Country women hit under Kennett

The lives of rural women have been hit hard over the past five years, particularly in access to justice, due to the polices of the Kennett Government, according to the latest report of the People Together Project.

The report, to be launched today, says cuts to legal aid funding and other services such as transport had hurt rural women and heightened their geographic, economic and social isolation.

The People Together Project, a non-party political organisation set up to assess the impact of government policy, found that country women often found it hard to get legal advice because they had to travel to regional centres to find it, and many then could not afford to pay.

This often led to women facing pressure to forgo claims on assets, such as farms, in order to secure custody of their children during marital separations. The problems were further complicated when working out their property entitlements in family law because farm ownership arrangements were often secret, the report said.

The report is based on information from a two-day public inquiry that included submissions from 53 organisations and a series of women’s audits involving interviews and focus groups in three communities.

Submissions said rural women had been disadvantaged by the Kennett Government’s abolition of crimes compensation for pain and suffering: “If a girl or woman is sexually assaulted in a country town and then has the guts to report the assault it is reasonably likely that no action will be taken against the perpetrator.

“The previous crimes compensation system provided many rural women with often the only form of acknowledgment of the harm done to them or the opportunity for justice in their terms.”

The report found cuts to domestic violence programs in rural areas had led to large waiting lists for women wanting help or safe accommodation, and country people were struggling to fill the gaps left by cuts to other services.

A woman from the Central Goldfields told the project: “The community needed to raise money to match Government funds: $359,000 for the hospital and $250,000 for the community bank. No other money is now available in the community for any other services.”

The Association of Neighborhoods Houses and Learning Centres told the inquiry: “We now have voluntary drivers in mini buses and/or their own vehicle taking elderly people to doctors’ appointments 30 kilometres away because the public transport has been withdrawn.”

The Opposition spokeswoman on women’s affairs, Ms Leonie Burke, said the report failed to give the former Liberal Government credit for the positive steps it had taken for women, including $100 million to support carers, and broad consultations with rural women resulting in the Women on the Move report.

First published in The Age.

Women forced to fill `care’ gaps

Victorian women’s lives had become harder because Kennett Government policies had transferred the responsibility of caring from the public to the private domain, according to the latest report of the People Together Project.

The report, Women: Balancing Social Justice with Economic Efficiency, said women are forced to fill the gaps left by early discharge from hospital, the closure of childcare centres and the tightening of criteria for respite services.

“Ancillary services such as the Royal District Nurses and many community health care services now incur fees, which many women are unable to afford,” the report says.

The report is based on information from a two-day public inquiry to which 53 organisations made submissions, and three “women’s audits” involving interviews and focus groups in city, regional and rural communities.

It is to be launched today by Ms Felicity Hampel, QC, president of Liberty Victoria.

The report challenged the former Kennett Government’s claim that its economic and social reforms brought a better quality of life for Victorian women through its “social dividend”.

“In fact, many women now carry heavier burdens than ever because of widespread cuts to services,” the report said.

The report criticised lower standards of care in public hospitals, closures of family planning centres and long waits for help from mother-and-baby units.

It said a lack of public housing had left an increasing number of women living in sub-standard accommodation, and many mothers were struggling to pay higher fees for kindergartens and cope with “voluntary” levies and fundraising activities for schools.

It said restructuring of school councils had discouraged women from standing, while the amount of time and responsibility required of women on kindergarten committees of management was frequently equivalent to a part-time job.

The report said caps on legal aid funding in Family Court matters forced some women to remain in violent or unhappy relationships or to represent themselves in court when trying to protect their own or their children’s entitle-ments.

“In one instance, a client instructed his barrister to keep a woman in the witness box for as long as possible so that her legal aid would run dry,” the report said.

It said the contracting out of health, education and community services – traditional employers of large numbers of women – had reduced women’s jobs, job security, and pay and conditions.

Ms Hampel said the report’s findings were “a shameful indictment on a society which prides itself on fairness, equality of opportunity and access”.

