --t''"' _,. 0\. ,_..., N f"-<, '"' ! '- ,_. C' ...-.,_ !-- - C C" N - Q 00 1 <'1 0> N Q.<X; Q t' ,.... <'<""• N N N N ,_ N ....< N N - N N N .., - ""' N - - rl

l;>'\ N Q'> +- N I"- N 0 + ...;- -t ._ M 0 Q ....-, 0 ~ 0 t<"> +00 : N,z; t.r.~l 0 N OX 0% ct--Q::fj ·:>- 0 (._ . .;!'; 0 '-"- "3'':'/'- •

I !

: !

_j 0

•~;uur~l{ ! --"'"~-~-"" ,_""_""_ -"--"-"-'"- ""~--- ~~""~ -"""" ----""- '"-- ""'-"----~

,,,,. I ~--~------

' 'S!Jjl:ut~_.{ ~

+\{) tr. """" ()'. - N ,....._ l"-'-0 ·---- ..,.. ~.., .... ... --- ...

,,.-,oo .,., 0 '-D t-, = oo v-- 0 •,.., ,....._ ;--, -«"', 0\ N Q\ - N (;' 0 OC• \·-..X I • 7J

:;r..; >r- N + 0 N I~ <I", 1r-, N -IJ"'"""000-0•rN ..,......,....,..++-+-r ..... -<i•

\C -.:- Jr-. + ....., N '..() «1- U' ff", -.,- Q • .., o. +......, 0 0 -r•x: \C 7:: ,....., t·-.. "T'"T+-+++""'·,.._·..,.."""'+-r-:

- N <:"", 'li: \F\\0 I~ 00 0' 0 - N .,..--, -t- U",\Q 1:'---00 C\ ::) - N ~. 0 Q 0 0 Q 0 0 0 0 ~ - - - ~ - - - - - N N N N ~~~~~~~~~~~~~~~~0~~~~~~ -- " ~ ---- ~ - ---- ~ -- - - . -- -

TABU~ Vl.-~howing the Atlmi,sious, Discharges, and Deaths, witil the .Menn Annual Mortality anJ 1->roport.ion of Recoveries and of HelleveJ pt:r ceut. of the

Admistlions for the Yeur end(Hl 31st December, 1923.

fi(l1lplt.al for the Il\1Uiin!'.

A•ltnittetl,

l>ischo.rged.

lllcJ.

net\•Ver~d I(P-liel·ed,

·---·---

.'l.veraNe ll!"uml1er li••w;~lning on tb.Jl fl'e~lden~; durin(t tno yt>nr

:JI"'' n~cemhrr, 19:3. 191.1. l'm"C£mtage of l:ttoml .. eriE'~

on A<\mlesion"· l'ercenta~:e M ne tl!:'l'lld

on AdmlsHf()ll"·

l'ereentPge cl J>eatbe (HI the Avetll!JO ~umbeu

lle~ldent.

·--- ~ 1 ~ ~ 11 ~ ~ 1 i ~ . - -----Yarra Bentl 90 31 LH t.f. 19 33 6 6 I 12 .

~ "

~ ~

3 ~ " ~

.f • ' :; " ~ ~

~

1 ::: ~ -;

~ . --·--- --. --·- I ] I ~ ~ ----- ~ ~ : ~ I _L

61'30127-z7 6·67 l9'.li 9·92 u ,415'f7 H·11

17"72~ 19"+4- 17'f<2 }2'66115')6 13'53 :13·98 ,'3"73

to·oo HJ·53 to·2c t3·8z I 6 43 J0'3C'

Kew 101 79 t8o 21 t~ 1 3) 18 10 :t.8

Kew Idiot 30 19, 4-9 Asylum

AraraL .H i to 6 t6 7

Beech worth 9 5 q. z

Hnnlmry ··~! 9). H 139 zo

Balltt.rat 37 44; 81 '4

Ro.yal Park 86 l20: 206 21

2 9

I J

IJ lJ

10 2f

li ;6

J

.i

7

2 5

' 9

; 12

I J I f

30 21 51 215

67 54 121 )j4

z6

32

'7

55

2)

3

11

t6

10

33

JS

5

);

4S

37

88

6t

8

201

HI

375

;86

2)0

57

pi 636 Z<S J8f 6z9 15'

460 I,Oif 495 Jh6

!82

1. (; I

290

590

530

Ill

JSJ I !88

6o81JSO •

66; i

1!1761

7gO

168

351

j82

ZIJ

++

lfl

z64

:!/8

)18

463

57

881 20'79

359

61f

629

J,coo

68o

IOI

:-o·oo 1 33

z:.·2:.>.

21 ·a;

37' 8j

l4' 42

;6· 25

21. f1

r6·67 6·zs 9'I.f, 6·o6 7·8z

7 · 69 1,.; 9 1 ; · 88

2J'i41 s·z6 9'C9· 6'4711-fl I 6'J7 S-8o

•9·6zl18'9z:n· q•8•.1o·; 9 8-zo 1 R- 9;

1.16 1o·R;- 6·8o 6 8z I 8'77 7'92 2:9'1/i zt•E8 I

MoutPark ... 1___::_9_[~1 _:_1 _+_1-1-l-,-'-•-3-1

1-5-!2[~ '3_~~- 2491

596 '54_ 229 _!~1 ;8·13_ 44'441-~J81_'_~6;i~~~J ZJ~~~~~~~~·;6 Total ... lf]0 1J5718z]l•o6l9s 204'4'144 s6'z76ll98i+H'·932.),09f.6,oz6z,6z61z,]50,S,376 zz·ssi27'45124'67 8'94 112'JZ'IC'40J,o·s· y·zo.S·Sz

""

'LUlLK VII.-~~htJ'\Vi£Jg in Quinqucnnia.llleriotiM th(~ Agesoftiwse Admitted, Re(•.on:~red~ Helitwed, Not ImprovE'tl, E.-tcaped not Retaken~ anti Died~ dnring t.he

Year I9Z3, and of th'lH>e Homf~jniug on 31st 1Jee€'tnlu.;r, 1923.

Dlacbarged. Aclml\td.

A;<<'~. Hw::F<'f:T\.-'~!. Hr·lilxe<L Nut Improved.

~b.!v. l'!';omal>•, T<,tll!, )!ale. V01m~le, TVhl.l. Male. F••nml'" 'l'ohW. MA}U. l<'emale.. Total,

PM!aped l'llotlents nn\ 1tetalro:u,

'In le. TotaJ.

Jlied.

:\1nl,•. F~m.~le· 'J<.ll->1.

nu,w\nlng 011 l'"~ lh<..wrnheT, !!J1'\.

:>.Tnlc. t'cnHII<'. Total.

------ ----- ---- --- ----- ---- --- ·--- __ , __ { 'mlcl' 5 )'C!Il d

5 yems and HUtk!' to yrar .. 10

I i 20

2)

30 31 40 45 so 55 6o 6) /0 75 So ss

"

"

"

"

00 " i.Jnk11owu .••

Total

O\'Br

I i 20

'5 30 31 40 45 so 55 6o

70

ss 10

..

..

.,

"

"

5 I 10 5 ~ -

zo 12

22

'i i' 2'} _10 40 .)Q JO +7 " !0 '9 37 1+ tS z; 14 ~~

17 " 16 '+ 10 + 3 3

I

2

10

I i I 5

2 l 2

9 6 ;; ') 12 St 12 + ;6 I' ,,

_;

69 <) xx l/ l ;

h9 I' 11

~t 10 i 'J r, 8 3 1 z 28 2 l

3J 2 I I+ 6

2

3 2 z I 5 3 ! g .. 5 + 9 16 ; 6 1 I 3

' J G 9 ' I 5 ; 10 I

_12 1 6 ,, l

,, i;

17 B j 12

'+ 2

l 2 2

_1 . ,_ z 2

3

:•

2

'I 1

"' i ... "' + 1 i 7

3 I l I 1 ',

~ I I 3 ~ + ... -t t(l

J I I , ,. l l j

2 "" :z :.q 2 2 ,.. :z l})

2 .•. ... 3~

1' 21 I B

'5 I J y (,

, z 8 7

z r,

10

,-1

z~

18 IS f7

'4 <I

7 6

9 3 6

I ~ I ('j

I 2

J 8 2) -n _," 35 --' ' +9 +I J5 +9 '4 10

12

s 26

3' 75

IJ5 191 260

J2 R Z~9 )22

~)0

'l 2

231

'47 Sz Jl z8 I)

I ••• 5 2 63 --- --- --- --- ··~ ·- -- --- -- ---.

7 20

z; 53 97

Lj )

235 323 3°5 360 ;p3.z

39' :z.St'l tj+ IO;"

5+ 12 I J 7

72

!2

+6 ,-"I t~S z,p: 336 49) 6 5 ,

59+ 6S:z

73 2

i 0 7 51 9 321 I 89 ss 6o zS

7 J 3:;

+70 357 :h; 1o6 98 .20.f +2 H· ~6 11 t r ·174 2,!)32 3,094 6,o26 --- -- --·- -----·- ~-- --- ·-- - - --- --~· --~ .--

1J n('l,pitals for tl1o I ll-"llne. :\lean Agt• , 4f · 9+ ;J 5 · p ++·By +:; ·oS.+ J · 6 5 1..3 · 4 3 · 3 8 .p · 2 ,· f-2 · 7 7 39 ·oS P)" o9 +3

ltliot Asylum, Mean AgT; ------------ -- -···- -- ------ ---1-----1----1-

10'4-0 <)'16, 9·96 •h ••• ... _r4· J)·;-c r_;·oo .•. ... ... I I

-----···--···--···-···-·-·-· ----·- --· ~-·-- ··--------

0:

- ----.ll-

'fA.IlLE VUL-Showiug t.he Prohnhle Causes of Insanity ht the Patients Admitted during the Year 19z3,

MORAL-Domestic Trouble l iudmling

loss of reb.tiveB nnJ friends) Adverse Circumstance.~ (in-.

~Ju,ting Lnsiuese anxief.1es and pecuniary difficulties) ...

)~ental Anxie1y f\IHl \Vony (not included under the a.hove two heads), und Over \-Vork •.. ·

Religions Ext·itemenf Love Aff<~ira (lnd11rli11g

;o:eduction) Fright. and :Se;Tollr; Sl,oek

PnYsJCAI..* luLemperance in Drink [ntempernrH'e (R<:XIti-11)

ne real Dit.ea::.e ... lf .. Abnse (6exunl) er Exertion ... nstroke ... cident. or ltljUI',\' egnnncy ...

...

... ...

. ..

...

Ve $e Ov Su Ac l'r P• rturitimJ tttul the l'uerplll'lli

state ... "'. . .. ctation ... ... Ln

Ute p,

rine n.nd Ovnrian Disonler lhel'ty ... ange of Life ... vera .. ... ivation

Ch Fe Pr 01 Jt

and Stnrvnt.ion d Age .. . .. her Bodily nisea.~es Disorders ... evinus Att.ncks ...

...

. ..

. .. ... ... or ... . .. Pr

He reditnry Inftneuces ne:cer-tuined (!lirect atHl colintcral) ngeuitu.l Defeut Mcertn.inetl htw ascer1ained Cat~:;p:; ... 1known .. ... nr Stmin ... ug Hnbit ... 1ilepsr ... ...

TtJrtd ... ... ... DeJont, for combined Causes

I

To~al Admissions ... i I

MhnlW<l0W! { :\(!, nf C'\'il?~-

iio _ll'.!"'~• H;FenalCd, &n Tobl. ~~~-

As l'rediepo~lng •w ,\,; Pt&ll~JNSit:~

Citns;;. A& Ev·!l-lllj.[Cfl.l!><l' E\dtln~ {•\hert> th<W' I'On:d not he <hR!IO •

;.:-ai<;h!id)

!'ilalt>, -~~~-m:~-~ 'rota! )la~e. I iJ"i?!l':l.k- ToLd,

+ ::c '+

+ 10 '+

2 3 2 I zS 2 2

If z 16

2 J ++ I 5 59 I6 16

... ... . .. ··- . .. . .. . .. ... ' . .. 8 ++ I +5 ... . .. ...

... i ... ... ... . .. ... ... I

. . ... ...

I ...

i ... I ... I ... ... . ..

. "' ... ... J ... I ... . .. ... [ .. I l 8 ... 8 ...

,i ... ...

... ... ... . .. z 2 . .. .. ..

2l I Zl ... ... ··- ... . ... "' . ... ... " ; ' ... .. . . .. ... ... ... ... I I ...

'

... . .. 7 I 8 1 3 10 '3 ... ... .. .

' K 8 ... z6 26 ... ... ... ... . .. . .. ... ... ... ... . .. •'-

. "' I I ' ... 2

i I

... ... 6i fO 101 ' I J 20 ... ... . "'

' 7 z 9 r8 '9 +7 4 ... 4

27 41 68 I . I I I 4 I 5

+' J8 86 ... .. .. . . ... ... 66 J6 102 8 8 16 ... ... . ..

I ... I 1 ... I ... ~·· ... '9 4 2J ... I I 21 2l 42 ...

i ... . .. ... ... ... ... . .. I ... ... .. I ... ... ... ... I ... .. .

