Holly Kemp and Paul Rhodes

In this presentation we focus on a description of the development of a unique research culture and method for our project on the history of mental health activism and community psychiatry in Australia.

This project aims to document the lives, perspectives and praxis of both consumer/ex-patient activists and mental health professionals who challenged the dominance of the medical model and institutionalisation, in favour of an aspiration towards a participatory and community based approach. The research is defined by three principles which correspond with the subject under study: co-production between academic staff and consumer/expatient leaders, non-hierarchical dialogicity among the research team, and witnessing as a frame for both story collection and research dissemination. In this presentation we will describe these principles in practice, arguing that they serve as a critical antidote to elite practices in academic knowledge production.

Georgia Valis

Until fairly recently, the experience of culturally and linguistically diverse (CALD) communities in Australian psychiatric institutions during the post-war era had received little attention in histories of psychiatry. Recent interdisciplinary work by social and cultural historians have demonstrated that a focus on migration and resettlement processes in (post-)colonial national contexts is a productive strand of enquiry in the history of mental health.

In this paper I examine the role and experience of migrants and people of non-English speaking backgrounds (NESB) in post-war Australian psychiatric institutions. There is a growing body of literature that analyses the relationship between migration, trauma, and mental health for ethnic and cultural populations, including some new and emerging communities in Australia, though few cover resettled communities in Australia after the 1950s. Studies in migration and resettlement, and transcultural and comparative psychiatry, have shown that the confinement of people of NESB within colonial social institutions was a qualitatively different experience than that of Australian-born settlers.

For these reasons I argue that historicising the experience of CALD communities in Australian psychiatric institutions and writing cultural identity back into our histories is an important step for accurate and comprehensive histories of mental health.

Robyn Dunlop

The Australian National Disability Insurance Scheme (“the NDIS”) has been introduced in recent years to support people living with disabilities with access community services to live an “ordinary life”. Community mental health services have now been running for more than fifty years in Australia, and the time is ripe to re-examine their development.

The NDIS was first trialled in 2013 in four sites across the country. One of these four was the Hunter Region.1 This reflects the early years of community mental health services, when Newcastle and the Hunter Region were also chosen as a trial region. In the 1960s Newcastle was the only location outside Sydney for a new, voluntary patient psychiatric clinic. In the 1970s it was one of two areas chosen to trial a regionalised health administration; was one of the first areas in the country to open a mental health shop and community mental health clinics; and was chosen as the site for the country’s first medical school to focus on community medicine.

In this talk I will examine the history of innovation and community mental health services in Newcastle to reflect more broadly on the changing roles and expectations of people who accessed these services: from patients to consumers and clients.

Annie Sykes and Ruah Grace

Annie Sykes escaped out of a mental hospital in New Zealand, left everything behind, and came to Australia with only a small suitcase and $200. She remembers her words to a physician early in 1988 when, unbelievably, he inquired what she wanted. Her response was: “A chance!” As she related in an interview: I had never heard of holistic care or received it. I come from a history of complex trauma, and complex health and mental health co-morbidities as a result. I used to be shunted around and out to become someone else’s responsibility or was simply abandoned as too hard [to deal with] or, worse, violated and object of prejudice within these caring health systems … receiving a surgical procedure without anaesthesia!

While receiving treatment in the private sector, Annie was encouraged to articulate her ideas on recovery. Recovery language and appreciation first appeared in community-based mental health NGOs around 2003. Care in the public health sector remained very basic and paternalistic. Annie’s “My Recovery Toolkit” was formally introduced in 2002 and heralded a new paradigm, no longer emphasising paternalistic care but, instead, self-agency and self-determination. Annie Sykes has been Flourish Australia’s Senior Independent Advocate since 2001.

She has extensive experience across diverse mental health services and identifies as a non-binary Maori Wahine from Aotearoa but calls Australia home. She loves cats, enjoys watching television, reading, going to the movies and live theatre.

Roslyn Burge

A project investigating the history of Australian initiatives in community mental health care from the 1970s has brought together a collection of interviews with individuals about their experiences of care as consumers, activists challenging formal locations and practices, and nurses and psychiatrists providing care.

This paper considers some of the ways in which their collaboration and how they mobilised influenced the development of community mental health care in the last decades of the twentieth century. Formulated in pre-COVID days the project had to adapt to new methods of interviewing: how did the project proceed and what were some reflections of interviewees on the leadership in and the legacy of community mental health care.