The shadow minister for women’s affairs, Ms Leonie Burke, said yesterday that the former Liberal Government had recognised carers of the aged and disabled needed support and had pioneered a four-year, $100million program to help them.

She said the Government had also consulted women over their needs, culminating in the Women on the Move report.

The People Together Project describes itself as a non-party political organisation that assesses the impact of government policies on social justice.


“The intern was doing an epidural whilst the supervising doctor was not present. Twice her (sciatic nerve) was touched. On the third attempt her respiratory system was knocked out and plasma was required to resuscitate herThe supervising doctor arrived and (asked) why they were using a glass syringe. The intern replied that they thought because of the need to save resources, they’d use the cheaper reusable type of syringe, despite it being more difficult to use.”


“Jennifer, a mother of two secondary-school aged children, approached (a charity) distressed that she was unable to afford her children’s school fees (voluntary levies). She was embarrassed when she attempted to negotiate payment arrangements with school staff. Jennifer said, `I was abused by the secretary and told that schools were not banks.’ It was then suggested that she apply for credit elsewhere.”


“One woman was on the waiting list for public housing for 8 years. Then her daughter turned 16 and she was removed from the list altogether because she was no longer classified as a supporting parent.”

First published in The Age.

If abortion is a religious issue, why is the state involved?

I ONCE met a woman who taught sex education in a Catholic school. She was warm and enthusiastic and transparently sincere. She told me Catholic schools had changed, and that she was able to teach girls they had choices about their sexuality.

“They can choose to be chaste until marriage, or they can choose to be the town bike,” she said, beaming. “Uh, huh,” was the most neutral response I could muster.

She was as entitled to her belief in the two absolutes – chastity or promiscuity – as I was to my belief that there is a responsible middle course involving neither. And her attitude was no skin off my nose because she was never going to impose it on me or mine; she moulded children whose parents sought out an educational system imbued with those values. Each to their own.

If only there were such a clear division between church and state in the abortion debate. This is an arena where those driven by religious belief often wield power out of all proportion to their support in the community.

Last week a visiting American doctor was detained and told he would be deported or imprisoned if he advocated “activities” in relation to abortion. This followed lobbying of the Immigration Minister, Philip Ruddock, by anti-abortion groups.

In America, President Bill Clinton has agreed to limit aid for international family planning initiatives that support abortion. Republican congressional leaders have for years refused to pass Budget legislation allowing the US to pay its back dues to the United Nations unless Clinton agreed to the restrictions.

Although pro-choice himself – heaven help any man married to Hillary who wasn’t – Clinton capitulated this time because the US faced losing its seat in the UN General Assembly if the debts remained unpaid. Now organisations funded by US money will be forbidden to lobby for liberalised abortion laws.

There will be little joy about that among desperate women in countries such as Nepal, where six women a day die from botched illegal abortions and two-thirds of women in prison are there for abortion or infanticide.

Like the sex ed teacher, these Republicans deal in moral absolutes: abortion is always wrong, never mind poverty or illness, rape or incest or despair. But, unlike the sex ed teacher, they are in a position to impose their views on others who differ.

The power of the American anti-choice movement is understandable. Opposition to abortion is strongly linked to church attendance, and a third of Americans regularly front up in their Sunday best, compared with only one-fifth of Australians.

The US is also a country in which the separation of church and state has favored religion. Its founding fathers, having fled persecution in the old world, focused more on protecting freedom of worship from state intervention than protecting the sovereignty of the state from religion.

But why is it that Australian anti-abortion campaigners – most of whom have strong links to churches – have so much political influence?

It’s certainly not because they speak for the community. Research findings released this week suggest only three in a hundred Australians oppose abortion under all circumstances.

Among the 2151 people surveyed, 97per cent said abortion should be allowed in cases of danger to the mother’s health, 92 per cent after rape, and 88 per cent where there was a strong likelihood of a serious birth defect. Most said abortion should be allowed for reasons such as poverty, unwed motherhood, or couples wanting no more children.