... . .. ... ... . ... ... . .. ... .. .

... .. . ... . .. ... i ... ... . .. ...

... ... ... . .. ... . .. ... . .. ... .~

... .. . ... i

.. i ... ... ... ... i . .. i '

T ,-; ,,,

I M:J.l<•. ~Y~uw~eJ T<>illl .. --1-

I '

I + 20 '4

4 10 lj

Z2 ~ 1 I 2 2

If 2 I6

61 I" ' ;R

. .. ... ;z I ~J . .. ... . ..

I . .. I

I . .. I

9 . .. ' 9 -·· 2 2

"' . 2l 21

. .. 2 ' 2

... I I

' zo ll J I . .. H 34 .. ...

2 I ! 3 68 53 121

'9 3 l 6o 39 45 8+

' 48 ]8 86 ' I 74 44 !18

2 . .. ' 40 z6 66 . .. . .. .. .

' I ... ... . .. ... ... .. .

i-492 ]68 86o

H 11 33

470 357 827 I i -

Jl

T.a.:aut IX.-~howkll;.! the Form ,.J[ Meiital Disurdllr on A!imissiou iu the Admis~ions, Uccoveries, anJ Deaths for the Year 1923 1 an•l the Form of }fentnl Di~vrLlflr of the Patients remi:\,inin(t 011 Books un 3 t;;:t December. 1921.

I. Cor1genital nr infantile mCJJtnl deficiency (ttliocy or imheciliry) oecurring ns eArly ln Jae a~ it mm lw ohRervPd-

! AdmJSiliPU'

'

I " I .~ rr --1

1. lote!Jeetmd: (a) With epilep;y {f;) Witlwnt epH~p:-.y ... .. ·I' 5 .... i9

2. i\inral ,,. 1. fu~J:anlty Q~('WTing IHtcr in life--~

1, Iusmily wii-h Epilep('j.y .•• . .. 2. Genernl l':ualv~ls of tlw ln:,n.lJe ... ,,, ln.:S:tnlty of dte ~To11sN !;rain lcxin11:- ... 4. Acule llclirinw (:wute il(1lirlon:-; tltllHilt)

.}. Coufusiomd ln-,;nnit\ ... . .. {i. Stupor .. ~ ... 7, Pl'imat·,· lh:meudu. ... . .. K, Ma1tin!

(a) R12eeu1 (b) Chror:i<· (c) UccmTCil t,

i-1. ~IelnnclJi_)] ia : (a) Heet>nt ... (h) Chn.ui(' ""' le) Rec:urre11t ...

10. AlrerJUHiug fus:nlil.' l L Delnsiomd InsrulitY:

++ 6; 6 10

9 +

9

' (rt) Sy:'itcmrttized . 1 z J 5 17 (/•) ~()li·~YS.f(lTIUI.Iizpl] ••· •. 4\L ;c,.. lG;"

l:!. Votidouu.l Insanity: .. t·. I;···, ···,. (:!} Impul$P .•• ... . (b) Ohse:::"iOtJ ... •.. .. (c) Dt,ubt ... ... ·

1:3. :\fora! l11Si.U1ity .. ... ... 1: ··; 1··· ' .. ~

I Z 9

2/ 22 49 .........

' ~I I I

l ~' ·~·!! z ~

, I p

f{(~!m.inm~ on nook~.

---..--:-··

T I z:

)6;1 ... '

i lCQ1

)Si t6j

si J.

,;c,t,

I 1 RJ 3 2 i

+' !

.,,j

99

'I9 s

12

.. 11

21

l\1~, , ; I

I (j. 'I '9.

' ' .p'

+31 '71

''I '.~;1

I i '

~· :: 'I

::;

l.

ll I

figz

221'

13 zS

3' 1 37 101

6; ; z

•+ 2 -~

+ l .J. Detnentia : . .. j (a) SenHe ... ... ... 6c 1 +~ 105 : 1 z -:-6 51 ufi I7f 2.69! ++J (b) Seeotnlary •11' 'l'ermitud ... "" 30 19 +9 l I z 36 24 6o 9Z~ H66i 1,791

15 • .:Sot Ct·llified ... ... •.. 1 ... 1 1 ... J ... ... ... ... 1 ••. i u•

Uu Trial. Lertve, or Bo1~nlcd 0111 ... .. ....... -=~ ~-~,:.:___· ___ 340] ~~ _ 62s

~ -· ---·--·l-'otu-.1-~.~--.. --~- --~··_ . ...:..~-·~-~-'~-;~_~,.~-~o_;_,_~.:_'_c_{,! 9; zq z;6~I~8j+;~...:-9lJ!~~~1-6,~~6 l'AHLE x.-Showing the conilitiou 88 to Marriage itl Pa.til'tJ;S Atlmi!let!: Repm·ered/ lkliaved, 1\nl lmpnH·etl,

.E~c:tpe.t not Herakcn, and Di{'d during tlw Yenr 1923. nml of P11tienL'I HemttiHin~ on /he hooks, 3Bt December, 192 J• ------~~-------~~ ----·----- -·~--~----~

LomJitlnll in ' lQ:fE>rcnce U>'

~t:Hril\ite. ! !

ti.ingle lb.rrletl 'r'v'itlowed Divor{'ed

"

Recovered.

F. : TNn!.~ ~1. j t•.

16 97, JS, 4-6' S7 20! 16 19

.: '

:'\ot lntpro,t:J.

V. Tnt_.!. .ll. F.

!\~NI <;tl i':.he•Jl~

:wt. fiHn.k•·:1.

19: 37' 8 6 q' 20' +0 2 +' 6: 2

7' I 12 zl ~z

+ l 2 'l 2 1C'

............... ;"·

F~ : To(n1,

'?l

+l

I: .... , .•. , r6 6 i -~ __ ..! ___ , ,-- .-1-l-·· --· s.:un Zj:tl ••. ll 250 i 18~ 4-3 i

l'atlen/1'. P.emalnin« J •~t· IH~c<'mber, 1cy1~.

210d~

57': 6()

+ 6J

',,653: 3,6ji 9;4' '·551 Z2l 290

1/ 21

4/i 1 IO

'-~-~--. z,73I I •.9"15,643

. -:-·-~· -·· - -·· --- ~~~ ~---~-·

C:.11.~e ,lf Dl'/lJh.

Di800.Sea of the N ervou 9 8ysrem-Mcnin~lti<4. Iufammatiun (>f Braln, t't>rebro- Spinar

l'>1cningitis .•. •.• ··• Genera.! Paralysis of llw lns:m(' Cerebral Softening .. Epilepsy a.ud ConvuJ,.imh; Ilf•mip.legi:t, Apoplexy, \ 'en~bml H:t•morrl\age, Ccn·hnd

!r:mhollflm ... ... ... • .. l)!h;;r Ol';nmlt Di"'cn~>csnf Brnln,indurhnu Tumnur,;; Exhau!>tion from Mania ur :'1.-lelancholitL, nDt r;tll~(;'d ny

:".'Prvoul> Ih~~·:u~;e otherwi;e del'iiornnted ... Puraplcgil~ and Disea;o;,·s of Corr!~. Locomott•r Al:n:ia ,\E>uriti." 11.ml! !(~uern! :·k!t>ro..,is of Nervvu~ Sy:;tuL

Dtseascs of Blood Y .:<JMI.tt-~~rtt:rhh~d<:l'<"•SiR, ;md oth('r (l\sca~c~;~ nut ill~ llisca><CI! of Nen't!U.S .Syfltem

Di.Beaae" of Respira!MJ/ Bg~;~tem a1od T.IJ.orru;-Pulmomtry Phrhisi~ }'nenmoni·l, Bronchitis, tHhel' forms

Di8euse.9 of Heart--Valvulnr J)ii!INlst•, Fatty .D~~g:vm·rn.tion, ( 'M·1liac Syncope, &c.

DtBt.asef!l of lJiges.tiT,'f. Sy8lf.7r~~ J)i!'Cil"'I!S of Mouth. Plmrynx. Sl~.rnal"h (noo-mnHgnant)

lntestin;;s, Li-nr, a.nd l'eriwrwum (nun-tubcrcttlar) Di.8erues of Geniio. Urina'f"'!l Sylltem--

Disc<t:<t:>1 vf l{iduey ~ B!adtk'r. Prostate. &c. Ot~HTal ])iotascs

Dy>wlltt.·ry (I 'olitis}, lCpid(•mic Dbrrhreu, r n recti n~ Ent 01 i1ls J)iarrhooa 1101 01JWl'Wi::>c til~sig-nCl.tCd Erysipela.s .•• ... . •. AhaeeRI'I, I'ya:nliu., Septica:mia., n.nd Ct:lliul!li~ 'l'yphoit1, Irrflut:>mm, and otlwr F'"Yer& ••• (::uwor, t:nrcinowfl, &rcoma, Malignant Di;,~;He, tJ:•·lu1l,.

i1t{l Maligmmt Tumonr o{ Jhain ,., Syphilis Al!d ojher VetWI't:n.l Dbease ... Grn>!rat Tuben~11losi" ami Tnl:wrelP nt urg:ml! othrr tlum

l,ul\1{!! Tt>tttmt>~ ... . •• Atrophy, l)(•bllity, ani! O!d Age

O<J,f"drexia Asrltcma Accidenlk Stricides

Total

TABbE XI.~Showing the Ca.use~ of Dnath~ tlnriug the Y.ear 1923. -YMI'll B\'tod. ~~~~w. K•w

Idiot A•.,vhuu. -"'t'i?llt. Ho~dtworth, Snal>nry. ttoral !',a.rk. ! :\hmt Park, I:Ullar,lt 'T'olal

- 1-

c I ' ci I I ci I ! I i ~ ~ ~ s:l~ ~ a:·g·] i.2 Jii.;::

cl ··1." "'." c " 1 ~1'1"'1·.~11 '1' "'I 1"1 I I•' J " ~~~ ~1']1~1'~1'§·1~1~1~1~ ,;i ~ ~ 41 il

:; ~ ..., "' : "' 'I &"" ;::: : ... Eo< .... .... ... :::: ::;;: ~ ..., ~1 ... ""' ;.. ... ::; ;;,I~ ~ ;.. ... ~ ;t.., f-<

--~-,-~ -r----1 ~· -,-r--=--r--r-1-

s '

' 9 I 4

4

;----- 1----~--~---

8 I •9

3 q

2

s

' 4

2

'

' 10

8

2 I 1.l

:1 ! z 2

3 2 r 4

lJ I :q

t6 2.4

4

2 2

4

2

l l 1 f) l i

'

' y

')

I

2 4

" I

"

I ! l \ <-

6

3

'!

' 6

1.)

6

z I z .1

f I I '! ;l

' ' 'l I ::.

' I 4

4

8 r; 1 !4- 6

... . , , I . I ... / . .. I

I

4

9 '

' 4

9 ' I

'

6 .i

'

'

ll

' 8

JC 6

"

4

6

8& 1-;- ~~7,-1.; 1 ;~ .~ :·~ ;; 1 ~·7 ;·, :·,~~ ~~·,- :~:-;;- 55

._:__:__~

A!:l(ltt'I:Ain\.-"<1 by P"~t-t;tm·tll11'11'.~:unimLtions--ma.1<-s. 1efi; imua\es HlO, Total, tB{i,

'

' '

'

'

'1 ;S

3

'

4

3 6

6

4

'

I 5

,,

I .. I ' i

'

I I ' I

' '

'

' 1 I 39

9

J 4

4 I H J. l 69

<0

37

' 6

:! l.j.

' 4 , 2

4

, I • 7 •' 4 . 5 5 I 14

5 8 4 &

6

,,

20 i 3J J'f lo6

1; l2

J)

s

9

"

7'

" "

" ·' ' 6

I•

7 ! i l ro 17

4

' 4!Z')Iz&lsi J ' 5 J i I 4

1-!-~1-1- 1-.. j-1--,-3 I 5 I & j l:l i JO I l3 )~76 !19~ !47-t

.... I>!)

13

BOARDED OUT ON 31ST DECEMBER, 1923.

Patient! OO&rdOO out to- ! "'""'· Feffilllel, Tnt&t.

---------·---------- ------ ------· Private Individual• . . . . .. H 6 15 Ballarat Benevolent A.;ylum . . ..

!

7 ~'!:1 3U Bendigo Benevolent A.aylum . . .. 1:) 21 :H Castlemaine Benevolent Asylum . . .. 39 10 49

--··-Total . . .. .. l 68 66 134

·····~---·-- --------~------

There has been an increase of h'n pat.icnts boarded out; these are principally quite demented cases, or senile patients who ar·e more suitable for a Benevolent Asylum than a Hospital for t.he Insane. WPre more accommodation available in the Benevolent Institutions, many more quite suitable patients could be sent there, part.icularl;· i[ additional nursing help was supplie<l.

It is an anomaly that there are many patients similar to ours in Benevolent lnst.itutions for whom the old age pension has been made available. When, however, they rea.:;h th~se A~yhuns by way of the Lnnaey Department, the old age pension is not obtainable. Frequently too, one eomes across imbecile. or other congenitally weak-minded case~ who are in receipt of the invalid vension, but if for an.v special reason they are admitted to a State Hospital, their pensions <lisappear.

lt woulol be an economic proposition to inerease and improve the accommodation for suitable demented and elderly patients in the Benevolent Institutions. particularly if the Commonwealth eoul1l he iwluced to realize its obligations to this class.

