Dr Meg Smith: Consumer, Psychologist, and Mental Health Activist

In 1981, Meg Smith set up a support group people diagnosed with bipolar disorder (which, at the time, was named manic-depressive disorder). It was initially named MAD: the Manic and Depressive support group. Smith herself had only been diagnosed the previous year, after suffering years of experiencing episodes of significant mental distress. Participants in the group quickly realised that most of them had careers and were enjoying life—they were not out-of-control insane people as common stereotype would have it. Yet most had not received the medical care they needed; very few physicians and even psychiatrists were familiar with this condition. The number of MAD support groups soon grew. Smith has been a mental health advocate ever since. She is currently president of Way Ahead (formerly the Mental Health Association of New South Wales). Until recently, she also held a position in the Department of Psychology at the University of Western Sydney.

Meg Smith had her first depressive episode as a high school student in Casino, northern NSW. She was Dux one year and the bottom of the class the next. There were no psychiatrists or other mental health professionals in Casino at the time. Her GP prescribed anti-depressants, which did not make much of a difference. After graduating, Smith enrolled at the University of New England in Armidale to study English and History. In 1969, she had a serious depression. Seeking answers, she switched to psychology, but found it did not offer anything about ‘counselling or how to talk to people’.¹

During her Honours year, her condition got worse:

…flipping me into ups and downs.

She hardly slept, self-medicated, and eventually overdosed. She checked herself in as a voluntary patient at Newcastle’s Shortland [Psychiatric] Clinic for three months. She says treatment there was:

just group therapy… The most that can be said for it is that the food was great; I put on four stone.

Meg finished her honours year at the University of Newcastle and wrote a thesis on women and feminism, and joined the local women’s liberation group. After being depressed for two years, she thought she:

..might as well accept the fact that I was going to be depressed for the rest of my life, and it was probably my faulty personality!

Like many others, it was ‘many years’ before she was diagnosed with bipolar disorder ‘and effectively treated’. 

In 1971 Meg enrolled in the Master of Psychology program at the University of New South Wales in Sydney. In 1974, when she started writing her thesis on women and sexuality, she was also employed by an inner-city Women’s Community Health Centre (in Leichhardt). The community health centre focused on women’s health and birth control, and had an anti-psychiatric orientation. She recalled:

[I]f you had a mental illness, it was all the fault of the patriarchy.

Meg was told that her lived experience of depression got her the job: ‘I kind of got kudos and credit for that on my CV.’

Some women Meg counselled told her:

…fairly awful tales of psychiatry. I met a couple of women who identified as lesbian and they’d been given lobotomies.²

She realised that:

...Many women [were] coming into the health centre who clearly needed mental health care and we just didn’t want to refer them to the local psych hospital because of all the horror stories.

Instead, the Centre opened Louisa Lawson House as an alternative for hospitalisation for women in emotional distress. It ran a day program but without sufficient subsidies it could not expand.

In 1980 Meg experienced a psychotic episode. She was admitted to a major Sydney psychiatric hospital (Rozelle Hospital) and felt:

[I]t was like being thrust back 20 years … coming from a politically active, feminist health approach, to the medical model of psychiatry which was: you were mentally ill if you had a mental illness.

She remembered that :

…the ward I was in had 20-25 people. There was an assortment of people: again, women who were victims of domestic violence, young people who were victims of domestic violence. And these were social admissions … in order to get them out of a violent situation. 

After a couple of weeks, Meg was diagnosed with bipolar disorder. ‘In some ways,’ she recalled:

it was a great relief to be diagnosed with something that was neurochemical, because I could do something about that. I didn’t have a faulty personality. It was neurobiological: there was treatment available, so it was pretty liberating, actually.

Shortly after being discharged, Meg attended a ‘festival of madness’ organised by a group called PALA, which provided community mental health initiatives at the Bondi Junction Community Health Centre. She met several others with bipolar disorder and ‘invited them to get together to have a group’. She followed the example of the Women’s Health Centre:

You know: the personal is political, if it’s happening to you … it’s happening to other people. The mainstream health system isn’t helping, let’s come up with some alternative ways of working with ourselves.

The group met in Meg’s lounge room at first, but it kept increasing in size every time it met.³ ‘We met in local cafes, we met in people’s homes, basically any space we could find to actually have a get-together.’ The group had several name changes, from MAD to Depression and Mania Sufferers Group, and then to DMDA: the Depression and Manic-Depressive Association. It published a newsletter with a mailing list of about 400 people.

Many participants:

had had years of untreated symptoms [that had] devastated their lives… And they were pretty unhappy with the treatment they’ve been getting, and they didn’t understand what the illness was and what the treatment was.

In the group they began:

learning from other people about how they manage their symptoms … we exchanged names of good doctors and psychologists … information about what medication worked and what the side effects were, and what the risks were in not taking medication…⁴

Meg became involved with the Mental Health Association of NSW (today: Way Ahead), around the same time as another consumer activist, Janet Meagher. Until then, this Association had been dominated by psychiatrists, social workers, and psychologists. The involvement of Smith, Meagher and others signalled that a new era of consumer involvement and representation in mental health had begun.⁵

Meg went on to work at Milperra college of Advanced Education (which was later amalgamated with University of Western Sydney) and started her PhD, researching people living with manic depressive illness. It was awarded in 1990. She smiles when she relates that her academic career was formed ‘around living with manic depressive illness or living with bipolar disorder’.^6

Meg was a board member of the Mental Health Coordinating Council from 1990-6 and chair in 1991-93. She has been a community member of the Guardianship Tribunal since 2010 and a member of the Mental Health Review Tribunal NSW since 2011. She is currently an Adjunct in the Social Justice Social Change Centre at the University of Western Sydney. She was elected to the Board of Way Ahead in 1989 and is now its President.

She received an OAM in 1990.  

1. All quotations are derived from Meg Smith, ‘Interview,’ interview by Paul Rhodes and Gemma Smart, Oral History Project on the History of Community Mental Health in Australia, 5 Aug, 2020.

2. Such accounts are hard to verify, yet the assumption that they took place at the time was not uncommon. See, for example: John Ware, ‘Psychosurgery in Australia.’ Camp Ink 3, no. 4 (1973): 8.

3. Meg Smith, ‘How it All Started,’ in The Fourth MD Papers: A Collection of Personal Accounts, Information and Sundry Items About Living with Mania and Depression (Sydney: Depressive and Manic Depressive Association of NSW, 1992), 1-4.

4. See also Meg Smith, ‘Community Development and Self Help Groups for People with Serious Mental Illness,’ Network: Newsletter of the Board of Community Psychologists 8, no. 2 (1993): 1-12.

5. See also Meg Smith and Heather Gridley, ‘Living with Mental Illness in Australia: Changes in Policy and Practice Affecting Mental Health Service Consumers.’ Australian Psychologist 41, no. 2 (2007): 130-39.

6. M. A. [Meg] Smith, ‘Living with Manic Depressive Illness: Psychological and Social Aspects of Bipolar Affective Disorders.’ PhD, University of Sydney, 1991.