Archives
Deinstitutionalisation: an unrealised desire
Janice Chesters
Centre for Multi-Disciplinary Studies, School of Rural and Indigenous Health, Monash University, Moe, VIC
Abstract
The mental illness reform movement of the 1960s and 1970s or 'anti-psychiatry' produced a rich critique of institutional responses to mental illness. One consequence of this movement was a powerful commitment from across the political spectrum for the closure of specialist mental hospitals and a move to community care - deinstitutionalisation. This paper briefly explores the reform movement's impact on mental illness services, but it also examines the much less well- known and less influential counter critique mounted by archivists, historians, clinicians and philosophers. This counter critique showed that while place was important, no one location guaranteed humane and effective mental illness care. Good, poor and horrific treatment occurred in the community as well as in a range of institutional settings. This paper explores the complexity, interconnectedness and cyclical nature of mental illness services in Victoria. A Gippsland case study and the story of Cornelia Rau help support the contention that deinstitutionalisation in its fullest, most humane and therapeutic sense is an unrealised desire.
Keywords
mental illness, deinstitutionalisation, asylums, anti-psychiatry, sociology, Gippsland
References
Australian Institute of Health and Welfare (2001) 'Mental Health Services in Australia 2000-01': 171. http://www.aihw.gov.au/publications/hse/mhsa00-01/index.html
Australian Institute of Health and Welfare (2004) Australia's Health Canberra: AIHW.
Allderidge, P. (1979) 'Hospitals, Madhouses and Asylums: cycles in the care of the insane' British Journal of Psychiatry 134: 321-334.
Allderidge, P. (1985) 'Bedlam: Fact or Fantasy?' in Bynam, W.F.' Porter, R. and Shepherd, M. eds. The Anatomy of Madness Volume 11 London: Tavistock Publications, pp 17-33.
Andrew, A. and Edwards, A. (1992) Two Turrets and a Dome Sale: Gippsland Base Hospital.
Australian Health Ministers (2003) National Mental Health Plan 2003 - 2008 Canberra: Australian Government.
Bachrach, L. (1989) 'Deinstitutionalization: a semantic analysis' Journal of Social Issues 45 (3): 161-171.
Barham, P. (1992) Closing the Asylum London: Penguin Books.
Bostock, J. (1968) The Dawn of Australian Psychiatry Sydney: Australian Medical Association, Mervyn Archdall Medical Monograph No. 4.
Brothers, C. (1962) Early Victorian Psychiatry 1835-1905 Melbourne: Mental Hygiene Authority.
Burdekin, B. (1993) Human Rights and Mental Illness Report of the National Inquiry into the Human Rights of people with mental illness Vol.1 and 2. Canberra: Australian Government Publishing Service.
Burston, D. (1996) The Wing of Madness The Life and Work of R.D. Laing Cambridge: Harvard University Press.
Busfield, J. (1996) Men Women and Madness London: Macmillan Press.
Cade, J.F.J. (1979) Mending the Mind Melbourne: Sun Books.
Cage, R. (1992) Poverty Abounding Charity Aplenty The Charity Network in colonial Victoria Sydney: Hale and Iremonger.
Chesters, J. (1996) 'Not Under Proper Care and Control': researching mental health and illness in East Gippsland' Gippsland Heritage Journal: 20:15-20
Chesters, J. (2003) 'A horror of the asylum or of the home: women's responses to asylum confinement' in Coleborne, C. and MacKinnon, D. (eds) 'Madness' in Australia: history, heritage, and the asylum Brisbane: University of Queensland Press: 135-144.
Currier, G. (2000) 'Datapoints: psychiatric bed reductions and mortality among persons with mental disorders' Psychiatric Services 51: 851.
Dax, E. (1961) Asylum to Community Melbourne: F.W. Cheshire.
Ellery, R. (1956) The Cow Jumped Over The Moon Private Papers of a Psychiatrist Melbourne: F.W. Cheshire.
Farran-Ridge, C. (1933) 'Mont Park Mental Hospital and its Inmates' The Medical Journal of Australia No. 8: 237-245.
Fead, G.C. (1994) 'Notes of an Unsettled Life' Gippsland Heritage Journal No. 16:24-36.
Gauchet, M., Swain, G. (1999) Madness and Democracy the Modern Psychiatric Universe New Jersey: Princeton University Press.
Goffman, E. (1968) Asylums London: Penguin Books.