The interviews provide a rich perspective on the involvement of consumer advocates in mental health care in Australia. While some consumers aimed to reform the system from within, others decided to establish their own initiatives separate from the mental health care system and mental health professionals.

Some quotes from one of the interviews (with Amanda Waegeli): “Take them on … (Amanda) … We were going to be disruptive innovators … Suffocated by the regulations … We are going to make change happen … When you’ve got a division … it generates a conversation.”

Asha Zappa

Mad Pride is an international movement that directly challenges mental health prejudice through celebration. This often takes the form of creative projects, including, in Australia, Mad Pride concerts. In this presentation, I will explore the ways the consumer/survivor/ex-patient movement has used creativity to de-stigmatise mental illness, and positively influence the understanding of mental health within mental health systems. As truly consumer-led initiatives, projects such as Mad Pride have enabled consumers to take control of narratives around mental illness, and re-situated the power away from the medicalmodel- informed view of creative pursuits of people with mental illness as “outsider” (e.g. “outsider art”) toward community empowerment. These events and projects also break down barriers between what is “art” and what is “medicine”, challenging traditional hierarchies of knowledge.

In this presentation, I will present information from the ARC-funded History of Community Mental Health in Australia research project (University of Sydney), drawing on interviews with consumers, medical and other health professionals, and researchers. The research project has interviewed over 40 people involved in the development of community mental health in Australia. The presentation will explore the history of the Mad Pride movement in Australia, and the way creativity has played a role in the consumer/survivor/ex-patient movement, with particular focus on the way that celebratory events – such as concerts and art exhibitions – can strengthen the impact of the movement.

The presentation will explore the experiences of people involved in these activities, including the originators of Mad Pride in Australia, and the way that these activities influenced and supported their work in consumer advocacy. I will also explore ways that creative approaches to the consumer/survivor/ex-patient movement can inform understandings of mental health, and how it has influenced the medical field.

Janet Meagher and Hans Pols

In the 1970s, Gough Whitlam’s government started to make funds available for initiatives in community health. Several initiatives started to spring up throughout Australia, often as collaborative efforts between mental health personnel, mental health activists, carers, and consumers. The pioneering work of ABC journalist Anne Deveson, whose son had schizophrenia, are well-known: through her initiatives, the Schizophrenia Fellowship was established in every state. The mental health personnel involved generally were psychiatric nurses, occupational therapists, and social workers, who were associated with mental hospitals. Fred Kong, for example, worked as a psychiatric nurse at Gladesville Hospital before he was appointed as head of the Richmond Fellowship. Most of the new initiatives in mental health distinguished themselves by encouraging the involvement of consumers, who came to play a key role in advocacy, public health education, and running community mental health services.

Anthony Harris

In 1983 John Hoult published the results of a seminal study in community psychiatry that demonstrated that community mental health teams were able not only to prevent hospital admission but provide care more cheaply than existing hospital-based services and in a way that was significantly more satisfactory for both consumers and their relatives. This finding, hotly disputed at the time, energized the development of community psychiatry services in Australia. The concept for this study had been developed through exposure to a number of innovative services in the United Kingdom and the United States. This paper will trace the development of the study, the local factors that altered the design of the intervention and how this has gone on to mould other community psychiatry services, not only in Australia but also as an exemplar for a broad range of international mental health services.

Ian Shoebridge

The 1970s in Australia saw a wave of initiatives and changes in mental health delivery. Deinstitutionalisation, the critiques of antipsychiatry, and new approaches and models of therapy led to various community-based treatment approaches and gradual reforms of institutional mental health delivery. The growing consumer movement, informed by other social justice movements and motivated by abuses within institutional psychiatry, led to political activism that fought for representation, inclusion, rights and self-determination for consumers/survivors/ex-patients, and continues even more strongly today, facing some of the same challenges and some new challenges of working within systems for change.

This presentation will focus on some of the early pioneers of these changes, across political, medical and consumer activism fields, the interaction of these different these groups, the common and unique challenges they each faced, the barriers overcome and how that has shaped the mental health landscape of the present. What were the most pressing issues these early pioneers sought to change, how did they each overcome various barriers, and what have been the lasting impacts?

It will draw largely from interviews and research conducted by the ARC project, the first to study in depth this history of changing mental health delivery in Australia.