NunsiNG ExAMINATioNs, 1923. Xo. of

Pa~sed, Failed. Co.ntlldatef',

First Year~-Attendants 18 8 10 Nurses 50 27 23

Second Year--Attendants 15 10 5 Xnrses 3:! 26 6

Third Year-Attendants 2.5 6 19 Nurses 2!l 20 9

The proportion of passe> in the first year i;; not good, the reason being that many Nurses take up the work without. any int.ention of going on with it. In subsequent Y'"'rs they become more. keen to pass the necessary examinations and qualify for promotion to second grade. There is always a difficulty in filling tht> higher grades on th<:> fenw le side, owing to the frequent changes on the probationer staff.

Preference to returned soldiers for appointment is not produeing the very best results in attracting the right type of applicant.

I have to aclmowlerlge the valuable help gi;·en me by Drs. Philpott anrl Hollow in the conduct ol the nursing examinations.

HOSPITAL FOR THE INSA.>U:, YARRA BEND. Starting the year with 315 males and 388 females in residence, the numbers

had dropped on 31st Deeember, 1923, to 183 males and 377 females. The decrease of the male population was due to the transferring of a number of patients to Mont Park and other Institutions. ThHe is every prospect of a steady depletion of our numbers in the near future, and, with the completion of the preparations and additions at Mont Park, it is hoped that the ensuing twelve months will see that long desired consummation-the evacuation of Yarra Bend-completed. ~

The condition of the institution generally reflects credit on the nurses and attendants. Working under most depressing conditions. and under every conceivable disadvantage, they have suceeeded in at least keeping the place scrupulously elean. The general decay and dilapidation have been the reanlt of the cessation of expenditure for many years on necessary repairs. The conditions here now are such that any

14

patient who recovers does so, not because of his surroundings, but despite them. Everyone who has :1uy regard for the comfort and well-being of the insane must heartily hope that t.here will be no fmther delay in their removal from Yarra Bend.

Restraint beyond the use of soft gloves is now non-existent, and seclusion has been H:<f'd for one patient only, mainly a.t meal times owing to her da.ngerous proclivities.

'!'he <leaths numbered 51, includiug nine of patients who were on probation. Thi>< number is eonsiilerably below our ,J,VCl'lL)!;e. Four female patients •md one nurse developP,<l typhoid during the yea!'. Bporadic "ases of typhoid seem to occur here year by year. Otherwise the geneml health of the patients has been s>ttisfactory.

I•'arm and garden result,;; have h<"en good. .Many difficulties have arisen in these Rpheres owing to defective fencing.

(t:lgfl.) J. OATA.RL"'l"ICH, Medical Superintendent.

HosPn'AI~ FOR THE INSANE, KE\v. The following table statistkally represents the changes shown on the last day of

1922 and 1923 respectively:------- -~--- ----~~··----.--"

Reception.~ Trausferrf•d to KL·"- .. Tra usf('rrt->d from K('\\ Helieved i:{,Pcov~·rejl

Die<l Resident 31st D(•cnmh(•.r On tri«l Hnfl:.J'f1rrl ont

Total ou J5ooks ---~--- . :.:=:... ·--

:!7 ::lO l'l 22 75

4tilJ fi7

-------~~

1\.•22.

F"nmle

<14 2?{ :j~

6 27 a:-}

38) 7f)

3

45H

1:!23.

T(Jiill. )h{<'. J'<)JnHl<:',

---~- ~--

208 liJ I ·iH i) ~) :t! :H o:::, 2:; if 20 18 ll! 4~1 21 14

108 t\7 :,4 8H 496 392 137 57 66

3 I 2

1,014 554 460

Heceptions -Of 180 uew receptions the prinmpal mental states were:- · Senile dementia . . . . . . . . 20 per cent. Congenital mental enfeeblement 13 , Primary dementia 10 , Mania • \1 , General paralysis of insane !l , Melancholia t! Dementia (secondary) 8 , Confusional insanity . . 7 ,

'l'()tn!.

I HO ;:Hi 14 iB aB

121 888 123

:;

The following are the principal assigned causes of the mental conditions :-­Predisposing-

Old-age Hereditary influences

Exeiting~----Bodily disease Congenital defect Venereal disease Alcoholic excess Mental anxiety

22 per cent. 18

15 9 9 6 6

" .,

" In considering the causes statistically tabulated, it is felt that the incidence of

venereal disease is of much too low a percentage in the causes assigned above. Recoveries­

The percentage of recoveries to admissions The percentage of recoveries and relieved to

19 per cent.

admissions 36 "

Trial Leave-­Percentage of trial leave to number resident 14 ..

15

Deaths~O! the 121 deaths the principal causes were­Disease of heart IJung disease other than phthisis General paralysis of tl1P insane Old-age Phthisis Kidnev diseaSl' Colit:il!

}lajor Casualties-­l<'racture of femur Fracture of clavidP Fracture of leg i:ltrangulation (suicide)

Restraint and Seclusion--Nil. Farm and Garden-

Value of farm produce Value of vegetables and fruit.

24 23 ~1 14

I •)

•)

£3,700 2,506

The ini!titutional routine has proceeden smoothly. The conduct and work of the s1:aff has been satisfactory.

The qnality of the food and clothing supplied Ull<ler contract has been good. There is still need for many general repairs to buildings and for better

accommodation for uUises and better workshops for the artisans. These improvements have been aske{l for previous!,\', and the requirements are well known t.o the f nspertor-Geueral of the Insane.

There is urgent need for increased aeeommodation for patients. On the female side especially there is always a number of pat.ieuts sleeping on floor beds. The Receiving House and Acute J.tental Hospital are always calling urgently for accommodation at Kew, and frecpwntly we are 1mahle to take t'ases fmm those institutions.

Comment must be made on t.be class of patients being received. A very large percentage of the cases are mentally and bodily helpless. The old workers are graduallY passing awa,v, and thet·e an' not snflkient able-horlied pati<'nt~ to take their places.

Receptions Transfers to Kew .. Transfers from Kti'.w .. Relieved Recovered .. Died .. Resident 31st Dt>cember On trial Roarded 011l

Total on Rook•

Cor.oNY J<'OR NlENTAr, DEF,ECTIV<~s.

24 4

30 I

: F'emale. ~ Tlltnt

I 1~ ! 4 2

49 2 4

]!) 5 20 26 11 37 1~7 171 358 182 I 171 353

12 R 20 l!l 11 30

- ~~-__ j~ ~--~~--~- ___ I_-~-378 201 1B2

There have been several epidemics of infectious diseaseE which have been suitably coped with by the means at our disposaL The need of a properly equipped isolation ceutre is acutely felt.

Improvement.s to the institut.ion in the way of sewering are projected and within sight.

There is still urgent need to Improve the housinl!: conditions of the female nursing staff.

(Sgd.) JOSEPH HOLLOW. iUedical Supe1intcndent.

,

lG

IIosrrrAL FOR THE INSANE, ARARAT.

Patients admitted ( HJ23) Patients transferred to this Im<titution

Total

)!afei!.

10 10

:w

Jicru.ales.

6 7

.13

Tot.a.l.

16 17

u.~ ~ 10 ~

These comprised :32, whose ages ranged from 60 to 8\l years, and were in all cases due to natural causes.

The general health of the )Jatients was good, and no epidemics occuned. Seclusion-Nil.

Restraint was deemed necessarv in the ease of one male for epileptic excitement~ 30 minutes:' one female, homicidal and suicidal-2 honrs 45 minutes.

Accidents~-Nil

:Escapes-Only one escape occurred during the year. A male patient escaped, but wa.s retaken : there was no blame attaclr!ed.

Repairs, &c.-The buildings generall;; require repairing and painting, and the erection of the nurses' quarter~ is, it is hoped, within reasonable distance of being carried out.

Criminal and Refractory Ward-The erection of shower baths has proved a boon to the patients, and the proposed new airing coLirt and the substitution of single cells for the m1sightly cubicles will in some way tend to relieve the monotony in this department of the institution. :Much good work has been done here, such as laying drains, painting, &c. It is hoped that. in the near future a system of water borne sewage will be introduced here and in the main building. The establishment of this system would not be expensive, and would be money well spent.

Accommodation, &c.-~·The wards are as usual overtaxed, and although in the male cottages, vacancies occur, still it is dillicult to get suitable patients for occupation, as the facilities for escape are easy. The class of patients now being received is very poor as regards worker, and as the old workers either die or become too infirm for work, the outlook for workers in t,he farm, gartlen, laundry, &c., is not at all reassuring.

Staff-The conduct of t.l1e staff was good. ln the female Division the scarcity of nurses is becoming serious. 11any changes occmred during the year through resignations.

ln Geueral·-'l'he Bnpply of wgetables wa' ~~~tt up to requirements and of the usual high standard.

G~od re.sult.s were obtained, but the :quantity of hay and milk fell somewhat short of expectations owing to a long period of drought, conditions in the early part of the year and continued rain and cold weather for the remainder.

The horse teams have been brought up to an efficient standard by. the purchase of suitable animals, and the policy of breeding for future requirements has been continued. Excellent results ha.ve attended the introrluction of Yorkshire pigs, which should be a source of considerable revenue as time goes on.

The pine and shrub plantations are responding well to the attention bestowed upon them.

(Sgd.) V. A. OAMPBELL, :\ledical Superintendent.

HoSPITAL FOR THE l:;SANE, BEECHWORTH.

At the end of 1923 there were in residence, 640 patients-368 males and 272 females. During the year there were 14 admissions and 70 transfers.

The general health of the patients on the whole was good, except that for a short period there was an outbreak of mfiuenza, when there was a large number of male and fernale patients in bed with it, and also a large proportion of the Staff. This year there were two cases of typhoid-one male and one female, but, owing to the vaccination of all patients under 60, there were uo more, although there were

1 i

several eases 'of colitis and summer· dianhwa. [f a sewerage system were provided, there would be' no need to Qoe the anti·typhoid vaccine, and the disease would be a thing~of the past.

Thirty-seven deaths occurred during the year, 2·7 males and 10 females, whieh were mostly due to senile demy. The necessity for a female hospital ward still exists.

The conduct of the Statr was goo<l. The uUl·sing examinn.tions were fairly satisfactory- ·8 nurses and 2 attendants being successful.

The lighting of the Institution is slightly better than it was last year, but the installation of elect1ic light would be appreciated. The rooms used by some of the uur,;es are not suitable, and sep£nate quart.erB should be built for them. The wards need better ±umishings, espe~ia.Jly in the form of easy chairB and floor covering.

Some improyemcnt has been made in the front garden and a croquet lawn has been provided on the female side. The kitchen has been painted and cleaned thoroughly. The dance hall needs painting and renovating.

There was only one case of restraint during the year-a female patient having to wear a camisoJe to prevent injury to herself, she being actively suicidal. There were four minor casualties, which were due pUI'ely to accidents, and not to any neglect on the part of the nursing staff.

(Sgd.) R. G. NAYLOR, Medical Superintendent.

HosPITAL ~-or< THE lN~ANE, SuNBUHY. --~-----.-.. _ .. _, _____ ,~ ... ---.. ------·-··----.~.~ ... - .... -·-~ --

To\& I.

- .. ~~--.. -·~·~·~-----------·-"-"----1---·1---- -~--

Resident in hospital on 1st January, 1923 .. Av\:rage numL•::r residc11.t Number of patient~; under care during HJ20 .Pat.ients admitted Patients recovered Deaths Resident in ho::;pital (•ll :iht Decem1et, H¥2:-;

Voluntaxy Boarders--Reoident ou 1st January, 1G23 , • Received Under care .. Certified Discharged Remaining on 31st December. 192J

Casualties-S.L., Dislocation of right shoLtlder J. C., .I<'racture of left arm .. 1<' • .1:1., Fractme of left thigh .. 1' .H., Frat-'tUl'e of left forearm R.U., Injury to right hand .. M.M.., Fracture of right hip ..

iil9 518 647 44 13 33

[,21

3 .. .. 2 1

.. , : : J Caused by accidental falls.

: : lcause~ by violence of other . . ) patrents.

997 J,OOU 1,334

139 33 88

9~5

6 6 3 3

'fhese injuries were =avoidable, and no blame was attachable to the attendants. Restraint and Seclusion.~One patient was secluded for li\- hours on account

of violence, and one was wearing lr,cked gloves for 66 hours on account of self-mutilation. Health.-~ The goneral l~ealth ui the p~ticnts has heeu good, the death~

numbering 88. There was a mild epidemic of influenza in ;July. Bm.trded~out Caseli.- -A fe\\ u:ure et~ses have beell lJt,arded-out at the

Uastlemaine and Bendigo Benevolellt. A,;_dnrns. Ther~ <Ue cltJ!l many cases m the hospital fit for boarding-out.

l:ltaft. ~ .. The ;.;cnera! condud of the staff hao heeu (!;ood. }?arm mHl (;.udetL·-'fhN<e have gi\ en··most. settisiactory .:etw·us. There • has

been' H C()J;;;;;h:n· ,,: .. ;·,ll}'l'(;\ PI,II"Pt in the oma.Inental gl'OJUJds. Most of the airing courts havll beell i·':.uted wrtl' tcH~ ;ll;:i ;;.mos in place of flower bed;;, which ·were unsatisfactory. The front of the b11ilding hu;; ueell in,pr<;ver] hy lawns and shrubs.

