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• W4321360726 abstract "(Re)Writing Care: Critical Histories of Community Mental Health Services in Australia and New Zealand Gemma Lucy Smart (bio) and Asha Zappa (bio) The provision of mental health services has been one of the most challenging issues facing Australia and New Zealand in the twenty-first century. Demand seems to keep on rising, despite attempts to funnel funding into the sector during the COVID-19 pandemic. Current government policies prioritise community approaches rather than the institutional treatment of people experiencing mental distress—these days, in psychiatric wards in general hospitals, rather than mental hospitals. Yet despite increased funding for mental health services, they continue to be the subject of significant criticism and government inquiries. The Royal Commission into Victoria’s Mental Health Services and the Report of the Productivity Commission are the latest examples—although it must be said that mental health has been subject of Royal Commissions and official inquiries every two or three years over the past fifty years, if not more.1 Both most recent reports emphasise the ‘missing middle’ in mental health services— for individuals whose condition is not serious enough to warrant treatment in a psychiatric ward, but too serious for psychologists and psychiatrists in private practices, there seems to be nowhere to go. This special issue of Health and History is an intervention into this situation by showcasing critical histories of community mental health. It reflects the diversity and the strength of initiatives undertaken in Australia and New Zealand since the 1980s and engages with history and historiography from a number of angles. There are several peer-reviewed articles that push methodological boundaries by engaging with the voices of consumers of mental health care—with the ‘mad’ voice both directly and indirectly. We have also invited several personal reflections from individuals involved in innovative practices in community mental health—consumers, professionals, and, yes, even historians. These reflections provide deep and personal insights and most of them ‘decentre the authorial voices of historians and lead to much richer insights’.2 And finally, we devote several pages to a range of creative works including art, poetry, and cartoons as an homage to the role that creativity and artistic expression has played and continue to play in the consumer/survivor/ex-patient movement. [End Page 1] A Moment in Time Community mental health services emerged in Australia from the 1970s, following the deinstitutionalisation of patients who had been confined in psychiatric hospitals. These patients were discharged to live in the community while there were hardly any structural supports available for them. Support services for people who had experienced institutional care were patchy, experimental, and often geographically specific. After the election of the Whitlam government in 1972, Australia experienced a period of community activism with protest movements opposing conscription, Australia’s participation in the Vietnam war, gay rights demonstrations, and second-wave feminism. Coinciding with these movements, coalitions of groups advocating for former and current psychiatric patients and advocacy by former inhabitants of mental hospitals emerged in the late 1970s, responding to gaps in community services. People diagnosed with psychiatric illnesses started to form self-help groups soon after. The mutual support and impetus to activism provided by these groups forcefully demonstrated their capabilities and increased public awareness of the nature of mental distress as well as the need for patient and consumer consultation in mental health. In their recent summary of deinstitutionalisation and mental health activism in Australia between 1975–1985, Dunlop and Pols argue that: … deinstitutionalisation, innovative initiatives in community mental health by civic associations, and a general enthusiasm for social reform, in particular the emergence of consumer activism, provided an optimal context for former patients of mental hospitals to have their voices heard and participate in debates on how to change and optimise mental health services.3 This special issue primarily showcases novel approaches, advocates, innovators, and experiences and challenges that accompanied developing effective and inclusive community mental health services, several of which were led for and by consumers and consumer activists. A key theme during this period was the difficulty of providing service provision and peer support in the context of the anti-psychiatry and civil rights movements, which questioned the validity of the..." @default.
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• W4321360726 title "(Re)Writing Care: Critical Histories of Community Mental Health Services in Australia and New Zealand" @default.
• W4321360726 doi "https://doi.org/10.1353/hah.2022.0039" @default.
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