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VII. ALIEN LUNATICS.

During 1926, 8 pauper lunatics were removed from Scotland as having no settlement in that country. Of these patients, all of whom were removed from asylums, 4 were sent to England and 4 to Ireland.

VIII.-LUNATICS UNDER JUDICIAL FACTORS.

At the end of December, 1926, there were 1290 persons reported to us by the Accountant of the Court of Session as under judicial factory in consequence of mental unfitness for the management of their affairs. This number is exclusive of some cases in which the means of the wards have been exhausted, though the factory has not been formally discharged by the Court.

These persons were disposed of in the following way:

947 were in asylums in Scotland;

267 were in private dwellings in Scotland under the care either
of relatives or of unrelated guardians; and

76 were resident either in asylums or private dwellings beyond
the direct jurisdiction of the Board.

All patients resident in Scotland whose estates are under the management of judicial factors were visited by our officers during the year, except some whose position and circumstances were otherwise satisfactorily known, and in whose cases visitation was thought undesirable.

IX. THE NUMBER AND DISTRIBUTION OF MENTAL
DEFECTIVES AT 1ST JANUARY, 1927.

The number and distribution of certified mental defectives on the
Register of the Board at 1st January, 1927, were as follows:-

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The following are general results during 1926 as compared with 1925 in regard to registered mental defectives :—

There was a total increase of 140, due to an increase of private patients by 13 and an increase of rate-aided patients by 127.

The total increase of 140 arose from an increase of the number in institutions by 103 and an increase of the number in private dwellings. by 37.

The increase of 103 in institutions arose from an increase of 12 private patients and an increase of 91 rate-aided patients.

The increase of 37 in private dwellings arose from an increase of 1 private patient and an increase of 36 rate-aided patients.

X.-STATISTICS OF INSTITUTIONS FOR MENTAL
DEFECTIVES.

(SEE TABLES AT END OF APPENDIX TO REPORT.)

Admissions.

The total number of patients admitted to institutions during 1926 was 245, which is 43 less than in the previous year.

Of the 245 patients admitted, 17 were private patients and 228 were rate-aided patients, as compared with 8 and 280 in the previous year.

Discharges.

During 1926 there was a decrease of 39 in the number of discharges from institutions, the total number discharged being 107, of which 2 were private patients as compared with 7 in 1925.

Deaths.

The number of deaths during the year was 35compared with the number for the previous year.

an increase of 3 as

The recorded main and contributory causes of death were as

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During the year many patients are allowed home from institutions for a holiday in the Summer at the discretion of the Medical Superintendent. In addition to those so liberated, 9 patients were allowed to leave the institutions with the sanction of the Board on periods of licence varying from 3 months to 12 months in order to test their fitness for discharge to their homes. Of that number, 4 were ultimately discharged from the Registers, 1 was placed under private guardianship, 1 was returned to the institution, and 3 were still absent on licence at the end of the year.

Escapes from Institutions.

The whole number of escapes during 1926 was 17. Of these, 16 were brought back to the institution and I was discharged.

XI. PRESENT CONDITION OF ESTABLISHMENTS FOR

MENTAL DEFECTIVES.

Baldovan Certified Institution.

Inspected 28th April and 15th November, 1926.

(Average number of patients resident during year, 269.5.)

All parts of this institution were found in excellent order and taste. fully furnished. A good deal of painting has been done at which some of the patients assisted.

The training of all pupils mentally and physically fitted to benefit by it is carried out assiduously and with much intelligence and tact in an endeavour to bring out the inherent capabilities of each patient to the best advantage.

Now that the institution is under the management of a Combination of District Boards of Control the demand for accommodation has increased to such an extent that it is desirable that the Board of Management should consider, at an early stage, to what extent and in what direction extensions and alterations should be made. Two of the primary considerations must be the erection of a hospital of the nature of a sanatorium and the provision of a colony so as to maintain in the colony and under the present administration patients who have hitherto had to leave on approaching an adolescent age and for whom there are at present no facilities for further treatment. Any schemes which may be contemplated by the management will be considered sympathetically by the Board who, for many years, have been pressing for the extension and widening of the beneficent work that has hitherto been done in this institution.

Barnhill Certified Institution.

Inspected 11th February and 30th July, 1926.

(Average number of patients resident during year, 51.0.)

Comment has frequently been made on the occupational therapy carried on in this institution. It is probably unexcelled anywhere. A new industry-the making of golf clubs-has been introduced, and the progress that several of the inmates have made in this work is remarkable. The nursing and general care of the patients is good and the management is carried on with great tact, skill and enthusiasm. An atmosphere of contentment, happiness and goodwill was specially noticed at both visits.