These views do not fit with abortion’s continued position in the Victorian criminal code. They do not fit with restrictions on the morning-after pill RU486, or the inability of many rural women to gain access to abortion services.

The report said the abortion debate remains very much a religious matter, with churchgoing the single most important factor differentiating opponents from supporters.

It concluded that “the separation of church and state” is actually a polite fiction that can be maintained only in the face of consensus about central values. Where the two do separate over values, there is friction, with abortion providing the clearest example.

The results of a previous survey tell us how Australians think such conflicts should be handled: only one-third believes it is appropriate for religious leaders to try to influence government decisions.

There is a case for churches to speak out on social justice issues because they are such big providers of services to those in need. Their dictates on reproductive morality are another matter.

Extremism in relation to abortion has declined in the past decade. Most Australians have come to understand that this painful, tragic, private business is a bad thing in itself, but justifiable if it avoids something even worse. They have abandoned the false certainty of black-and-white positions to grapple with the complexities of greys.

Some will see the shift away from the absolutism of “never” as godlessness. Most of us, though, will recognise it as a moral coming-of-age.

First published in The Age.

Abortion extremism in decline, study finds

Fifteen per cent of Australians surveyed believe a woman should be allowed to abort a foetus if it is the “wrong” sex, a survey has found.

Asked if abortion should be permitted if parents wanted a child of the other sex, 6per cent said it should be allowed and 9per cent said it should probably be allowed. And 2per cent said parents should be allowed an abortion in order to choose a child who would be a great athlete or intellectually brilliant.

The figures are based on an analysis of the 1996-97 International Social Science Surveys Australia by researchers from the Melbourne Institute of Applied Economic and Social Research.

The national sample of 2151 people was compared with a sample of 3012 people taken in 1984-85.

Researchers found only 1per cent “definitely” thought abortion should never be available, and a further 2per cent “probably” opposed abortions under all circumstances.

Extremism of both kinds has declined over the past decade, with fewer people holding absolute views for or against abortion.

“Instead of an intractable conflict between entrenched positions pro and con, we see a full spectrum of opinion with the majority near the centre,” said a report on the findings in the Australian Social Monitor.

A big majority said abortion should definitely or probably be allowed in dire circumstances such as danger to the mother’s health (97per cent), pregnancy following rape (92per cent) or strong likelihood of a serious birth defect (88per cent).

Most also supported the availability of abortion in difficult social circumstances such as poverty (69per cent), unwed motherhood (68per cent) or couples wanting no more children (65per cent).

The report said: “Very few Australians think abortions should be prohibited (although many theologians would disagree) but, equally, very few believe that a woman has an absolute right to an abortion (although many feminists and some moral philosophers would disagree).

“Rather, most Australians view abortion as somewhat of a bad thing in itself but justifiable if it avoids something even worse.”

Older people were less opposed to abortion than younger people.

A co-author of the report, Dr Mariah Evans, a senior research fellow with the Melbourne Institute, speculates that people’s views might change as they age and become exposed to more life experiences.

First published in The Age.

Was the blokes’ republic a turn-off for women?

Did more women than men vote no to the republic – and if so, why?

Polling before the referendum showed several divides: yes voters were more likely to be younger than older, Labor than Liberal, urban than rural and well-off rather than struggling.

But one of the most consistent divides was around gender, with polls reporting that the number of women supporting the republic plan lagged about 10 percentage points behind men.

The Labor Party president, Mr Barry Jones, says election results suggest that women generally put a higher premium than men on the concept of security, “that is, hanging on to the known”.

Women also tend to be less attracted than men to themes of separation, independence and self-reliance, according to the historian Professor Marilyn Lake.

This might translate into less enthusiasm for “cutting the apron strings” from the mother country.

Social researcher Mr Hugh Mackay says he would have accepted that explanation 30 years ago but today’s women are much more independent. He believes the predicted gender gap was the result of more women than men resenting the way the referendum process was handled.

