It was encouraging to see the NSW government accept the 13 recommendations from the coroner. But it did not commit to implementing two of the most important recommendations. These related to providing short-term accommodation and long-term accommodation with attached clinical and rehabilitation support for acutely and chronically mentally ill patients. This reluctance to provide long-term accommodation for these very disadvantaged patients is disappointing.
It was the dispossession of long-term chronic psychiatric patients from their accommodation, clinical care and rehabilitation when the state mental hospitals were closed that has caused much of the problems in public sector mental health services right up to today. It would be a pity if the New South Wales government didn’t take the recommendations of the coronial inquiry and move to provide a substantial increase in long-term accommodation, clinical, support, and rehabilitation in the community for patients with chronic mental illness.
I am certainly not defending the old state mental hospitals – far from it. But at the time they were dismantled well intentioned community mental health clinicians were both championing the changes but yet naive. They had convinced themselves that mental hospitals caused mental illness. They did not. Patients were in hospital mainly because they were very unwell. But the mental hospitals needed to be reformed. They were preoccupied with containment and not with recovery. The community clinicians believed the money saved from closing hospitals would come to the community. It did not. It went elsewhere.
We are still living with the consequences of this dispossession of services from our chronically and severely ill patients, most obviously in the lack of appropriate long-term accommodation and rehabilitation. I do hope the Bondi Junction coroner’s suggestions are taken up in full.
See the National Association of Practising Psychiatrists analysis of the current Crisis in Australian Mental Health Services at:
https://napp.org.au/addressing-the-ailing-state-of-australian-mental-health-care-2024/
Prof Philip Morris AM
President NAPP