Birkwood Certified Institution.

Inspected 5th March and 30th November, 1926.

(Average number of patients resident during year, 88-5.)

The children in this institution gave the appearance of being very happy in spite of the disturbing conditions unavoidably consequent on the carrying on of structural alterations. The marked improvement observed in the physical and mental states of the majority of the patients is due to a combination of influences-the medical care, informed nursing, good teaching and individual attention.

The numerous additions and alterations which have been in progress for some time have, in many cases, been completed. The new kitchen, for example, is a model of what an institution kitchen should be. The school was practically completed and has on its southern aspect a movable glass partition which can be thrown open, thus allowing scholars to be practically in the open air. The excellent manner in which the sanitary arrangements throughout the institution have been adapted to the special requirements of the patients is also very favourably reported upon.

The general impression was formed that there has been marked progress in every direction.

Bridge of Weir Certified Institution.

Inspected 22nd April and 5th October, 1926.

(Average number of patients resident during year, 9-5.)

In the course of the year there has been nothing of special importance to record in connection with this institution. At both visits the patients were found in good health. Their circumstances are all that can be desired, and they are well clothed and have abundant exercise in the beautiful and extensive grounds of the institution.

Broadfield Certified Institution.

Inspected 22nd January and 1st July, 1926.

(Average number of patients resident during year, 20-0.)

This institution, belonging to Paisley District Board of Control, was opened for the reception of male patients on the 6th of June, 1925, and a careful inspection has shown that the management is proceeding on lines promising success.

At the date of the second visit a conversation with the boys showed how contented they are and how happy to be working in a kindly environment amid the numerous diversions and delights that a farm, garden and the tending of cows and poultry afford. These boys are all in good health, and it was learned that although some of them before their admission to the institution had presented quite a serious problem to the Local Authority there had been little trouble in controlling them.

The material comfort of the patients is well attended to in every respect and the dormitories especially were found in excellent order.

Falkirk Poorhouse Certified Institution.

Inspected 25th May and 17th December, 1926.

(Average number of patients resident during year, 80-0.)

The management continues to merit approval for the individual attention given to the patients in this home. The patients are all in good health and manifest in their demeanour the excellent care which they receive.

The sitting-rooms are bright, comfortably heated, well ventilated and scrupulously clean. The dormitories also are in excellent order.

Gogarburn Certified Institution.

Inspected 10th May and 27th December, 1926.

(Average number of patients resident during year, 42.0.)

The accommodation for male patients in this institution was made ready early in the year, and the male patients who formerly resided in Craiglockhart Certified Institution have now all been transferred. The quarters for these patients which consist of an excellent sitting-room, a dining-room, kitchen and dormitory accommodation were carefully inspected, and the impression was formed that the institution is progressing on solid and substantial lines.

All the inmates--both girls and boys-appear to be very happy and responsive to the attentions of a very kindly and efficient staff. Training in all forms of domestic work is afforded to every patient who is fit for it, and the individual attention bestowed has produced excellent results.

Southern General Hospital (Govan Poorhouse) Certified Institution. Inspected 7th April and 12th August, 1926.

(Average number of patients resident during year, 38-5.)

The care of all the patients in this institution is of an excellent description and their material comforts are well attended to in every respect. They are being carefully taught and have such individual supervision as is calculated to bring out the intelligence of each patient to the best practical advantage.

The sitting-rooms and dormitories are most comfortable and the patients themselves are neatly dressed.

Larbert Certified Institution.

Inspected 26th March and 24th August, 1926.

(Average number of patients resident during year, 473-5.)

As was intimated last year, the Estate of Larbert House, consisting of about 750 acres of land, has been acquired by the Directors who propose to establish a colony on it. The acquisition of this Estate gives expression to the long felt need for more land in connection with the present institution which has hitherto not had the necessary facilities for the open air care of so many young people, as many of the young people who are received into an institution such as this are prone to tubercular affections. The establishment of a colony for patients who are emerging from childhood into the adolescent period will be of great advantage. The education which has hitherto been given in order to train mentally defective children so as to be useful at least to themselves and possibly to the community will thus be further elaborated. An opportunity was taken in the course of the second visit to inspect the Mansion House which it is proposed to utilise for private patients.

The work in the present institution continues to be satisfactorily carried out on that high plane of efficiency which has frequently been noted in previous reports. The varied schemes of education and occupational therapy are applied so as to bring out to the fullest extent the capabilities of each individual.

All the children are very happy, bright and responsive to the kindly and patient attention given to them by their nurses and governesses.

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