“One of the standard things said about gender difference is that men are more interested in outcomes, and women are more interested in process,” he says. “(It’s) an analogy for sexual foreplay, in a way: the male just wants to get on with it, and the female wants to be romanced and gentled into it.

“The (referendum) process was so rushed that there was a sense of being hustled along, and I think women intuitively felt the process wasn’t getting the proper attention, that we jumped straight to one model with no real public debate.

“It was men who were typically saying, `It may not be the model you want but nothing’s perfect. Let’s just do it’.”

Mr Mackay says women are also more likely than men to favor Mr John Howard as preferred Prime Minister, and therefore his stand.

Former Victorian Labor Premier Joan Kirner agrees that “blokes like just to get on with the decision” but says: “The research we have done for Emily’s List on elections indicates that women are far more likely to make a positive decision around issues that affect what the pollsters call `the details of their lives’.

“If matters don’t affect the details of their lives – and they don’t regard the republic as doing that – they will either be dismissive or vote against it.”

The deputy leader of the Victorian Opposition, Ms Louise Asher, suspects that the pressure of women’s lives militated against their positive involvement: “Most are incredibly busy trying to juggle triple roles. In the end, this was not going to impact on their economic wellbeing, it wasn’t going to buy them more time, and I don’t think anyone in Australia – putting aside the question of the monarchy – thinks the current system is actually disadvantageous.”

But there is evidence that women do care about Australia’s future identity. Says Mrs Kirner, “When I did consultations around Australia for the centenary of federation report for Keating in 1994, we had droves of women coming up to talk to us about the kind of Australia they wanted to see, their desire for reconciliation between black and white, and their pride in the country.

“It’s not that they are not interested in these issues as such, but they have got to be reflected in people-type terms.”

Mrs Kirner is critical of the Sydney-dominated yes campaign for failing to take ordinary women with it: “I said to the republican movement five years ago that … we needed to have community consultations with women, but it wasn’t the Sydney style. They had lunches and dinners, more formal functions rather than a community process.”

She suspects women were also alienated by the campaign’s blokiness. “If we had got more people like Hazel Hawke and Nova Peris-Kneebone out on the ground as part of a proper deliberative process, we would have done better.

“The last two weeks of the campaign was almost entirely dominated on the republican side by the faces of men. I thought if I saw another face of a bloke over 50 I would scream.

“When the coup de grace was supposed to be Malcolm Fraser and Gough Whitlam saying `It’s time’, I could just see women in the kitchen saying, `Yeah, it’s time to get the bloody dinner’!”

Rather more mortifying for women is the possibility that any gap could be explained by their greater political ignorance. Dr Pamela Ryan, managing director of Issues Deliberation Australia, oversaw a “people’s constitutional convention” in which 380 voters debated the issues with leaders of both sides of the republic debate.

She says that among the voters, “Women had lower levels of political knowledge than men, and that can often motivate a no vote.”

At the start of the debate only 33 per cent of the women, compared with 47 per cent of the men, knew that the role of the proposed president was like that of the current Governor-General. Ten per cent of women (22 per cent of men) had known that the prime minister could remove the president with the approval of the House of Representatives.

But here’s the rub: in this group, that ignorance did not translate into a marked gender gap, with support for the yes vote at the beginning of the debate running at 50 per cent for men and 48 per cent for women.

First published in The Age.

Free at last, with little to celebrate MENTAL HEALTH

“JOHN” supposes, rather tiredly, that he should buy a bottle of champagne to celebrate the 14th anniversary of his release from a mental hospital. A man with severe schizophrenia, he was locked up from the ages of 17 until 31 in his home state of Western Australia.

He spent most of those years either being forced to make toys, or sit around aimlessly watching television, watching the world go by. He is now free of the petty cruelties of that institutionalised world, such as the injections from a nurse who liked to blunt needles on a concrete floor before using them.