2420.-2

----········ ········------···. ------~---······

18

Patients.--The patients have been taken outside the wards every afternoon, and those who were unable to go for walks were allowed to remain in the grounds nem: the buildings.

Two observation dormitories have been established for epileptic patients, but it is unsatisfactory keeping epileptic patients in wards with non -epileptics.

Improvements.--Many windows have been made t.o open, thus improving the ventilation throughout the buildings. l'<lore might be done in this direction. Two of the male wards have been thrown open and handles fixed to the doors and gates, so that liberty patients can have free access to the wards. This has been most satisfactory, and no patients have escaped from these wards.

A refrigerating chamber has been attached to the kitchen and a new shed built for the protection of the patients in one of the female wards.

Improvements are still needed in the nurses' quarters. (Sgd.) JOHN K. ADEY,

Medical Superintendent.

HOSPITAL FOR THE INSANE, BALLARAT.

The following changes have taken place during the year:---

Cases Admitted­First admissions Not first admissionR .. Transferred to the Institution Escap~!d patients rt-taken

Total c .... .ses admitted during the year

!

i

I

i i

I

. Male~.

28 9

12 l

..

! ~ Felnillet.

I

41 !3 8

..

I ..

Tot-al. 1-In.tee •

I I

69 12

I ..

20 .. 1 .. ·-.. 50

i

I -----

rrotal eases under care during the y~ar

Cases Di.schare;ccl--Reoovered ~ Relieved Not improved .. Transferred from the Institution .. ~ooaped Died ..

Total "'"'"''discharged anrl dierl Juring the year

Remaining in tl1e Hospital, 31st December, 192:) Patients on Leave . , . . . .

..

I 14

7

i 1

I 2 2

i 2!3 1----

I 2~~

.. ..

10

I 24

5 12 ..

I 1

.. 2

.. 2 38 i 61

-----~--~

. . .

30 52 I 471 I 6~0

1 22 9 29 38 Pati~nta hoard~d~out . . . . I~ ____ ----~]--J

'1' otal numbtr on books, 31st December, 1923 I

Avcrag:~ nu m her resident durilll5 the year , ..

299

..

..

..

..

..

49

..

. .

. .

\ Femalu. TntnL

--~---

.. ..

.. -

..

52 102 ---- ----------

583 882 -~---· ~----

.. .. ..

.. ..

.. . .

.. ..

.. .. 5'{ 102

·--I . . ..

.. ..

.. ..

780

6il0

••- ··-··~ ••~·•-~·-•-~c.-• ·~·-·~·- . .L,. .~ .. -'-----·-'··•••

There were 61 deaths at the hospital during the ye.tr and of this number 15 were under the heading of "Atrophy, Debility, and Old-age," and of the others 10 deaths occurred in patients over the age of 65 years. With this exception no single eause stands out prominently as a cause of death. In June, July, and August there was an epidemic of influenza among the male and female patientsc There were a large number of cases, but, few of any severity. There were no other epidemics throughout the vear. . c Two male patients escaped during the year. G.S., a case of Recurrent Mania, was in a convalescent condition and would have been discharged in a few weeks. He was engaged in sweeping outside the wards, and made his escape. He was not ]eCJ.ptarel, a.nd was written off the books under Section 94. P .J .l'<l., a harmless imb•ecile, escaped while working with a number of other patients in the grounds. He made his way to the home of some of his relatives, and was returned to this place afte-r an absence of seventeen days.

l!l

There was only one casualty of sufficient severity to require reoording. .l\f.M., a female patient, a very demented imbecile, was pushed off a chair by another patient and fell on the floor, getting a fracture of the surgical neck of the right humerus. She made a good recovery from this injury.

Two male patients were subjected to mechanical restraint by means of the eamisole for different periods during the year. In both cases the restraint was necessary to prevent them from removing surgical dressings. T .B. was thus restrained !or seven days, and A.:\L for seventeen days. There was no seclusion during the year.

The results of the Nursing Examinations during the year were as follows:-

First Year. l'u."'d ExrunillR.tion .

. \\tPmlnnts, Xnn;p,,.

4

Second rear. 2 7 6

5

In view of the wet wintry weather that prevails in Ballarat, the provision of a covered way from the general kitchen to the diff,rent female wards is very desirable. A requisition was made for this work in the year 1921.

The reforming and metalling of the road from the Clillies-street entrance to the Farm is an mgent matter for which a requisition was sent in, but this work has not vet been done. " Among other new buildings required the provision of a new store would be of great. advantage. The old store is too small for its purpose, and it also requires the expenditure of money to keep it in t·epair. The demolition of the old store would also make room for the construction of a number of single rooms much needed on the male side and would also allow of the completion of the new Airing Court.

The house occupied by the secretary is now in a very decayed state and the provision of a new hou<;e for him is a matter oJ extreme urgency.

There still exists here very inadequate accommodation for the nurses. Despite the fact that some of the staff are allowed to .~Jeep at home there is insufficient accommodation for the nnrses sleeping in the hospital at night, and the day room accommodation is also very restricted.

The satisfactory condition of the sewerage system noted in the Annual Report for the year 1922 still continued last year, and there were only a few blockings of the drains, and consequently no extensive excavations so common in former years.

The more satisfactory conditions with regard to the gas lighting still continue. The Ballarat Gas Company has continue,] to maintain satisfactorily the lights installed by them according to the terms of their contract. However, the provision of other lights is required, riotably in some of the single r'Oorns and in certain parts of the grounds round the wards. 'rhere is no doubt that the electrilication of the whole lighting system would be 11 great advantage.

Some years ago the Engineer-in-Chief recommended the coiL>truction of a number of surface drains. These have not yet been made, and the Public Works Department will be required to supervise their construction .

. Much painting requires to he done to keep wood work from deteriorating, and , in many plaees new wood work will have to be put in. Repairs and replacements are

necessary in placer> to the spouts, anrl a large wooden fence forming part of the boundary on the female &ide is in a minous condition and is in dang&r of falling. These repairs will require the supervision of the Public Work< Department.

The installatiou of a Steam Sterilizer larg:t' enough to dea.l with material a' bnlky as blanket' and mattreilse, would be ,·en, advantageous here. After the initial outlay oi installing it there woltld be little expense iu it.' use. and there would be a ,;aving in the m,e of di>infeetants uu;ompailiul h:,- a more efficacious and handier ilystem of dealing with infected materia.J.

Exteu,;ive repair:o are .nced,;d to the asphalting in different part~ of the yards. lt would be of admntage to the place to haw built a proper!:: equipped Hewing room. An urgent requirement is the provision of a fimprouf strong room for the preservation of books, papers, registers, and valuable•, as in the othllr Hospital< for the Insane.

~u

'l'he.re i,,. a great lack of suitable store room acconuuod,,tion for the dirlerent wards on the male side.

·rhe Public \Yorb Department has u11der cmJBidemtion ,,, scheme for the extensive remodelling of the main l>lock of buildings on the male side. It would be well to embody in this scheme a plan for the provision of the necessnry store rooms.

The work of past years in filling in, levelling, trenching, and digging the ground, and in planting trees, shrubs, and grass, is now sho\\·ing its effect. ::\1uch progress has been made in the formation of lawns and the la;·ing out of new llower beck As a result the ground in front of the office is already in good order aut! has a well·kept appearance. The uoual amount of phwting of trees and shrubs ,-,·,1,; dontl during thH year. Certain hardy plants and shrubt> were established along t],e front avenue, although there is difficulty of growing plants tl1ere as there is a htck of water supply in that area.

The fa.rming and gardening work has been well c<trried out, ;md shows good results.

The conduct of the sta.ff generally has been good, and the '""rds have been kept in a elean and tidv condition.

. (Sgd.) l'ATRICK SHAW, Medical Superintendent.

RECEIVING HOUSE AND MENTAL HOSPITAL, ROYAL PAHK

The report for the year 1923 is as follows :~-RECEIVI:s'G HousE.

Seven hundred and fourteen cases were received, being an increase of 12 males and a decrease of 16 females, on the fignros for the previous y0ar. Owing to the ~ill:onic overcrowding on the female side, due to the fact that pradically a.ll cases of tneutal defect are sent here, and also to the inability of th0 other hospit>1ls to accommodate those who ought to IJe iiellt, l)olice eases could not he received, and notice to this effect had to be SO'tt to the Polic0 anthoritieo. 'fhe i\lenical Suoerintendcnt at Roval .Park has been more than once in[ormen thnt it is understood .rtat all cases must be sent first to a Hecciving House--an assumption only too acceptable to the certifying practitioner. 1'he severe handicap to s,..,tisfactory and etfuctive treatment of the curable cases, as well as the economie loss, from such unfa vorable conditions is again stressed.

The chief forms of Mental Disorder in those received were·:-~ ----------···--··---···--··

Conge:nital Defect with Epilopsy . , Congenital Defect without Epilepsy Acquired Epilepsy Generol Paralysis Oonfruioul Insanity Primary Dementia Recont Mania Recent Melancholia . , uusystcmatised Delusioml Insanity Senile Demontia .. Terminal Dementia -

The main causes in whole percentages were :-··­Moral-illclucling domes~ic and business worry, men~al at.:ricty,

work Intemperance in Alcohol . , Ver,eJ:<Jal Disease Pregnancy, Parturition 1 Lactation .. Puberty and Adolescence ~{el10pause

Se11ile Changea. .. •. · Bodily Diseases •• Previoru Attack Heredity and Congenital Calli!""

Males.

13 30

6 21 52 62 35 27 77 46 33

ove~: I 18 .. ' 14

I 10

7

13 fi

!0 16

Femaltt!!'. T"ta!.

13 9 3?

16 22 1 22

79 131 18 80 31 66 44 71 60 137 27 73

7 40

24 5 3 8 5

12 12 3.

20 9

•

21

1'he last <'lLtW) mu,;t eertainh· be regarded as much too low, l1t1t it must he remembered that more tilne j,q reqilired to asccertain the extent of this factor, tha••. can be giveD to 11. :1.~ in nH1·llY (''' ')c-;. tl1c1·e 1~ a n1arkBd objection on tlte part of relatives to stat<J, even ,.,e,nly, the full iaeb ; it is of milieieut imp01'tanl'e to warrant any expentie of au ol0eer iu eollel'tini!, iu!ormation, 1:\uch research, however, mnst not clo;;e ow· eye,; to the, <Lt [,,,,,t, "'tntlily illlport<>nt iuiluence of en,·iromuent. The kno•dedge of tbc i'onJier <epart. lmm 11 eni'cni<· UNJ, m of chief value to the psychiatrist, in poiutiug out the ot~\""'" to Lu a'>'oi• led b· tl1e individual to prevent the influence of innnte harmful tendeu~ies.

Uecoverie.s. :\Ia.leo JO!J, females 6i, total 171, recovered ; in addition 13 males and 19 females '"" n; rclie, eel The percent>1ge of reeoveri0s is of no value unless the classes of ca>es are nmddered. Fonr hundred and eighty-six (males 285, females 201) W<Jre transferred to other hospitals of the department.

Deaths-~!1 m11les and 11 females died--of these 9 were aged 60 years or over ; no less than 7 died within :H days of reception (4 ol them within 5 days). The chief cause of the deaths was disease of the Cardiac or Respiratory Systems.

In Hospital on 1st January, 1923 .. On Trial Leave , , Received-

Direct from Friends or Police .. From Receiving Ho11sc

Diacharged-R.cco·,,ered .. Tic}j,•ved

Transferred tu oth;:.~r Mental Hn.spitnls Dierl 'l'ram;h•n·r:d tc' Jjccnt>N1 HousP.s In HD2.!Jib;.l on 31st D0ei:ntber, lH~~; On Tri<il L~:ave on 0l!'it Dt_'Ctom:wr, Hl:?:-)

MENTAL HosPlTAL.

