therisingblues wrote:Some interesting comments there Psyber. When were those services disbanded? You appear very knowledgable of the subject matter. Is this sort of a well publicised thing in Australia now? I haven't lived in Oz for 6 years now.
I had worked in the SA Mental Health system at one time. This stuff tends to be very hushed up in Australia and denied by state governments and those who want to stay in their employ, but is widely known among the broader health community, and those who try to help people penetrate the defences of the system and actually get help. Geriatric services are slowly going the same way.
The transition from "lockups" to integrated services begain in Oz in the early 1960s as a flow on from the discovery of new antipsychotic medicatiions, beginning with chlorpromazine in 1947. [It was intended to be an antihistamine, and it was a while before its use for anything else caught on widely.]
It was during the mid 1970s that the "Citizens' Commission for Human Rights" [Scientology front] began its campaign in Oz, arguing that existing psych units were "imprisoning" people inappropriately. [Scientology offers an alternative cure involving their "E-meter", being "cleared", and giving 10% of your income to "The Church of the New Faith" instead, and was opposed to competition, especially any that worked.]
This created an atmosphere that enabled state governments to create a basis for moving to free up saleable land locked up in hospitals and save the costs of running the specialist hospital units, and they embraced the "liberalisation" of the old detention laws fairly universally during the early 1980s. First this meant the potentially harmful to themselves or others could not be held until it was irrefutable that they were indeed that, because they had done harm,
In SA, the first aim was to close Glenside and sell the land - valuable housing blocks close to the city in the SE suburbs - but the push to save Glenside's buildings based on their historical background forced the SA government to back down and close Hillcrest instead. Of course that land was not in as sought after an area, and was transferred to the SA Housing Trust for development of economical housing.
The move of the acute beds into general hospitals "and the community", began during the late 1970s, and really gathered momentum in the 1980s. In theory, much of the money saved from closing the hospitals was to go into thes services. In fact they were underfunded, the support in the hostels slowly declined and the overworked CAT teams slowly tightened the definition of mental illness they were meant to deal with in self defence. The law has not changed since the 1980s but what is done within it has shrunk.
In Victoria now, the CAT teams are not interested unless the patient is overtly psychotic and there is strong evidence of pending suicide or homicide - and even then the suicidal ideas tend to be fobbed off as "attention seeking".
The Cornelia Rau saga reflects this change. The Brisbane hospital said, after observing her and sending her back to DIMIA, that while some of her behaviour was strange she did not fit the criteria for Schizophrenia. This translates as, "These days we apply the very strict criteria set up in DSM-IV primarily to make a very tight diagnosis for research purposes and can get away with fobbing off anyone who does not display the full symptom cluster."
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