But he can’t see much reason to celebrate his new life. He spends most of his time sitting in a small, bare housing ministry flat, smoking, his only regular visitor the psychiatric nurse who brings his fortnightly injections.

John is quietly spoken, but looks dishevelled and often scratches himself, a legacy of rashes he caught while sleeping rough. For 11 of his 14 years of “freedom” he wandered homeless on the nation’s highways, sleeping in parks or on roadsides.

His appearance today does not go down well with the locals. “You walk down the street and people call you names,” he says. “You don’t go into places because they say you’re bad for business. One caf owner threatened to put a false charge against me because I used to have a pot of tea, but nothing to eat.”
John does not want his real name used because he fears it could lead to abuse.

He would not want to go back to hospital, but says he is not really happier now than when he was institutionalised. “No, not really,” he says. “They got it all wrong. They just threw everybody out on the streets, and when the community know you have a psychiatric problem, they don’t want to help you at all. Sometimes I think, would I rather be in, or would I rather be out?”

He feels he has too little to show for his 45 years of life. “I should have something of my own, not something I get for free. I used to earn $350 a week as a rouseabout on a sheep station when the wool industry peaked. I could have been a shearer, a wool presser, anything.”

But he sees little hope now of his situation improving. “The medicine makes me very sleepy, low energy. I can’t imagine myself driving a car. I will never be able to understand or know the real me because I’m sedated 12 months of the year.”

Ask him about his symptoms and his manner remains matter-of-fact but he starts telling bizarre stories that, on some level, he recognises as being part of his illness. “I got picked up by a dead person in a ghost truck,” he says. “There’s one between Sydney and Melbourne. I shook his hand and it was freezing, his body was ice cold. He definitely was dead as a doornail.”

Then there are the voices in his head: “They are looking for something,” he says. “They are questioning where we are living, where we should go from here.”

His plans, then? “I don’t know, really. I suppose I should get my act together to buy this bottle of champagne. I don’t know.”

First published in The Age.

Has a well-intentioned policy gone too far? MENTAL HEALTH

MAUREEN O’BRIEN reels off the stories. There was the young man who killed himself by ramming a car into a tree, after support services had been withdrawn because he was considered well enough to manage without them. Her own son, Paul, who had severe schizophrenia, once took a knife to his brother-in-law but was kept in hospital for only three days. Eight hours after Paul was admitted, the hospital rang to tell his mother to come and pick him up, saying: “He’s had a good sleep now.”

O’Brien refused, arguing that her son needed more help to stabilise his mental condition. He was discharged anyway. A week later he tried to kill himself with an overdose.

O’Brien, who is convenor of a support group for carers of schizophrenia sufferers, talks of another mother whose son “was so out of it” that his one bent in life was to kill his father. “The hospital staff … told the father not to come anywhere near him. A new psychiatrist came in on the Friday and the boy was discharged on the Monday. On another occasion this boy had gone on a suicide run and ended up in a four-car pile-up. They had to helicopter four people out.”

It wasn’t meant to be like this. Victoria has been hailed as a national and even world leader in providing modern mental health services. It has moved away from institutionalisation and into community care faster and more fully than anywhere else in Australia.

No one wants a return to the big, isolated psychiatric hospitals in which people were shut away in Dickensian conditions. But, both here and overseas, people are asking whether deinstitutionalisation of people with psychiatric illness has gone too far, depriving some seriously ill people of the intensive help they need.

In Britain, it was not compassion for sufferers but anxiety over public safety that triggered a new look at the issue. There was a public furore after 150 killings in six years by people with mental illness.

A former mental health worker, Jayne Zito, campaigned passionately for policy change after her husband, Jonathan, was stabbed in a tube station in 1992 by a patient with a history of psychosis and violence.

The British Government concluded that “community care” had left too many wandering the streets and sleeping rough. (In Australia, an estimated 25per cent of the homeless have a psychiatric disability.) It promised a network of nursed “safe haven” hostels and more psychiatric beds. But it did not take up advocates’ demands for legislation to give people with mental illness a right to treatment.

