‘The government is the cause of the disease and we are stuck with the symptoms’: deinstitutionalisation, mental health advocacy and police shootings in 1990s Victoria

Abstract

The deinstitutionalization of mental health services in Australia happened first and most rapidly in the state of Victoria. In the final decades of the 20th Century, a period of immense economic and social policy reform accelerated this shift. Policy change appeared to be guided, at least in part, by ideals of human rights and citizenship. However, these same principles could be undermined in the vacuum of services created by deinstitutionalization and the broader restructuring of the welfare state. One expression of this paradox was a reported increase in violent encounters between police and those in states of distress and mental crises. Another example of paradox was rights-based mental health law, which both increased procedural safeguards for involuntary psychiatric intervention but also perpetuated differential treatment of persons with psychosocial disability on the basis of unfounded beliefs. This article will examine the intersections of policing and mental health policy in order to examine how boundaries of normality and disablement were contested during a transitional period of mental health law and policy.

Acknowledgements

I would like to thank my anonymous reviewers for their considered feedback. Moira Jenkins also provided illuminating comments on an earlier draft. Thanks also to thank Dr. Zora Simic and Associate Professor Tracey Banivanua-Mar for their support and guidance through an earlier iteration of this material.

Notes

1. The term ‘psychosocial disability’ is being used increasingly since the coming into force of the UN Convention on the Rights of Persons with Disabilities (UNCRPD) in 2008. This includes use of the term by the UN Human Rights Committee (2016), the WHO (2013), the UN Office of the High Commission for Human Rights (2009, para 49), various governments and a range of disabled people’s organisations. This term is by no means uncontroversial, nor does it refer to a coherent and easily-defined human experience. Many people who experience mental health crises, mental illness, and so on – even the majority – may not think of their experience in terms of disability. Nor may mental health professionals be inclined to use disability to frame their practice. Nonetheless, the term is used here as a broad term that includes, in the terms of the UNCRPD (art. 1), ‘those who have long-term physical, mental, intellectual or sensory impairments which in interaction with various barriers may hinder their full and effective participation in society on an equal basis with others’. This non-exhaustive list could include the disablement that may come from imputed disorder or from short-term crises.