By PhD Candidate in History, Robyn Dunlop
The theme of October 2020’s NSW Mental Health Month is “tune in”: tune in to what’s happening within you, and in the world around you.
I am a PhD candidate in History, researching the development of community mental health services in Newcastle, NSW. Newcastle was a significant location for innovative services from 1967 to 1987. Showcasing its mental health history highlights the transformations that have taken place over time in the roles and expectations of people accessing mental health support, and helps us tune in to our attitudes and understandings of mental health and wellbeing in the present.
Day and Out-Patients
The Shortland Clinic was formally opened in 1967. Before this, the principal mental health service in Newcastle was at the Watt Street Psychiatric Centre (later the James Fletcher), which offered long-term in-patient care in an institutional setting. The Shortland Clinic aimed to be different. Established by psychiatrist Dr Howard Johnson and attached to the Royal Newcastle Hospital, it was housed in a new, purpose-designed building with a striking cylindrical shape, lots of natural light – and no long, straight corridors or locked wards. Services at the Clinic were designed for people voluntarily seeking mental health support, typically while living at home and coming to the Clinic for day programs or appointments (though limited in-patient care was available).
Consumers and Clients
Experimental and innovative services developed over the 1970s, with federal health reform and funding in Australian community health services – including mental health. New initiatives began to spring up outside of hospital settings:
A drop-in, mental health shop opened at 737 Hunter Street (Newcastle West) in 1975 – one of the only places of its kind. Located among other shops on a busy thoroughfare, people could walk in and see a social worker, psychologist, nurse or counsellor – more like consumers than patients. If there were issues that looked like they needed a medical review, a community psychiatrist was available once a week.
Community mental health and health centres also opened in Hamilton, and across the Hunter Valley (Maitland, Kurri Kurri, Cessnock, Windale, Charlestown, Port Stephens). Run by psychologists and community nurses, they offered consultations to clients and a variety of services, such as skills training workshops, group sessions and social events. A regional community psychiatrist came regularly to see clients in the centres, and, in conjunction with the nurses, visit people in their homes.
In this period, general practitioners recorded increasing numbers of people coming to see them for mental health consults. After a nationwide search, the federal government invested in a new medical school to be established at the University of Newcastle, to have a specific focus on community medicine. In 1974 Dr David Maddison – psychiatrist and former Dean of Medicine at the University of Sydney – was chosen to be its new leader. He and a dynamic team created an internationally influential medical school. Significantly, the curriculum centred on a person-focused approach, combining psychological and social aspects of health and disease with clinical problems. It trained doctors to see the person as a community member, not just an illness.
Dr Beverley Raphael was appointed the first Professor of Psychiatry in the new medical school. She had been a general practitioner before training as a psychiatrist, and she united general practice and psychiatry through her work on bereavement and community-wide mental health disaster responses. Dr Raphael was interviewed by Ron Hurst on The Valley’s People in 1980 and discussed her part in providing support for those affected by the Granville Train Disaster.
Ron Hurst’s interview with Dr Raphel begins at 13m 25s, the video will start at this point. Video from https://livinghistories.newcastle.edu.au/nodes/view/79787.
From the 1970s, the politics around the patient role became more visible with the formation of community groups in mental health. Psychiatric patient rights and social action groups were formed, largely in capital cities and influenced by similar associations in the UK and the US. Self-help groups mushroomed, led by people living outside of institutions who met for mutual support, information sharing and friendship.
These groups highlighted new roles emerging beyond the “patient” and “consumer” identities for people with experience of mental distress and psychiatric treatment, roles that offered empowerment, responsibility and involved helping others.
Community groups made up of relatives, carers and other interested community members were also established, contributing to advocacy and mental health promotion. In 1979 a public meeting was held in Newcastle’s Town Hall inviting people to become involved in this area.
Mental health services in Newcastle diversified in the 1980s, with separate services emerging for adults; adolescents; and children. They all centred on supporting people and their families in the community. Self-help groups and community associations continued to play and important role in the mental health field. The example of innovation in Newcastle services provides a new perspective in mental health histories, highlighting the changing ideas about and responsibilities of people with experience of mental disturbance over time. In contrast to institutional care, which was characterised by broad trends and similarities, it also reveals that the development of community mental health services has been locally specific and diverse.
The full exhibition was held in October 2020 and is now finished. All the posters used for the exhibition are contained in this PDF. After Wards by Robyn Dunlop Complete Display
After Wards TIMELINE
If you experience distress from viewing this exhibition, now or later, please seek out your support network or access those at:
University of Newcastle Counselling 4921 6622 https://www.newcastle.edu.au/current-students/support/personal/counselling
Lifeline on 13 11 14 https://www.lifeline.org.au/
Beyond Blue on 1300 22 46 36 https://www.beyondblue.org.au/
A list of Dr Ann Hardy’s work on Newcastle mental health histories on the Hunter Living Histories blog, and Dr Hardy’s profile of a key figure in Newcastle mental health from the 1960s through to the 1990s, Rosemary Ramsey.
Our Consumer Place – a resource centre for mental health consumers.
2014 Mental Health Week: Janet Meagher on the ABC’s Conversations with Richard Fidler.
Further information on Dr David Maddison.
Further information on Dr Beverley Raphael.
2 thoughts on “After Wards: From Patients to Participants – Community mental health services in Newcastle, NSW 1967 – 1987”
The Shortland Clinic enabled the public to use the expertise of the Mental Health Unit without having to enter the site. Access was by way of a bridge off Ordnance Street to the Foyer on the first floor of the building. The exterior and interior of the building were photographically archived before its demolition and a copy placed in the Newcastle Regional Library.