Britain’s swing back to a more punitive and custodial mentality disturbs Australian observers, who worry that deinstitutionalisation, there and here, has been blamed for problems that are really due to inadequate resourcing.

The man with paranoid schizophrenia who killed Jonathan Zito because he thought he was a devil “had also knocked on the doors of services begging to be admitted for days before it happened”, according to Bill Healy, head of social work and social policy at LaTrobe University. “That’s an example of an absolutely tragic event that can be distorted out of all proportion and finish up serving frightening political ends, such as the conclusion that we should lock people up.”

Deinstitutionalisation aims to give people the support they need to live in the community. In Victoria, acute care has moved from old psychiatric hospitals to general hospitals. Mobile support teams and emergency teams treat psychiatric patients in their home. Sixty per cent of Victoria’s mental health resources are now allocated to community care compared with 32 per cent in 1992-3. The number of registered clients of services has increased by 40 per cent, and Victoria now spends more per capita on specialist mental health services than other states ($76.20 compared with a national average of $68.78).

Community care dovetails with human rights goals to treat people with mental illness in the least restrictive and stigmatising way possible. Medically and socially, it is better for most patients and their families. But Australian carers say that while the problem used to be that some people with mental illness could not escape hospital, now they often can’t get in, even when they beg for help. Isabell Collins, director of the Victorian Mental Health Awareness Council, knows of people who have slashed their wrists or taken overdoses in order to get a hospital bed. Says one woman who has schizo-affective disorder (a combination of schizophrenia and what used to be called manic depression): “Basically, to get into hospital now, you don’t talk suicide. You talk homicide.”

Many carers say services are so overstretched that “community care” has become code for “saving money by dumping the problem on families”. It is parents and spouses who often now look after someone having a psychotic episode, and they say they often cannot get crisis assessment teams even to visit.

In 1997, The Age reported on Keryn Gordon, 35, who was repeatedly sent home from casualty units after suicide attempts without any psychiatric assessment. Shortly before her death, doctors advised her to stop her medication. Despite family protests, she was released into the care of her elderly parents while going through withdrawal. She held her mother at knife-point before grabbing two carving knives and escaping in a car. Some time later she was admitted to hospital, where she apparently suffocated herself.

Says O’Brien, “The biggest problem is that they don’t listen to carers when they ring. But this is not just like nursing someone who is ill; many times we are dealing with horrific problems that most of us are untrained to deal with.”

Roma Drummond’s son has had schizophrenia for 21 years. She says it is crucial that sufferers get medical help early in an episode of psychosis to try to minimise the damage of an attack. Yet patients and families are often told that the person is not yet ill enough to justify hospital admission. She says it’s a Catch-22. Experienced patients know they are becoming unwell and have enough insight to want help, but the psychiatric teams who act as gatekeepers to hospital beds often say if patients have insight they are not sick enough to justify admission.

Yet Professor Peter Doherty, director of psychiatry at the Alfred Hospital, says acute psychiatric beds are always available in Victoria. If a particular region is full to capacity, it refers patients out to services in another area. Doherty believes carers might misinterpret as bed shortage a refusal to hospitalise that is based on a clinical team’s assessment that admission is not appropriate.

In 1995 the Royal Australian and New Zealand College of Psychiatrists called for a moratorium on psychiatric bed closures in Victoria, saying that deinstitutionalisation had gone too far. Today’s president of the college, Dr Jonathan Phillips, says there are still not enough beds.

Phillips says lack of community housing is another major problem. “Where do people live who are deinstitutionalised? Most unfortunately, many will be living in sub-standard boarding houses, others will be living on park benches and others will be in jails.”

