the out-patient department established a year and a half ago under the care of a visiting nurse maintained by the hospital. Mrs. Loughlin made during the past month some 66 visits, mostly to patients at home on parole. The steadying influence of such a visitor, and of her friendly and expert advice coming at the right moment, results in relieving many cases of mental, physical or other trouble in the families of the patients. Where necessary the patient may be brought back to consult with his physician, but oftentimes return to the hospital is avoided by discovering the intimate causes of worry or breakdown, and by relieving the strain through securing employment or change of surroundings for the patient. During the past year the visiting committee has suffered the loss by death of two of its members, Mrs. John J. McWilliams, and Judge George A. Lewis. Mrs. McWilliams had previously served on the Board of Managers of the State hospital, and was therefore thoroughly conversant with the aims and activities of the institution. Judge Lewis possessed marked qualifications for a member of the visiting committee. For many years he served as trustee on a number of State and other charitable institutions, and was at one time an important member of the prison parole board. (Signed) FANNY H. BARTOW, MANHATTAN STATE HOSPITAL A visitor from the central office reports a number of improvements at Manhattan State Hospital during the past year, most important of which are a new power house, just completed; a reception building for women, and another for men, very recently opened. These reception buildings are of the most modern and approved type. They are provided with all the equipment for continuous baths and hydrotherapy. They will reduce the overcrowding by housing 350 patients. The system of recreation and amusements provided for patients has been completely reorganized. A moving picture machine has been installed and out-of-door movies once a week are a summer feature. The band has been rejuvenated and as a result cheerful music is to be heard daily in one building or another. The women's industrial department has a large victrola at its disposal which is kept up-to-date by the purchase of a dozen new records every month or two, and the women are thus able to combine work with pleasure. Miss Jestley, the matron of the industrial department, was delighted to report the fulfillment of one of her long delayed plans-she is now able to subscribe to all of the interesting women's magazines and thereby add greatly to the happiness of the women on the wards. A resident dentist has finally been secured for the hospital. He is to have an office in the women's reception building. Manhattan State Hospital is to be congratulated on the produc tiveness and attractiveness of its truck gardens. Every spot has been utilized. Beets take the place of cannas and foliage plants. The coloring is quite as decorative and the beets far more useful. The ground around one of the new buildings is growing a fine crop of lima beans, and an unsightly mound of dirt which was not removed in time to escape the resourceful farmer has become a glorified melon patch. One of the most serious situations which the hospital has to face this year is the shortage of physicians and attendants. On the date when this inspection was made there were 61 vacancies among women nurses and attendants and 24 among the men. The figures have run as high as 100 vacancies at a given time. This condition is due to a combination of causes including the shortage which the war makes among the nurses and employees generally, the poor pay and long hours of a State hospital, and the unusually large number of opportunities elsewhere. The very efficient social worker at the hospital has had an unusually busy year. Her work is increasing in volume and in importance. When one stops to consider the population of Manhattan and the number of cases requiring supervision which are paroled yearly, it is easy to see that one worker cannot possibly cover the ground adequately. In the past year 113 cases were assigned to the social worker for home supervision in addition to all her other duties, such as obtaining employment, securing case histories and investigating the homes before parole. For these 113 cases it was possible to make only 199 visits, which means that the vast majority of the patients were seen in their homes only once during the year. An out-patient clinic which should be located at a more convenient and accessible point than Ward's Island, a clinic where patients could see the doctor and the social worker at definite intervals, would also add greatly to the effectiveness of the social service department. REPORT OF THE BUREAU OF STATISTICS Submitted by Horatio M. Pollock, Statistician and Editor To the State Hospital Commission: I beg to submit the following report of the Bureau of Statistics for the fiscal year ending June 30, 1917: EDITORIAL WORK The editorial work conducted by the Bureau has been increased by the enlargement of the State Hospital Quarterly and by the assignment to the Bureau of the compilation of the Commission's annual report. EXHIBITS The Bureau conducted the Commission's exhibit at the State Fair September 11-16, 1916, and assisted in the preparation and arrangement of the exhibit of the hospitals and the Commission at the meeting of the American Medico-Psychological Association, in New York City, May 29 to June 1, 1917. Both of the exhibits attracted much attention. for Elaborate plans were made by the Bureau early in the year a unique exhibit at the State Fair of 1917, but their execution was prevented by the use of the State institutions building on the fair grounds by the Federal Army. STATISTICAL WORK In addition to the preparation of the annual statistics of the insane in the State hospitals and private licensed institutions and of the finances and administration of the State hospitals which appear in this volume, the Bureau has made special studies during the year as follows: 1. "The Relation of the State Institution Farm to the Cost of Maintenance." This paper was read at the meeting of the State institution farmers at Ithaca and at the Quarterly Conference held in Albany, February 27, 1917, and at the special request of the Agricultural Committee was distributed in pamphlet form at the meeting of the American Medico-Psychological Association held in New York City, June 1, 1917. 2. "Decline of Alcohol as a Cause of Insanity." A review of the influence of alcohol in causing admissions to the State hospitals during the years 1908-1916. 3. "A Statistical View of Mental Disease in the State Hospitals." A detailed study of the outcome of the several psychoses in the State hospitals. 4. Statistical Information for the State Hospital Development Commission. 5. "Occupation and Dementia Praecox." A comprehensive study of the rate of dementia praecox in the various occupations in this State. In company with Dr. August Hoch, director of the Psychiatric Institute, the statistician visited the Brooklyn State Hospital April 1-3, 1917, and conferred with the medical staff relative to the hospital statistics. During the early part of the year the statistician cooperated with the National Committee for Mental Hygiene in the preparation of a national census of the insane, feebleminded, epileptics, and alcoholic and drug addicts in institutions. He also assisted the statistical committee of the American Medico-Psychological Association in the preparation of a plan for the collection and compilation of uniform statistics of the insane throughout the country. The general statistics of the various divisions of the State Hospital Department are submitted herewith: |