.. __ . __ , :Un,[e~>,

44 18

18 66

21 1

62 ., d

1 ;);r 1.:-)

I

Feml:lles. TotaL

53 97 45 63

17 35 103 169

35 56 13 14 bO 112 J ~

1 R .)t\ fl7 .-;;) 71

----·-~---~-----------~- ~----~

Only one ';ase was sent l>y the ]>olice, while, to the Receiving HouJ>e they sent 148 male,, and :l2 feJ1lales ; mu.nv of these should have been committed in the fust place to an Hospital for lns:me. "

Attention i.; ng:1iu lhawn to the anomaly o[ eertifying a reeovering patient as insane at the <:xni.n .. nf the arLitran· neriod fi:-rcd ],y Statute for detention in a Heecivi1'g !fonsr;... If •·<:rtifteation is t1ec~ssv.t.l', then there should he 11 certain amount of eJastitity in ;J,e j1lte;·r:·--,t~~ of those aHlicted. ~\gain, the \Ynekly remanding o·f patieub ulJvious[,~· l<lCm<Lll~· aflt:n.ed oeCllh to l;e " waste of time awl effort,

He,tr,cillt.· ,\, com;m:ell with other Ye11nr, it i~ regretted t.lw.t this method of trea.t•nent lHtd to be lb;:d mme frequently owing to"- mnniacal fnror, persistent dest;·ud:iY\llH-:88, O!' :;Hr2:io,-d (inehH1ing sr!J-rnntiln.tion) nec-t:shit.\-, Re,~cnteen casetl were so T~:;tmiJ:e<l J,,. ean•i,ole for " total of 1 ,22i!l hom·;; ;;prca1l over 8!1 periods; in each msrr it WB·! ordered hv tl:n 1\Iedical Oflieor, lt is admitt<ld that where re'traint is needed, oxpcrienr·c b.s ]ustifir•<l the morht>:1icd form in pref:"rem·o to the manual, or the elwmio,t.l tw thorL Oi tlw two latt<Jr, the fo11ner i;; prone to reomlt in some injury. w-hi1e tlw L),ttet iJ' (:nntirntnd, ~;,pt to f't1llS(; JH'.Hronie deg-cnerntiOJ'. The elass reeeivecl is t.ho ohid reasou for c,neh use of restmint.

In Rrsitie11e0 un l;:..t .J.~t~>lllHY. ) ~l:l:J Reeci vNl · HecoYPn·d Oertifif'd to llecr'i\'iJ12: Hou::e: Cerlifir-d to M~·nt.al Huspital Died Remaining on Slat Decem bar, 1923

VoLl'NTARY BoARDERS.

(&;d'flll

1-\1:,!,.,,

d

JO :ln 10 2 1 5

10:>.) 'l'ct:<L

Vd:h:l("·.

6 ,, 26 76 !ll 53 4 J4

2 1

10 15

22

Nine males and 1 female had to be certified within 3 weeks o£ reception, and a few others were only technical Voluntary Boarders pending the receipt of the necessary papers under other Sections of the Act.

A male, T.J., while convalescent and employed in the workers' block, committed suicide by cut throat ; the only reason that could be assigned was his desire to continue in the Institution and the idea that he was to he discharf!ed; a Coroner's inquiry was held and found as stated. ·

There is a tendency for recurrent alcoholic cases to utilize this voluntary provision for the purpose of hastening the onset of the next break-down, as recovery is rapid and their request for discharge brings release.

GE.NERATJ.

The ;;horta!/;e of working patients, so essential in these institutions, is being felt and seen o·wing to death and old age. The class of admiBsions ami the fixed period of detention do not supply this faetor in the arhninistration of the farm, garden, and ornamental grounds,

Owing to the abnormally w~t summer, the water question hao not, been so prominent as it would otherwise have been ; hut the eontemplated seheme should be carried out before next summer. ·

The roads to this hospital have not been attended to ; the Council and the Public Works seem to disown respmu;ibility, but it i9 certainly somebody's business; if they were inspected shortly after ordinar:v rain the necessity of something being done would be obvious.

Extra single rooms were built on the female side, and were occupied before actual completion owing to the demand for accommodation ; the class of patients were such as to show that this building was not intended for the worst cases ; owing to the material in construction, damage was caused from the first night. Cement should be used for the walls instead of lime plaster which is useless against hard treatment, and I fear that the wood work will shrink rapidly.

(Rgd.) J. W. PHILPOTT, Medical Superintendent.

HosPITAL FOR THE iNSANE, MoNT PARK.

Rooeptiolli! Transferred Transferred from Discharged Died .. . . Re•ident, 31st, December, 19'22 Resident, 31st December, 1923

. I

. I

Mall'S.

12 129 27

0 13

~1:3 2R~

Female!!. Totat

9 21 17 146 1 21\ 9 18

10 23 224 437 2:ll 5!H

Of the 59 males on trial leave, 46 are imnates of the Military Mental Hospital, Mont Park.

Severe Accidents-A male patient (.J.B.) sustained fatal injuries accidentally in helping to move a piano.

A female patient (.T.K.) sustained a fraeture of the femur in a scuffie with another patient.

No blame was attached to the staff in either ea;;e. General Health----Was satisfactorv. Restraint and Seclusion-NiL · Staff-···-General eonduct was satisfactorY. Divine Service---Regular services have "been conducted by the Chaplains of the

several denominations, though, as reported on several previous occasioll.S, a chapel is needed to give such services a proper and suitable sett-ing.

Entertainments-For reasons advanced in previous Reports it has not been practicable to provide such.

Farm and Garden-The harvest proved to be exceptionally good, and large supplies of hay, oats, and straw will be available for use at our other hospitals.

•

During the year much needed breakwindll were erected in th~ gardeD. The 1-esult~ has been largely increased yields of vegetables.

The Orchard hall been enclosed by a strong barbed wire fence. The need for quarters for the gardener, and a store room, is becoming increasingly

urgent. Ornamental Grounds-The opening up of a ward in the Chmuic block, and the

transference of 100 male patients from Yarra Bend, has enabled marked pro11:ress to be made in planting fresh areas of trees. >~hrubs, and plants.

Particular attention has heeu paid to the entrance from the W1Lito-road, and with happy re~nlts.

Consideration should he given to the appointment of an assistant m· under gardener. '··

Hoadways-As reported last year, these are in a bad condition. During the year an engineer from the Public Works Department inspected the roads on two occasions, and submitted a report. lt is to be hoped that effect will he given t'> his recommendations at an early date.

BuildingH ...... The quarters tu ac.cornmodate the chief nurse and muses were opened during the year. The chronic block is in course of renovation, and requisitions for furniture for same have been submitted.

Lanndl'}·~ .. 'fhe enlarged Laundry and new yard were put into commission during the year.

Genera).. lf matters progres:s sati:sfactorily, it is hoped that by the end of the ensuing year, the Y arra Bend patients will be accommodated here. Steady progress in the preparation of the wards and airing courts has been made during the past year, and with the removal of the Military Mental Ward patients to the block built for them, the final obstacle to t .. he transfer of the Yarm Bend patients will ha .. ve been removed.

(Sgd.) J. CATARINICH,

J\iedical Superintendent.

REPATRlATION :MENTAJ, HosPITAL, MoNT PARK.

Patients on books, 1st January, 1923-Resident On Leave

Admitted during year

Total number of eases under care during year

Cases discharged during year­Cured Improved Not improved Committed to Hospital for lu"a"e Deatl1s ..

Remaining at end of year­Resident On Leaye

CanBes of Death-General Paralvsis of Jnsa,ne Tuberenlosis · A IJeess of Liver ..

107 17

6 2 2 1 1!

103 24

5 2 J

124 22

146

19

127

~

24

During the year tbo health of the patient,; l•as h~et> sati:;faetoiT. tlte comparatively heavy dev.th rate havinl£ been due to the inevitaltly fatal termination of five cases of General i'arahtilli of the Insane.

The condition of this H~spital, during the ye,;r l!l23. remains nmeh the same as at the date of the stllnnission of tbe last Annual Hcpmt. and, at t!JC preseHt moment, it is doubtful if any good pmpose would l•e served bv a recapitulation of the various matters which, at that tim0, it was eon.'lidercd were in urgent need of rectification.

(Sgd.) DAVID CADE, Medical Officer.

RlllOEIVING HOUSES AND WARDS. TAm,R 1 -SlhJWitlg the AUr~tissior\S, H\htdtnls . .;i~J;ts, u~~~h;lrgeB, and Den.th.':>; during the Year

eu:led 31st, Dccem.bcr, 1923, ~~--~--~--- ··------ ··---~---~-------- .. ------~--··-.. ·----

I . . ·-- ~!=~: Tott~L '1att. i Fema!e. Total.

' I

in the lnstituLioul', 1st .J am<nry, l u<)·J I 41 .J:l S7 A•"~"" .. ... ... ... .. . ---~ -----~

'

... i !

Cases admitted-First tH.lmis::;ion~ ... ... ... 3H ' ~fi:t I (lUG .. ...

i

. .. X ot first admisEions .. ... , .. ...

i l:l9 115 2P:4 ... ... .. .

Enenved p:1tients n:lab'n ;\ " ... ... .. . !

... " . ,. .. . ... ---·· -----

Total cases admlt.k:tl tinting .the :·e,H

I -tt~6 3"" i 863 ... ... ... ... .. . .. . '' -- ----- ---

Total eu.ses mHl{'r care an ring the yo:11 ... ... . .. .. . ... ... fJHII 4'20 %0 Cases discharged-

I Recovered ... .. ... ... 13·1 ::.t:: 21i ., . ... . .. Relieved ... ... ... .. ... l ;) 29 44 ... ... .., !'lot improved ... .. ... ... ... " ·I 13 ... ... l ...

Trttusferred fmm the 1nstitution ... ... ...

I .'1:!0 :::-J-(1 :.liO ...

' ...

I

. .. E:;;ca.ped ... ... ·-· ... ... . .. 3 ...

I :) . .. .. .

Died j() ! I~ 22 ... ... . .. .. . ... .. . ... i . .. ... ---

4Hl ;{7H. i Total cases discharged and died during the yml.r ... ... ... .. 86~ 1------ --- -:<9-142 --

Remaining in tho Institutions, 31 ~t December! 1923 ... ... . .. i

... ~~ --· '

•

Average nnmber resident rlming Uw ye"t ... ... ... .. ' .. . 39 .J I RO .Persons under cu.re during the yt·ar ... ... ... ... . .. .. . :)07 401! 907 Persont admitted .J68 ! 3W t-127 ... ... ... ... .. . ...

I

... .. . ! Penons re<'overeli ... . .. ... ... ... .. .

' ... 13U 8'1 2!9

' ' .

CaN<s admitted-­First admissions Not first admissions

'rota I cases admitted during tht• y(:fH

25

:H j:J

40 lT I

I 3H i 57 93

'I'otal ca.&s under car;\ dm·ing the yen·

Cases discharged--­Recovered Reliever!

12 10

20 1:1

<~-r . 62 ___ 1~--

Not improvul 2 3 [1

1':rauaferred from thr: Institution Died

25 33 51{

'~--~~-- -1- - - - ~- __1_ -Total ca.ses discharged and difd during the y('aJ'

1

1 1

i Hemai!ling on 31:'lt Dl'Cf'mbm:, 1923, in Receiv~ 1 I

ing Houee . . . . . . - · I 2 I ·!

Total nmnl;er f}fl th<· l)ooh. Sist Deecnthet, IU·!:) !--~- ·-- ~- ------ ~-----

.bwage.numoorre,irh·ntr;ucillg;r·M . 1

. I

1

li

1 38 96

As in former yeo.rs, this Receiving House was required to admit. a number of cases t.]w,t cou!a not in >mv waY eomn under t.be catcrrorv of " Receiving House cases " The records for t.J1e yenr ~ho,\1, amm•g the fortrrs o( ir,,;;mil/' on admission, a nUirt~r of caseR of irn hecilit,,~, rdn<tH'Y denwntia, df•h1sinnnl iHsrudt~~, N(lllile rlf'nwntia., and terminal clenh'uti,l,, antl ,,-dl w,:rke<l e-;_,.;u:: of oilH~T !'onr;s of lr~s.::.itY. n11 1A whit'h were readily recognized ns in~u.;tr:, nml p;,--n~" l'f '' l1i~-1~ '1\t-'Tn 1T;n~,duTed ~t~ ibe I-lospitn.] for the lwiane, Balhrat, with little <kin.\·.

The average 11lll11hcr dnih- r-hi,knt. tlmnwhcut the war conl.inncs with little variation. nw1, dt~!'l_;)iic- the ndnd .. "'~ifJ:l of a P1lrFL(·1' (.f 11tJsnitnl:,le C<'!-ses, a eert.uiu nun1ber of ca.se~-; -dJit-fl.\~ 011 t1w fnttnlr-: ~J,:t'- nro t!.dn~ittcd t<J \\hf'JT· tho }•rnYisioil o( a Receiving Hom·:t_' i~; <1 dif-\tipf't ;t.tlYtlldn~_J'. HcnYe\0r, thr-r( j;.; ~Jw dh..,tiiwt dit:r.dYai,tage of the lack of s1d1;cient 1t1Ctlir:t"lJ M!lfA1:Yis}(!1! (;1--1: .~l t1: tk:-- {'(lDJ]1fl.l';ltiVe ]gel; of accer-;sihiJitv of the :!:f'f'Fi\'il- 1_: l-fcn:J~i·, fi\li_i l!l'(~ft· prrsent Cill~(lit1mls, it. is nocessury to transfer to the Hoonihd fr;r t.lw i nsatw fot· t;Gd-n·eut D<etim:to ',"ho under o'tl•er eondibions nti~'ht rm'~~ain at tlte ·Htcrh-inu Jl(:Pt<c·. rt fgr; also lJccm IH.Jeessary to transfer pati•::nts vd1n ;Pi~d:t h cm e ;m <:I.lil''-:-": 1;<'<: to thr~ J!ei:rllh(l111'S 0\'·ing to thPir noiS<:. - ·

'!'here wm·e five \'n1mJhrv ho'P·ders lnRt Year, n.ll fcnH>Ir.,_

There wa; one r:."sc nf dt•,d:h, ''' m;tk p: tir Pt wh~ \\liS a.dmiltcd in a condition of acuto confusion and in a st;:tc of lmd hot:ih' J<c,o.]tli, Tk gmilually lJecame worse, and died, hiH'illg been n l'"tinnt·. for fifteen 'b:• '· ,'; post. l"ortcn• cx~tminatiou slwwed that the muse of death WM aeute mel'in;Iitiil.