Hanson, V., Jacobsen, B. and Arnesen, E. (2001) 'Cause-specific mortality in psychiatric patients after deinstitutionalisation' The British Journal of Psychiatry 179: 438-443.
H&CS (1994) Victoria's Mental Health Service The Framework for Service Delivery Psychiatric Services Division.
Human Rights and Equal Opportunity Commission (2005) HREOC Submission to Senate Inquiry on Mental Health. http://www.hreoc.gov.au/disability_rights/inquiries/mental/senate05.htm
Hyslop, A. (1987) 'Microbes and madness the exclusions policy of Ballarat District Hospital 1856 to 1876' in Attwood H and Kenny G (eds) Reflections on Medical History and Health in Australian Medical History. Melbourne: University of Melbourne.
Jodelet, D. (1991) Madness and Social Representations: Living with the Mad in one French Community Berkeley: University of California Press.
Jones, K. (1993) Asylums and after a revised history of the mental health services: from the early 18th century to the 1990s London: The Athlone Press.
Jones, R, Chesters, J and Fletcher, M (2003) 'Make Yourself at Home: People Living with Psychiatric Disability in Public Housing International Journal of Psychosocial Rehabilitation vol.7:71-85.
Kennedy, A. (1950) Report to the Minister for Health on mental health and mental hygiene services in the State of Victoria Melbourne: Government Printer.
Kesey, K. (1962) One Flew Over the Cuckoo's Nest London: Picador.
Krupinski, J. and Stoller, A. (1962) 'Survey of institutionalised mental patients in Victoria, Australia, 1882-1959' Medical Journal of Australia: 8.
Lewis, M. (1988) Managing Madness: psychiatry and society in Australia 1788-1980 Canberra: Australian Government Publishing Service.
Local Government Focus (1999) http://www.lgfocus.com.au/editions/1999.april/green/dev.shtml
MacKinnon, D. and Coleborne, C. (2003) 'Deinstitutionalisation in Australia and New Zealand' Health and History 5 (2): 1-16.
Mechanic, D. and Rochefort, D. (1990) 'Deinstitutionalization: an appraisal of reform' Annual Review of Sociology 16: 301-327.
Mental Health Review Board of Victoria (2003) Annual report for the year ending 30 June 2003.
Mental Health Services- Victorian Government Health Information, Australia 'A guide to mental health terminology -deinstitutionalisation.http://www.health.vic.gov.au/mentalhealth/termnlgy.htm
Mental Health Council of Australia (2003) 'Out of hospital, out of mind!' A report detailing mental health services in Australia in 2002 and community priorities for national mental health policy for 2002-2008 MHCA.
Rogers, A.and Pilgrim, D. (2001) Mental Health Policy in Britain second edition London: Palgrave.
Russell, D. (1995) Women, Madness and Medicine Cambridge: Polity Press.
Sedgwick, P. (1982) Psycho Politics: Laing, Foucault, Goffman, Szasz and the future of mass psychiatry New York: Harper and Row Publishers.
Shera, W., Aviram, U., Healy, B. and Ramon, S. (2002) 'Mental Health System Reform: a multi country comparison' in The workings of the system and system change
The Haworth Press: 547-575.
Shorter, E. (1997) A History of Psychiatry from the era of the Asylum to the age of Prozac New York: John Wiley.
Skultans, V. (1975) Madness and Morals London: Routledge and Kegan Paul.
Smith, P. (1873/1874) 'Hints on the giving of certificates of lunacy' part 1 and part 2', Australian Medical Journal December, January: 356 and14.
Springthorpe, J.W. (1902) 'The treatment of early mental cases in a general hospital' Intercolonial Medical Journal of Australia 11: 198.
Stoller, A. and Arscott, K. (1955) Mental Health Facilities and Needs of Australia. Canberra: Government Printing Office.
Stone, M. (1985) 'Shellshock and the Psychologists' in Bynum, W.F., Porter, R. and Shepherd, M. eds. The Anatomy of Madness, Vol 11 London: Tavistock Publications.
Thomas Embling Hospital http://www.forensicare.vic.gov.au/website.nsf/web/InpatientServices.html
Victorian Parliamentary Papers (1884) Report of the Zox Royal Commission: 12-14.
Victorian Prisoner Health Study (2003) Deloitte Consulting Department of Justice Government of Victoria.
eContent Home