per cent. The most serious condition obtains at the Manhattan State Hospital on Ward's Island, where the overcrowding is 38.8 per cent. At Central Islip State Hospital the overcrowding is 20.5 per cent; at Kings Park State Hospital, 27.7 per cent; and at the Brooklyn State Hospital, 34.1 per cent. These figures relate to the patients actually in the hospitals on January 1, 1917, and take no account of the 1,625 patients on parole from the several institutions. The patients cared for in the State hospitals in excess of capacity exceed the inmate population of the State prisons by 1,065 and equal approximately 60 per cent of the inmate population of the charitable institutions. The situation now with respect to lack of accommodations is more acute than at any previous time since the State assumed the care of the insane. During recent years especially, provision for new accommodations has not kept pace with the increase of patients. Since the Gowanda State Hospital was opened in 1898, no new hospital for the insane has been built in this State, although during that time the insane population of our civil hospitals has increased from 20,845 to 35,613, or 70.8 per cent. Since 1912, in spite of the efforts of the Commission to parole to their homes as many patients as possible, the overcrowding has gradually increased. On the basis of patients actually in the hospitals, the overcrowding increased from 15 per cent in 1912 to 22 per cent on January 1, 1917. The evil effects of overcrowding are much more serious in hospitals for the insane than in institutions for other classes of dependents. When congestion reaches the height now found in our metropolitan hospitals, it becomes exceedingly difficult for the institutions to perform their normal function of restoring the mental and physical health of their patients. In a hospital for the treatment of mental diseases, sanitary conditions with respect to air space in day rooms and dormitories cannot be restricted to the cell space allowed convicts in State prisons, without transforming the hospital into a veritable madhouse. When wards become crowded, assaults and accidents increase in spite of the watchfulness of nurses and attendants; the death rate rises and the recovery rate falls. The Commission feels the necessity of directing your serious attention to this matter, because the institutions in its charge which should stand, as they have stood for the past twenty-five years, as havens of hope to afflicted minds, are in danger of becoming merely custodial asylums. Since admission of the insane to the State hospitals is made mandatory by law, the only way to remedy overcrowding is by providing additional accommodations. The new construction now under way and the appropriations of last year will provide 1,856 additional beds, which should be available by June 30, 1918. During this period the expected increase of patients will be 1,692. The overcrowding will thus be reduced from 6,098 to 5,934. This latter number indicates the accommodations for which appropriations are now needed. The Legislature of 1915 authorized the undertaking of contracts at a total not to exceed $1,500,000 for the construction of the Mohansic State Hospital, and appropriated for immediate use the sum of $300,000. This latter appropriation is still available, and we would request that both the contract authorization and the $300,000 appropriated be transferred for use in developing the Marcy site. This could be done without placing any additional financial burden upon the State. This site, now owned by the State, consists of 933 acres of unexcelled farm land located at Marcy, a suburb of Utica. The site is bound on one side by a branch of the New York Central railroad and on the other by the Barge canal, which makes possible the necessary construction and maintenance at a minimum cost for transportation facilities. If the suggestion of building upon this site is approved, the present buildings at Utica can be used for the care of patients, particularly the feeble and demented, who require but little ground for exercise. The Commission plans to relieve the metropolitan district by taking away from the Hudson River State Hospital, located at Poughkeepsie, some of its northern counties, namely, Albany, Washington and Rensselaer, and transferring their patient population of approximately 1,500 to the Utica hospital district. This would release that number of beds for transfer to the Hudson River State Hospital of an equal number of patients from the metropolitan district, and would enable this hospital to continue to receive from 250 to 300 new patients annually from New York City. This plan should prove acceptable to New York City, inasmuch as the transportation facilities are admirable between New York and Poughkeepsie and the fare and time consumed are approximately the same as are required to make the trip to Central Islip, L. I. The Commission also urges the adoption of the recommendation of the Governor that an additional building to accommodate 600 aged or feeble cases be started immediately at the Middletown State Hospital, thus affording further relief to the overcrowding in the metropolitan institutions. This construction at Middletown can be made in the least possible time, inasmuch as the institution is provided with a new and adequate power plant and laundry equipment. The Commission respectfully requests your careful consideration to the other items for construction which provide additional accommodations and necessary improvements, as submitted in the requests of the various State hospitals, for appropriations to the Governor's Budget Conference and to the Joint Legislative Budget Committee, which are already before your honorable body in printed form. The Commission respectfully suggests that the Legislature consider the advisability of adopting a definite program, extending over a period of several years, which will provide for the gradual reduction of the present excessive overcrowding and the provision of adequate accommodations for the annual increment to the insane population of the State. During the past ten years the average annual increase in the State hospital population has been 937; during the past three years it has been 1,044. The greater increase during the past two years is partly attributable to the necessary falling off in deportation of the alien insane because of the European war. Allowing for the normal deportation of the alien insane which will follow the cessation of the European war, and taking into consideration the normal growth in the State's total population, with a tendency to crowd into the cities more and more, and the present overcrowding, it will be necessary to provide for an increase of at least 2,000 beds per year during the next five years. If the cost of construction returns to its normal level at the close of the European war, this necessary annual provision would cost the State approximately $2,000,000 a year. Respectfully submitted, THE STATE HOSPITAL COMMISSION, CHARLES W. PILGRIM, ANDREW D. MORGAN, FREDERICK A. HIGGINS, Commissioners. AGRICULTURAL OPERATIONS OF THE STATE HOSPITALS The accompanying tables show the results of the cultivation of the State hospital farms for the 15 months ending December 31, 1916. Hereafter the farm reports will cover the calendar year rather than the fiscal year. This plan of reporting was adopted in order to enable comparisons to be made between results and outlay of the same year. If the farm accounting ended on June 30, the report would show the outlay of the current year and the results of the preceding year. The total acreage cultivated by the hospitals was 5,708 acres, the total farm investments, $1,362,494, and the total net profit, $243,134. The average net profit per acre was $42.60 and the average per cent of profit on the investment, 17.8. The principal products were valued at wholesale prices as follows: Very satisfactory progress has been made in the production of potatoes, garden products, pork and milk. Several of the hos |