Up to 2 per cent of Australians will suffer a psychotic disorder, most commonly schizophrenia. John Farhall, senior lecturer in LaTrobe University’s school of psychological science, has researched Victoria’s switch to community care. Preliminary findings from his joint research with Monash and Melbourne Universities show that the vast majority of those released from long-term hospitalisation into community care units have done well. ” I am absolutely convinced that we have a better system than we used to have,” Farhall says. “But … there’s never been enough money to meet the reasonable needs of people with psychiatric illness, so both before and after deinstitutional-isation there were people who are underserviced.”

Isabell Collins says concentration on only the most basic needs can have tragic consequences. “A young man suicided and I was asked by his parents to look at his file to see if there was anything that indicated that the system had contributed to his death. He was a university student who developed paranoid schizophrenia. He was treatment-resistant; he didn’t respond well to the drugs. As a consequence of the illness he had to stop studying for his degree, he lost his girlfriend and his friends, he became homeless and he couldn’t get a job.

“There was not one single sentence in the whole of his file that would indicate that any member of the clinical team looked at the impact on his life of having this mental illness. When he came into hospital suicidal, the care plan was `Contain, medicate, allow to ventilate (talk about his anxieties)’. Collins says the man was allowed leave from hospital, despite his mother warning that he was suicidal. He walked in front of a tram.

Still, there are people receiving help now who did not before. For psychiatric nurse Graham Doidge, who until recently managed a homeless outreach service in the inner city, community care meant the freedom to conduct his consultations in alleyways, parks and the back seats of cars. His team looked after “Ian”, who was living in a city garden. They left appointment notes in a cup under his favorite park bench and gave him his medication injections in the toilet block. Eventually he began to trust them and they coaxed him into moving to a nearby rooming house.

Letting people out of custodial care is only half the answer. Accepting them into the community might take longer. The Reverend Marie Macdonald, a Uniting Church minister who works with residents of rooming and boarding houses in Kew and Hawthorn, tells of an attempt by a young man with serious mental illness to share one of life’s simple pleasures. “Victor loves cappuccinos. One pension day I saw him mid-morning, dressed in his fineries and on his way down to a local coffee shop to buy `a cappuccino, a coffee scroll and a packet of fags’. He looked really pleased with himself.”

She was surprised to see him again soon afterwards. The cafe owner had told him to come back later, when there were no other customers.

Not all the walls have come tumbling down.

Finding happiness in adjusting to everyday life

PSYCHIATRIC social worker Robyn Humphries had never seen patients like some of those she met on her first day as manager of a service for newly de-institutionalised people. “They were feral,” she says now. “Their appearance, their gait, their grooming – or rather lack of – no eye contact, no verbal communication except for a grunt, didn’t relate to each other at all. Pacing, shouting, wandering; some were defecating inappropriately. I was shocked. I can remember thinking, ‘What have I done?’.”
Four years, a new environment and a change of medication later, most of the former patients have changed for the better, some dramatically. Many of the people she met that first day have “graduated” from the community care unit that Humphries runs into more independent accommodation.

A big factor in their improvement was new anti-psychotic medication. They have also responded well to their new homes. They left large hospitals such as Larundel and Mont Park for the Northern Community Care Unit – small houses and units on a large green block in Preston. The 20 patients have 24-hour supervision by 23 staff. The aim is to stabilise their medical conditions and teach them the skills to live more independently.

“You can see the change in people here,” Humphries says. “They like being more normal, going to the shops and out to the cinema or the bank. The old way was a very artificial way of living.”

“Alex” used to be totally directed by staff because he had little control over his behavior. He had poor hygiene, smoked everything from teabags to rolled-up newspapers and vomited often because he ate out of rubbish bins.

Now he is relaxed and cheerful. He plays the piano accordion, can make eye contact and talk briefly about what he has been doing. After a year-long slow-eating program, he can put down his fork between mouthfuls and control his urge to shovel food. Humphries suspects that in a big, noisy setting he might have grabbed his food quickly to stop others snatching it.

Patients can now choose what to wear and eat and do. And their families look at them differently. “You don’t see them any longer as a mad person in a mad place,” Humphries says.

First published in The Age.