Deinstitutionalisation: an unrealised desire

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, Australia. A regional case study from Gippsland, Victoria, and the story of Cornelia Rau help support the contention that deinstitutionalisation in its most humane and therapeutic sense is an unrealised desire.

Key Words:

• mental illness
• deinstitutionalisation
• asylums
• antipsychiatry
• sociology
• Gippsland, Victoria