I first encountered Brian Stagoll in the early 1990s when I started attending the Australian and New Zealand Family Therapy conferences. This conference was a rare event in my life and in the culture of psychotherapy at the time, a community meeting place for those of us who rejected the dominance of the cognitive industry of psychology in favour of practice focussed on values, justice, and creativity. Stagoll had co-founded both the conference and the Australian and New Zealand Journal of Family Therapy in 1979, and I still remember hearing him speak on Gregory Bateson, too nervous to go up and speak to him but grateful he was helping to set me free from the dictates of my own field of clinical psychology. Later I would become the editor of the Journal myself thanks to the legacy he had created. Without his leadership much of my career would not have happened. I am eternally grateful.

Needless to say, I was thrilled to have the opportunity to interview Brian last year with my colleague Ian Shoebridge.[1]  I think Brian, then 77 years of age, was also excited showing such enthusiasm and joy at recalling some of the seminal moments in his life. In line with our research agenda, we focussed on his career from the late 1960s to early 1980s. Rest assured, however, that a lot happened after this period, but that’s another story.

Brian attended the University of Melbourne Medical School from 1963-1968, which at the time offered a conservative course where the bio-medical model was dominant and students (mostly male) were removed from lectures if they did not wear suit and tie. He went on to study as fellow of Psychiatry at the Bronx State Hospital in New York City, where he first encountered the burgeoning community psychiatry movement. Here he learned the key precepts of social psychiatry: that pathology lay not in the individual but in oppressive social structures, that intervention should be preventative and focus at community-level interventions, and that systemic practice offers an alternatively to a purely bio-medical or psychoanalytic paradigm.

Brian returned to Australia in 1976. Australia had become a very different country as compared to the one he had left five years earlier. Whitlam had ended the White Australia Policy in 1973, the Women’s Liberation Movement was well underway, and despite the recent Dismissal there was still “a tremendous energy in the community for community projects.”[2] Brian started working at the Bouverie Centre, still the pre-eminent family therapy Institute in the country, spearheading the development of systemic training courses, consolidating this practice as “the clinical arm of community psychiatry.”[3] Two years later he joined the Melville Clinic in Brunswick, the first community mental health centre in Victoria, bringing social psychiatry to life in a struggling suburb. He described the practice there as “outdoor family therapy,” a form of “macro-community psychiatry,” inventive, multi-disciplinary, injecting hope and support for families in distress.[4]

It was an experiment that worked, undergoing a rare comprehensive evaluation.[5] 

This is the first time anybody in Australia has ever properly evaluated [a] community health centre. So, what do we find in this document? The lowest medication rates in the mental health system. The lowest hospitalisation rate. Increase in utilisation by otherwise unreachable groups, the Italian and the Greek community.[6]

By 1982 Brian experienced burn-out and after a short stint in academia developed the Williams Road Family Therapy Centre with Moshe Lang, the first private family therapy institute in Australia. He also became involved as a policy advisor for the Victorian government, helping to develop three important reforming Acts, the Mental Health Act, the Disability Act, and the Intellectual Disability Act.

One of the critical issues I have been reflecting on as I have revisited this interview is what made him such an effective change-agent. Firstly, Brian was never restrained by the limits of his formal profession, psychiatry, but instead looked well-beyond the silo, to systemic practice of course, but also to sociology, social epidemiology, cybernetics, feminism, leftists politics and more.  Brian was a scholar, not simply a psychiatrist, and he synthesised these influences in his practice. In systemic practice the family therapist aims to introduce ‘news of difference’ into a stuck system, breaking down homeostasis through new and relational ways of interpreting meaning. It seems Brian’s wider interests allowed his to perform this function for the mental health system, making direct “links between poverty, marginality, and mental illness” in order to challenge the paradigm.[7]

More than this, however, Brian was a doer, surviving in academia for only short time, preferring instead to build services for real people on the ground. As he says “there is a lot of rhetoric floating around mental health and we were involved in a kind of metaphysical revolution around Laing. But often it was a critique of psychiatry that was quite relentless, that didn’t actually address what you might do about it.

And the question is: What we could do about it? And the way we could do it was open up a community, discharge people in the community and look after them properly.[8]

This year Brian was awarded Medal of the Order of Australia (OAM) for service to medicine as a psychiatrist. I can’t think of a more well-deserved accolade for this lovely man.

By Paul Rhodes

References

[1] Brian Stagoll, “Interview,” interview by Paul Rhodes and Ian Shoebridge, Oral History Project on the History of Community Mental Health in Australia, 21 May, 2021.

[2] Stagoll, “Interview,”  25:56.

[3] Stagoll, “Interview,”  16:58.

[4] Stagoll, “Interview,”  48:14.

[5] Lenora Lippmann, and Alan Mackenzie, Melville Evaluated: An Experiment in Community Mental Health Care (Melbourne: Mental Health Research Institute, Health Commission of Victoria, 1982).

[6] Stagoll, “Interview,”  45:49.

[7] Stagoll, “Interview,”  11:39.

[8] Stagoll, “Interview,”  22:11.