'L'hc Institution has been free from epidemics and ftw+ geuemllv from serious illness, although most of the pn.tic11ts n<lmitic'r1 have be<'ll in ilidiffmeJ1t bodily health and condition.

The hot water supply system l1as not :nt hem> pnt in order. This should he done without dela\' to obviate tlw ncccssitv of ]JUtting the lm·ge fnrnaec into action unnecessarily. " · · ··

The conduct or the stnff lms heen good.

(Sgd.) PA TRICK flHA W,

Medical Superintendew.

26

COST OF .MAINTENANCE.

The details of receipts and expenditme for the fumntial yew· 192il··l!J24 ure shown in Tables XII., XIII., and XIV.

The collections made by the Master-in-Equity amounted to £2,584 more than on the previous year, and there was also an increase in ilales and Fines of £965, and in General Collections of £487. The expeuditure for 192::\.-1924 exceeded that of 1922 1923 by an amount of £38,041, prineipally in th.c items " Salaries" and " Provisions:· The increase in the former was the result of a reclassification of the offieers in the General Division and the payment of bonuses, am! in tht• latter, the hi11her. prices tmder contract for some of the main articles of diet.

In the following statement, the average weekly cost per patient for the last three financial years is compared with that of the year 1914.

·- ·-~. ~--·-·--·~·-- ·--·

Salaries Provisions and Extra Art.ictes , , Clothing, Bedding, and ~laterinl fur }[anufactlll\' Stores .. Fuel, Light and W at.er .. Medicines and Stimulants

1\ll L ·--~-----

' S. d. 1 101 1

·l 4 . (l lli ~ 0 4!' 1 If i

Inci~\ala (Postage, Travelling Exp~nses, Chaplail1s' Fees: I 0 lit ' I

0 2

Avefa.ge weekly cost per patient

Daily A:verage Number RPsident

111:2\ ::::o.

s. d. I 13 il '

7 Ut I . I lit i

0 7f I i

1 10! i n 2! i

I 1~\::!t-:n. l!i23-C'-I.

S, d I

s. d. 13 O! 14 o!

0 10! I

(j ut 1 10! 1 11 I) 7 0 ~-} l 91 2 1 0 2t 0 2!

0 2t

26 2f

5,476

The gross weekly cost is shown at 26s. 2~d. per p{'tient, but when the Collections for Maintenance, &c., are deducted from tl1is amount, the net cost is 23s. 4d., as compared with 20s. lOid. for the year 1922-1923. ·

The total receipts and expenditure for the year' 1919-1920 to 1923-24 are as follows;-

1919-20 192{}-21 1921-22 1922-23 1923-24 .. I

£ 33,621 ;l8,474 42,980 38,716 41,300

Bxp•tidillll"l',

£ :l09,531 391,216 360,878' 347,287 385,328

Non:.·-Receipts comprised collection' ln· the J}laster·in-Lunacv for maintenance of patients, sales of live stock and snndries, fines," and miscellaneou.s.

Table XV. shows the return of produce, &e., raised in the various farms and gardens of the Hospital:, for the Insane, the total value of whieh amoL.tnted to £29,989. Although the ;;mount is slightly less than last year, the result,; may be considered satisfactory. Suitable employment was provided in the farms and gardens for a large number of patient.'>, and a regular supply of vegetables and fresh milk was maintained for institutional use.

Tbe clerical work of this Department was materially increased during the. year. The transfer of the Military Mental patients from the Department of Repatriation to the State Lunacy Department wa~< attended with such questions as the equipment of Bundoora and of the new Hospital for these patients at :aiont Park ; the taking over, and valuing of the stock belonging to the Commonwealth, &x.

Materials for the manufacture of clothing and bedding are still being imported from Elngland. These supplies are being consigned t{) Mont Park and are distributed therefrom to the Hospitals for the Insane and other Departments.

Additional clerical work Wall also imposed on the staff in eonnexion with the reclassification of the General Division, and bv the increase of salaries under a bonus system.

DEA ... "l'E SbUTH, Chief Clerk and Accounta.nt.

27

TABLE Xff.--Showiug the Totu.l Reeeipb and Expemliture of the Lunacy Depa.rtment durjng the Year ended 3oth June, 19:14.

Receipt,,

Collections by the :\Iast.er-in­Lunacy for Maintenance of Patients at the Hospltnls for the lnsane-

Yarra Bend " .. ;1 Kew and Kew Idiot Asylum :, I _<\ramt Beechworth Ruubury i

£

Ballarat and Receiving r 35,z96 Hou•e

Royal Park a.nd Receiving IlouHe I

Mont Park I Receivin~ \\'" ard, Bendigo .J

Sales • I Fines

Collectioms

s. d,

5 8

10 .

6 11

3 i: 'I '

Expenditur~

General Expt.mses, Salaries at Head Office, Fee8 to OtnciR.l ; Visitors, Travellinf!' Expet1ses, !

Poi5tage and Telegrams, &c. Maintenance at the HospitaJ~ for

the Insane at­Yarra Bend Kew n.uJ Kew Idiot Asylum Ararat lleeehworth Sunbnry Batlarat and Receiving House ... Roya.l Park and Receiving House Mont Park ... Receiving \Vard, Bendlgo

Expenses in connexion with the Committa-l and Transport of Lnnatics

El:pcnses in connexionwith Boarded· ont Patients

s. d.

6,97 5 3

J9,0Ii + 79,098 7 fJ.SI) 7

8

fO,fJI )2 J )!)tO+ 11 +

47·905 17 25.8-a. JO 1 4°,67f '5 9

1,07 r 5 J 1

l,lOZ 8 7

2)769 :t 4

Total -----. -11 . .c4,,299 16 J I Total ... i.£j8),,;86,;;;

~---- ------

'fADLR XI H.--Showing the Total Coi:lt of Maintenauee against each Hospital, the Sums expended ag'ain8t eR.ch Vote • .a.nU the Amoqnt of General Expenses for the Year ende•l 30th ~June, l9Z<f..

Daily I Jio:anlt.Jfot tb.e Insa""',, Avemr.t:~ Tfltal CO!'lt 0! S•hlltle~. .!''eel! to Allowances to

y• ""' :'fo•plJr.J ..Mainv.mane_e. i Ollict.lVJglton. Ch&p!.AlD~.

i ··~·-"·--.~·rl~'"~'~· -1·--------1---------~------ ---------

Yarn;~. Bend .... Kew and Kew i (

ldiol Asylum , I Arara.t ..• Beechworth .•. Sunbury ... i

Ballarat aml ' ( ReetJiving H on~(~ i Royal Park nuJ f Receiving House I Mont Park ... General expenses

559

1,149

61;

"+' 1,004

694

£ •. d. 39,017 + 0

7 f01 l7l U 3 57,204 I l + 47·9°5 1 7 '

25,822 IO I

i +0)674 I5 9

1 6ms J s

£ •· d. I

ZJ,009 16 j

' 4),6,8 0 10

>3,S98 3 10

::u,;sz s 5 30,990 IO 2 :

14,885 J r o

18,zH 1 + 22,j6I 6 I [

+,il86 15 8

£ s. d.

475 0 0

£ •. d. 86 0 0

96 0 0

92 0 0

l'ro vl&ions ani! Extra Artlele..

£ 8,86+

s. d. 6 0

,8,;s+ 17 ;

11,179 6 2

12,115 7 3 l ),940 9 5

ll,S'ff 8 :z

~,8i9 17 JO

9,844 5 0

Total ; )80,J8; IO 0 "J,SR6 J 4 5 471 0 0 68o 1o o 9'·955 17 3

28

TAHL-E XlV.-S!mwing the Average Weekly Oo~t of Mr1-intemlnee of PM.ientt: rlnrin~-t the Yfla.r ended 3oth June, 1 ~P4·

!Jajly Avcra~e Numt.er Jt~)idt>m.

'rolai C\J~( ii( J'lfafntl!ntOil<'".

Col!cdina~ 111r 'l.tini-!'-1lLH1~t',

S.•···~. fi,.,.,, f<'P~, <Jc<

~"-•tlan•.'~. .\](V\VUJICe lo n:rt;.!a!n~.

l'r..,v!slc.>Ll\l!nd f:xtrJ. Ar!I<JIIl~.

----~-:-.,.--.--~-- -~~-·······-·!------------

Yarra Bend Kew andKew l.A. Al'arR.t Beech worth Sun bury Ballarat. •ud

necciYing H OU:<C R.ovn.l Park and R~ceiving House

}font Park

l }

5;; '.J !,1..{)1

6Ij 641

I lO~f

69+

£ '· d. s. d. 3914117 + 9 7'N:98 7 43·5'; 6 40,171 ll 3 5f,ZCf I { 4

+7·905 17 ,.

25,)4zz lO I I

40,674 I 5 9

£ '· d. £ c l) l 0 0

c 1j 5! 0

0 q J li 0

01:211-l: 0

0 I l IO! i 0

0 IJ 9! I 0

!6 "! 0

0 16 8! 0

s. tl. o o:{ 0 l

0

0 0~ 0 0~

0 0~!

o o'j

0 0~

.£ 0

0

0

0

0

0

0

0

s. d. 6 s f V

7 Jt 6 •l 6 5

to! 2~

·-------'Total

General expenses

37).4-10 6 .j. 4'·'99 16 3

6,m 3 s I

F.ud, L!~f-.t, !l.!HI 1".'1\lr.r,

)le!licinell llntl . }fc~ical Cmll1.,rta.

~U(gJen.l

h:s:rumtUJts, &c.

---·------: -~-----~----~--~·-~·~-£ '· d. i

Yal'l't~ Bend o Kcn-v .tnHll{e w L A.: v Arttrat o BePchwm·th o Snnbury Bnll:trnt. nw! Uecdv!ng T-Jou"e

Royal Pnrk nnd Receiving Hon:-e

:\lout Park-

Totnl

0

I ) o

1 )0

0

2

2

2

;-'le 4

0

0

0

0

0

0

0

0

'· 0

0

0

0

0

0

d.

+~

.£ '· 0 •

0 z 0 ' 0

0

0 3

0 z 9

£ 0

0

0

Q

0

0

0

.. 0

0

0

0

0

0

0

0

Stimuh.ml«­\'tTint>~. spirits

and Beer.

£ 0

0

0

0

0

0

0

0

a. d. 0

0

0

0

0

0

0

0

' I

cl o! oJ 0~

0

0

0

0

0

0

a.

0

0

0

0

0

d.

--~~~~---····················-

luclJ~nlll~t>. . p,,!lf,.~e llftd , :Td~.·r,\.!nllll.n<l; ' T;~v~Eing '

:£:\}>OHI!\!11, 1

Yarra Jhmti Kewand Kew LA.

£ fi, d, 11

0 0 1~: 0 ') l

Annat o BeechwortJJ o Snubury o BR!Ittrnt und ! 0 Rec"h·intr House 1

[{oynl Pa1 k awl \ 0

Ree€iving HonseJ }lont. Park o

0

0

c

0

0

0

TtiUll W;WI<ly C<•H

uf l!ailr:cnttnre vcr l'n.tient.

f s. 6 +

+

d. IO

++ zt 11

6 6J

---1--------Tot.a\

GN!~m! !3~peqs.e!') ----'=cc

:A VIJ<lili{<' (tiiJct-'tJ!ill~ pPf! ' f'aw.:ntlJ('r Wc<:k '

f,r .>:ah1tr.mm1 e. , :O.!i,lll!, Fees, Finfi',&e,

I £ •. d.

0 l 10-f

Wt:eklr C<llll !*f l>tltlent, l;e.Juctln;: Ot.>!h;ctlom;

!tlr "f:tlll!fhlifl.C>J, A:<.l('•, I<"<.>~.;s, Finmo, &c.

£ I. d.

3 4

0 0 5*----

TABUi; XV.-Showiug the Qua.nt.ity antl \"a.lue nf Pro,!ucc ~upplieU hy tb<:- Fanus anti GarGellf. at thu Vftrions Ho~pirals for thP lnsttHC tinrin;:! the YeRr ended tho 31st Def:!ember, 192.3.

HOEJ!ir.:.l [0r tn~an;:. J;ggK. J )fe;,_L , l'onltr.;. &•·-

)\llk ' l;rt>tn Food. H,-,;. \'t"..;~:\aiJ!I'~- Jlrui:

-I- ------~---

llo& lhs.

Yarn1 Bend ... jl9 J.qo6 Kew z,IJ6 ) ,57 3 A rami, IJB 609 Be~chworth ...

1

.s~ I;9i9 Sunbury 3~· 2,101

Ballnroi 3CL I ,3li7 Roynl Par·k 369 zs Mont. Pnrk . I z.8p

1£ i'i, di £ s. Totn! Value ilz:.t 16 IC )305 2

-~

..

1: ' 1-hmO arra ew K

A rarat Beech worth

unbnry s B R M

allarat oyal l)ark ont Park

...

... ... ... ... ... ... ...

'

J<lre-\\ood. ll.oot Cm)''·

. -- ---l,ons. toll~.

... ... I 50 ... ... ... ... ... ... ... ... 160

.. ... 6o So

'11il· l()!l~.

8f,CO ~ JO '44•6+9 •so

75·390 JO 55,54° 70 97, 170 IZ9 78•431 48,2lf 9" 79.907 2f0

d., :£ '· ·1. £ s. d. j 11Z 1521 9 2 971' IC 0

En~!r,l;~. .4tr'"'. Peil.B. . ----- ·-~-·-~

ton~. t<·t:h. ! ,h. ... ... ... ... .. ... ... ... ... ... ... ... ... ... 390

100 I2 i ... ... ... I ... ... ...

---~--·~-··-·---~-~---~ J~

£ .;. d.i .£ •• d. £ 8. d. :£ s. d /.£ R,

l'otal Value 20 ' 6, 20 Q 0 IOC c 0 I l ~ 0 C]l 6 IO 5 3 J ---·-·--·

tons.

IOCr

100

lOO

90 300

140

'5 "9

£ 5.

4,]08 6

'

:M.angel9.

I ..... ... ... '5

I ... ...

i ... ! .. . ' ...

d . .£ 1!.

0 - IC

Grand total Yulue, £29 1989 8~. od,

il1S

l/1d8:J 5R6,96, ljj,6]J

Zj9,575 !J8,6+9 z 36t96+ ++·4'3

111,272

1 I

!b~.

J1soo 4·'97

f,RJSS I t,g68 5·367 g,:.L}8

t I, 565

U).tlB.

JO

1 •

'

6o

d. I £ o! 8,723 '

d. I .£ '· d. £ !'. d. 2 3Z IO 0 ! 5 J I 661 0 .:;:

i

___ '::~'-.....-._ .. LUcerM.

Barley. Oat:>. Wheat. --- ·--- ----

...... buthels. bnsheh • bU&bebl.

.. . ... ... . ..

... ... .. . .. . ... .. . . .. .. .

.. . .. . . .. ...

... . .. . .. .. .

... ... .. . .. . .. ... ... . ..

i qo $22. 2~3 so ' JO

'

•;; dJ£6 d. .£ '· d'. £ '· d . £ • ;f c 1 0 0 o1Jo 1- 2! 7 10 0 ,f 9 I

NM.&--Sceds ~rown at }[unt Park, were distTlbuted t{l various Boapitals for Tn&nu·.

•

f,ICENSED HOUSJ::S.

Table sh~t"ting Admissions, Discharge;~, and Deaths during 1923, and the number~ remaining on 3h:!t Uecemht>r, 1923.

I'"'. r:; "· I •. 1J. I "· •. I !! ..

-'t I ~

Ruiden.t in Lk'eniled January, 1923.

St. Helen's •• Mount Ida •• Merton

Uou&es,

_,__·~-·--F

1&\ I j I I ..

115.10 125

1

. !

Olen Holrue The Tofts.

.. j13 16 I .. .. 19 19 I

.. I' .. 19 19 I

.. .. :l 3 I I' . -- IS 64 82' On Trial Leave from. Licwsed ll rmees. 'I !

St. Helen's . • . • • . 5 3 8 I )fount lda . . • . . . l 2 3 . Mert<m ........ 3 3 I .

1

Gien Holme . . • • • ·l 5 5

Th• Torts .. • • ..,_:_ _:_1 6116122 T<tlal number on Booh a/ Lkensed

H0114el1, !B( Jant~ary, 192:l

R.Wved--

First Admissions 1\{. F. T. n 18 ~7 1 o n j 'i 2

Not Finlt Admissions Esoa.peee Retaken T:ra.naferred ff.<>m Res~ I

pitals for the Wane 5 6 11 I Transferred to Licensed

Rouse!! from other I LicenFOO Houses 4 4

Total 1s :14 r.o I

.. .. .. • 2<111 so1

w.l

I

St._ Heion's •• -.-. ---.-. l 9 0 114 Monut lc.lo. • • • . • . 1

1

1 :~ 4 I I

I I Merton • • . . • . 8 ' 8 (Ht"n HoT me and HMtmont. • • • • 7 J 7 Thfli To(tg

T1·arrsjerred from Hospitals lvr I t~sane Transfcrr'!il to Licenaed Ilou8es from

other Lir..tn-$ed li wse11 • • • , R~mpees retaken .

Total

101231 3:1

51 6111 .

1

4 4! 1 l 2

ol 34 5t :'roCal caltfii Ut1ifer cart during

1923 the year

.. ' 4(Jill4154i

"·' p, I ~ I " I F.[ ~ I "·lj· ~ 1-1--l~i-1-i-" 1-1 ..":: ........

1.. ..

1 ..

1

40J!14j154

8 , 5 1 1~ 1 1

1

I

TtA.al OORe.i undtr eare during lhe year 1923 • • •• ••

Discharged &cl)t.IUetf-. St. Hulen's •• Mount Id& •• Merton •• :V·.2

1

·::_~1 s 9 171 Olen Ho!me and Helmont 'I'be To£1$ • , ••

l>ichaFf!ed. RelieV<d. 5 : .. 1&1

.. ! I! I . • • . 1 ; 1

St. Helan's • , •• Mount lda.. •. Merton • . • . Glen Holme and Bt>lruont Tbe Tofta . . •• .. , 1 1 I

1-1---1--, 5 7 12 Di~ltarq4(1 110t Improved..

St·, Heleu•s •• :M:ouut Icta •• Merton ••

1 • 1 2 I .. r.. . I .• .. I

.. , 1 11 ·. :_:_1:_:_11 ~ 3

Glen Rolme and Bel:mont The Tofts • . , .

Dii!IL St. Hefen's.. • . Mount Jda. • . *. Merton • ~ .• Olen Holme and Rclmont The Torts . • • •

3

"l .. ll .. " .l .... ..

4

1 3

JJJt;·t:aped . St. Hul•n's.. . . , . 1 1"11 Muunt lda. . . . . • , • . • • . .

~l~;Holme·:~nd BeJ~~nt ::I'' i· ~· i The Tofts • . . • • • · • • • · •

a o s

I i . I I . 1 1 2' I 3 8 111 I

'I 4 I Trau8ft:trNi to HOS'piiol.afor tke Insane~---.. -~~-Trausfe1'1'~vifrom UceMed 1Iou.9e:s 10 i

oJhr:r Li('.enscd H<nUJes • • • , i .•• 1 ••

. I I

I i I I I I I I I !

On Trial Leave from Lt'ten~ed Houfles. St. Helon's • . . • • • Mount Jda. • • • . Mertou Behnont .• The Tofts

N.H.-Tb:is table does no~ Jnc1ude Voluntary tsoa.N.ere, \\h!Ch are set. out hereundor.

St. Heleu'a,. :Mount Ida. •• Mcrlon Glen Bolnw Belmont Tho ToftA , .

Tota.l

I

I on Book" Ren,aillln){,

! -~,~::__ ~- - ~-,3_1~12.l!~-·-

I M. I F. l'rot"l lr, 1 l', ITot.l.

• • 4- 1 6 w , , 1 . t4 .... 0111 illl3 ...

1

919 ·10111 ] .. nlu .. 1 ..•

.. I "I" I .. I' . I 10 I!U 1_:.:_ _ ~ 1_1 ·- _._._

1_z _ _:

.. I 4 28 I 32 I 7 I 32 11 311

·-· ------ __ 1_ I_. __ L __ _

, C·

VOLUNTARY BoAnmJRS.

T.tDLB showing the number of Cu.aes admitted, discharged, and remaining at the end of tbe year ~~~ Voluntary Boarders in the institutions untler the control of the Lunacy Department during the year ending 31st Deeember, 1923.

-- 31ale. F$.1Dal*· i Total. !11111), F\'lnal6. Tiltal.

·------· ----· - ---Remaining in the lnstit.nCions on the 1st January~ 1923--

In HospitalH for the Insane and ReceiviHg Hon::;es -·· 8 10 !

IS ... ... .. . In Licensed HonseR ... ... ... .. . 4 zS JZ ... . .. .. .

Admissions- I In Hospltals forth;:' Insane and Receiving Houses ... : ;6 35 9' ... ... .. . In I.~leensed Houses ... ... . .. ... 18 6t 81 ... ... . ..

---Total caiR'S under cn.ro during the year ... ... ! ... ... .. . 86 IJ7 ZZJ

lJischa:rgetl-Reeovere;l-

In Hospitai!S for tl..u Insane and Hecciviug Homse;; ... 38 zs 6j . . . .. .. . In Licensed Hour!es ... ... ... .. . 11 48 6o ... . ..

Certified ns Insane or Apparently Insane-In Hospitat::> for !he Insane and Receiving Hou~e;; ... I 3 8 " ... ... . .. In Licensed Houses ... . .. ... ... J ~ 10 .. . ... .. . : :

Died-

i I11 Hospitals for the lnsaue and Receiving Houses ... T .. I ... . .. .. . In Lie€n~ed HouHe~ ... ... ... ... ... s I s ... . .. . ..

---------Total diecharged ... ... ... .. . ... ••. .H ! ••. 6• 93 160

' Remaining in Institutions on 5 tat December, 1913~ !

In Hospitals for the luMne ltml Recehtug Houo.e:; ... u IZ 14 .. , .. ... In Licensed Homes ... ... ... ... .

l' 39 ... . .. . .. ' ---- --- ---

Tol&l .remainitq( ... ... ... . .. ... .. . 19 44 6] :

--·· ...

PATHULUGH'AL L,~J;Ol:UTUitY, 1\Jm.

Uurin~ the yt:<.tr 1U2J} tJw tnmdJcl' of < rt;-;,e;-; e.xalltii:(;d_ po:t Jt:ortelU \rH,~ ~lH_, distributed as follow> :·

Kew Ya.rru Bend Hoyal Park Munt Park

!-------~,--~---

' . .,u 1 1~2 j,~) :)8 1a 25 ll

Private Vcelllied Ilou~v::~ 11

Total

Continuetl stwl.1 of these Ci1oes allirms the theory that the .ymptoms known as Insa,.ity are due tu pathological eh.wgu; in, or aLuormal architecture of, the ],rain eelLq, lVluch eonfusiu11 has been canhcU Ly the failure of stuuents uf psycniai.ry to distinguish between insanity ana usn:honeurosis. A p.,yehonouro:oi-< has the same relationship to i11sauity aH physi~lo"gieal depre,,ion has' to pathological or inaane depres~ion. In the l';ycho11eurosis and the phygiological depression cure is effected immediately the idoa which is producing the ·condition is changed. Ou the other hand, cure in insanity iB pmetir·,tlly IWVl,r sudcku, becaubu the patient is always physically ill, the ;aid ill slate of health afleeting the nutrition of the bmin cells which suboorve the function 'Jf judgment and l'ea«oniug.

During the year an investig<Ltiou waq marle of the typ· of congenital llliJntal. deficiency known a;, the }loue;olhw, .K,~lnmek, or ,Tartar idiocy. The follo\\'ing conclusions vcere arriv;·,l :et, based np.oll the di>:ir·al and po~t~m,Jrtun evidence of twenty ca'lCS :-- .

(1) 'fhe p,rtieuts arc ::ithct "t tlw uml of the family or arv the first born. (2) Of the patiuntc at the <:nd ul tlte fmnily, sevm: ont o£ twelve were the

peuulti~rmtc, ant.! the ot!:er live the last. (:3) Apart from the iJmiu eh,wge,, Lh" post-mortem finding" an; the fiLmtic

chu~tges fom·d iu <MtgeHital syphilio. T!tc&: lihrotic changes are >tlmost constLtul in this eolldition, although only Hi per cent. give a positive Wass,•mlfmtl reaction. .h; congMital syphilis, however, the Was.-;ermanu toot bucomes umrliable after the age of puberty, which may account for the failure to obtttilt more postive results in this series of cases.

{4) 'rhe sti~c;mata of Mongolian iuioey ~closely resemLle th~ stigmata accompanying other conditions due to disease of eudocrines, such M cretini~m aud:eachondroplasia.

(5) Only :l per •.ent. of the congenit:Al medal defidents segregated at Kew arc lrongola, yet the £actors ascriLcd to the c11usation of J\longolism are common to must o£ the patients segregated thcr0.

(6) Although instan<:es of lllungolrem >tppear in a heredity chart lik<, " a bolt from the blue," the result of this i!tvestigation supports tl<e heredity factor which was obt<>.inetl i11 a big percentage of the cases and denied in none.

(7) The use of the term " products of exhaustion of the reproductive f1mdio>: ·' as a cause of "\longolism is imcdmissiLle unless it admowledges ill he"ltb in the -parent, <:1-> ., exhaustion of the reproductive function" is ·· sterility," mtd, eunoequently, a state of a!Iairs which results in no conceptioJJs.

One of the post~mortem exall>i!.ntions made <lnriug tlw ,Hmr was the last of the cases of epiloia ding11o,;erl by the .PatJwlopist of ihis llejmrtn:cnt and reported in the New Zealand Congress of 1!.114. lhis eoHtiit.iOJl, w!tich iH a. sptdl'l')llle of tubcrose sclerosis of the brain, adenoma subacomn, and gn:.wths in tl1c kidneys, is :assoei<lt<:d with epileptic fits a11d pl'ogroHsive wettt+tl deficieney. Thme wefe ~ight of these e.ases in the Kew cottagns dming the last twelve years, and the eow·& of the disea.se h:ta

33

been examined. The report of the whole series of this rare disease, being too bulky for inclusion in this Report, will appear later on as a contribution to the Psychiatric Section of the Medical Association.

Although the Wassermann test is a help to the medical officers in the diagnosis of general paralysis of the insane and other syphilitic manifestations, in some rare cases the result of the test is persistently negative to the serum although the disease is progressive. During the past year one of these cases occurred. From the time of his certification with " ac1tte excitement " up till "' increasing dementia " was three months. In ten months, he was " Wtt and dirty," and he died " bedridden" fourteen months after his certification. Clinically and post-mortem he was typically general paralysis of the insane.

Recent literature on the function of the corpus striatum leads one to expect a cert-ain train of symptoms in many of the patients wlw have been examined post­mortem during the last and preceding years. In many cases lesions of the putamen and globus pallidus are found post-mortem in patients who have had none of the symptoms ascribed to lesions of this part. Tl1e syndromes ascribed to lesions of these parts are so definitely described in these writings that failure to find them reported in the mental cases where there are gross lesions post-mortem requires some explanation. Do microscopical degenerations elsewhere counteract the effect of gross l6sions in the corpus striatum ? A !though the corpus luteum of pregnancy is stated to persist till two months after delivery, none of the cases of puerperal insanity examined before the expiration of that time has shown a corpus luteum. As this class of patient comes to post-mortem but rarely, it is too soon to express any opinion as to whether there is any 11ssociation between the puerperal insanity and the absence of the portion of the ovary which is credited with possEssing a definite influence upon the female economy.

During the year the routine work of section cutting, urine examination, ex:amination of sputum, blood, and swabs, Wassermann examination and vaccine preparation, have been carried on. The annual vaccination of the patients at the Idiot Cottctges against typhoid will always be a necessity so long as that place remaira unsewered, as typhoid is endemic in the building. Attempts to isolate a carrier have failed. By using the local strain of the organism, good results are obtained, but it means a lot of work to the Pathologist and the Jl.iedical officer of the Idiot Cottages. During the months of August, September, October, and November, there was a slight outbreak of scurvy at tl1e Main Building, Kew, three cases appearing in the post­mortem room. A former outbreak at the Idiot Cottages which was investigated a few years ago, showed evidence of an infection besides a food deficiency.- The peculiarity of the outbreak is that it picked ont a few as its victims, although there are so many living under the same conditions and having the same diet.

A report on the pathological work would not be complete without reference to the subject of the association of venereal disease to insanity. It is recog11ized by gynaecologists that the gynaecological disease in a community is an index of the gonorrhoea therein. A sound authority states that there is decidedly greater frequency of gynaeeological disease in the insane than in the sane, the proportion being as 74 per cent. to 47 per cent. Post-mortem examination discloses pelvic adhesions in many of the cases who die in the Metropolit-an Hospitals for the Insane These adhesions would prevent the proper functioning of bowel and pelvic organs and produce chronic ill health, which would produce a mental break-down in those with vulnerability of the neurone.

From time to time synopses are made of the post-mortem findings in the insane, and attempts to fix the number of syphilitics are made. In the idiots 60 per cent. showed changes similar to syphilis, and the heredity charts of these patients confirm those findings The Wassermann is unreliable in these c.ases when over the age of pubert,y. Out of 189 cases of different insanities, 106 showed changes similar to syphillis. The number of illllane per thousand of population in Victoria is between three and four. The number of syphilitics who become general paralytica is between 30 and 40 per thousand ; therefore, calculating on general paralytics alone, the syphilitics as a body contribute ten times as many cases of insanity as the non­syphilitics.

(Sgd.) W. A. T. LIND, Pathologist and Neurologist.

,~420.-3

IN GENERAL.

I have thought it desirable to present extracts from the reports of each of the Medical Superintendents of the various Asylums. Whilst the Inspector-General's Report to Parliament must speak for the condition of the whole Department, it is reasonable to· present the reports of tho~e officials who are each, in their turn, responsible for the Institutions themselves. These reports testify to the amount of work done in the Hospitals, and almost always accentu~e the difliculties arising from insufficient accommodation.

In order that the transfer of the patients from Yarra Bend to l\Iont Park may be facilitated, Dr. J. Catarinich has been appointed as Superintendent of both Institutions. Whilst it very materialiy increases his work aud responsibilities, it is really the only satisfactory solution of the problem. It should, however, be pointed out that the complete opening of the Chronic Block at Mont Park will not provide the much-needed additional accommodation. lt will gi•·e us sufficient room for the male patients, but for the female patients there will be barely su±!icient.

At the present time the usefulness of the Receiving House at the Mental Hospital at Royal Park is being seriously discounted, mving to the extremely large number of wholly unsuitable cases which are being sent there. Primarily a Receiving House is for the reception of doubtful and early transient cases of mental disorder. As a matter of fad, the medical profession seems to think that every patient, no matter how obvious the mental disorder, or hmv incmablc, must necessarily be committed or sent in the first pbce to the Receiving Honse. This mistake, which has been repeatedly pointed out, has the effect of involving the Department in a very large amount of unnecessa.ry work. Besides, it means that 40 per cent. or 50 per cent. of the beds in the l{eceiving House and l\lental Hospital at Hoyal Park are rendered practically useless for the proper purposes of those Institutions. The Mental Hospital accommodation should be reserved entire! y for those early cases of mental disorder who are likely to recove~ in a comparatively short time--say, up to a year. As things are at present, barely heJf of these patients arc able to be retained for a greater period than t.wo months. There ran be no reason why definite cases of congenital defect, general paralysis, chronic mania, epileptics with marked mental deterioration, and long standing rases of dementia praecox, should not be sent at once to the appropriate State Hospital.

The number of mental cases in Yictoria are certainly not increasing out of undue proportion. Un the other hand, the ratio of insane to population is definitely decreasing ; ancl it is interesting in this direction to realize that fewer cases of general

· paralysis of the insane are being receiYed each year. ll this means anything at all, it means that the morkm treatment of syphilis is proving efficient in preventing the occurrences of hte manifestations of that disonler; and if this is true, it will probably mean a yery considerable reduction in the numbers of congenital mental defectives born into the world.

Admissions.--·Into State Hospitals, 470 males and 357 females were received, making a total of f\27 as against 8:38 in 1922.

Into Receiving Hollses and \Yards, 486 males and 377 females were admitted, totalling 863 as a.gainst 878 in the previous year. Of these, 560 patients were sent on to State Institatiom;, a.ml are included in the above numhers.

Discharges.--- These numberd 311 from the State Hospitals as against 299 in 1922, and from the the Receiving Houses, 288 were discharged as against 222 previously. ·

The discharge of 30 per cent. of the Receiving House admissions necessarily reduces the number of discharges from the State Hospitals, but it means that a goodly number of patients snftering from early mental disorders have been successfully treated without the stigma o[ full certification.

Deaths.-The number of deaths in the Institutions is very materially higher this year than it was in the preceding year, but beyond the fact that there was a considerable increase in pulmonary infections, there does not appear to be any special reason for the increased death rate.

There was one unusual de,tth at the Hospital at Kew : a male patient succeeded in strangling himself with the chain in a lavatory opening off the ward. No blame was attributed to the attendants in darge at the time.

At Beechworth there were two cases of typhoid, and at the old Institution at Yarra Bend, four female patients and one nurse developed typhoid during the year. In both these Institutions, it should be pointed out that there is no water-borne sewage scheme.

Voluntary Boarders.-··The returns of voluntary admissions to State institutions and l.ieensed Houses remain much the same as in the previous two years.

Int.o the State Institutions, 91 patients were received, and 63 were subsequently discharged recovered. Into Licensed Houses, there were 82 admissions, and subsequently 60 were discharged recovered, and :31 were certified as insane, whilst there were 6 deaths. This means that 173 patients were admitted voluntarily, and ol that number, 12:3 were suhsequent.!y discharged as recovered. Such a high proportion as this necessarily militates against a high recovery rate from the certified cases, but it certainly has the advantage of bringinrr patients into a,ppropriate Institutions fur early treatment, and is sufficient justification for the continuation and extension of the voluntary boarder system.

At Royal l'ark, a male voluntary patient, whilst convalescent and employed in the Workers' Block, committed suicide by cutting his throat. It is believed he did this under the impression that he was very shortly to be discharged from the Institution.

L£censed Hou•es.-The position of these Institutions remains almost the same as In previous years.

The lieence for '· Glenholme,'' which has been held for some years by .Mrs. Stackhouse, was surrendered, and a fresh licence was granted for a house named "Belmont," i1r Studley Park-road, Kew, to the same licensee-that is to say, there was practically a transfer of the licence.

There was nothing in the conduct of these Im,titutions specially ealling for comment. There were eight deaths of certified patients, and fh·e of voluntary boarders during the year, but none of them called for special investigation. '

As has been previously mentioned under the heading " Voluntary Boarders," it will be seen that the Licensed Houses get many sueh admissions, aml it would appear to be a procedure appreciated by the relatives of mental patients. Provided that there is adequate inspection of these Institutions, there can be no possible objection to this procedure.

The opening of the Nurses' Home at Mont Park a~centuates the desirability which exists for the establishment of further similar 1\urs~s· Homes. This is particularly the ease at Sunbury and Aramt, and to a less extent also at Ballarat, Beechworth and Kew. The projected decreast> in the working hours for the staff will inevitably mean additional acrommodation for the nurses and other female officers. On "the male side, where most of the stafi !<re married, the necessity will not be anything like as great. '

In their reports, the "'ledical Superintendents have usually outlined the principal desiderata for their Institutions, bnt it may be of value to recapitulate some of the principal worl(s which it is hoped will be supplied in the near future. Amongst these are:-----

Electric lighting of Kew and Beechworth. ·water-borne sewage schemes for Ararat, Beechworth, and Sunhury. Re-modelling of the male Division at Ballarat, with provision of additional

single rooms for troublesome patients. Improvement of the Criminal Ward at Ararat by the erection of an outside

airing court, and a wing of single rooms which will permit the wooden lock-ups to be dispensed with.

By the erection of various wards in certain Institutions, additional aceommodation will be given, and at the same time, the improvemmxt of the classification and equipment of each of those Hospitals will be brought about-·-for example, at Beechworth the provision of a female hospital ward is something more than a desirability.

At Ararat additional accommodation in the Receiving Ward is desirable. At Ballarat, there is considerable necessity for a female refractory ward.

To further develop the equipment of Mont Park as a general hospital for mental disorders, additional wards are wanted for the reception of male patients, and for the nursing of hospital cases, both male and female, by nurses of the latter sex.

Recreation hal~, wherein divine services can also be given, are very seriously needed at Mont Park and Sunbury.

This list may appear to be a very long one, but it must be pointed out that very little has been done indeed during the last twelve years to ·provide for the increased numbers which an increasing population must inevitably bring to this Department.

It has recently been conceded that the most satisfactory way of increasing the accommodation for mental cases would be to provide, in a central portion of Gippsland, a new Institution to deal with the cases occurring in that district. It would mean relieving the Metropolitan Institutions of some 400 patients, and it would provide facilities for the ready admission of cases occurring in this increasingly populous area. Apart from the ill effects of a prolonged railway joumey, which at present is necsssary to bring the patient from Gippsland to the metropolis, it is a distinct hardship to the relatives that they also have to travel long journeys when they desire to see the affiicted member of their family.

It is in the highest degree desirable that a suitable area of land should be obtained close to one of the larger of the Gippsland towns and railway centres.

I should like to stress again the necessity which exists for the establishment of a special Institution for those high grade mental defectives, particularly for children of school age, who are capable of receiving some benefit from training in special schools, and for whom appropriate residential Institutions arc necessary. Whilst this in some respects is essentially the work of the Education Department, it touches very closely the functions of this Department, which, however, should be entrusted more particularly with those imbeciles who are incapable of scholastic advaneement. In this respect, I would urge that renovations and additions should be provided for the Children's Cottages at Kew, and the most desirable advance would be the appointment of at least two trained kindergarden teachers, who would be entrusted with the education of those who are capable of benefiting from such education. Of the 350 cases in this Institution, there are some 30 or 40 who would definitely benefit from such education. There are perhaps 50 or 60 more who would benefit in some less degree. The remainder are entirely unedueable, and can only be trained in habits of cleanliness and discipline.

• The work of this Department is growing heavier and more complex each year, and it is only being carried through successfully by the enthusiasm and loyal support which I have received at the hands of the principal offieers of the various Institutions, together with the co-operation of M.r. Deane Smith and those who are employed under him in the Head Office.

W. ERNEST JONES.

fly Authority; H. J. GRJBN, Gov~tnmAnt Pfinter, Melbourne.