Not Before Time

Victoria’s mental health system has been and is both a product and producer of an ongoing process of colonisation.

This process continues today through practices that devalue or discredit non-Western approaches to social and emotional wellbeing, and through culturally unsafe care. Aboriginal Victorians experience racism through higher rates of restrictive practices.

The past and current use of seclusion, restraint, compulsory and coercive treatment, police killings and violence, comas, iced baths, lobotomies, institutionalisation, locked wards, racism and neglect.

Many of these practices still occur. All of these practices have been accepted at one point in Victoria’s mental health system.

When people enter the mental health system, their personhood is denied.

This can occur through the denial of human rights that other Victorians enjoy. Our mental health laws continue to violate Australia’s international human rights obligations.

Being distressed does not make you any less human nor any less worthy of human rights.

Narrow biomedical hurt us.

They often presume ‘what is wrong with you’. They don’t ask ‘what has happened to you’ and ‘how did you survive?’. People die up to 30 years younger in Victoria, in part, due to the medications they receive (often involuntarily).

These narrow biomedical approaches harm all. However, marginalised communities feel it most. First Peoples, women, same-gender attracted, trans and other communities are pathologised for who they are.

People are told to speak up and ask for help. When they do, help is not there, or it is not helpful. For consumers and survivors, this often results in a denial of human rights. Sometimes we lose our lives.

For families, carers and supporters, it can mean a life of stress and trauma, and despair for those who are now gone.

Force pervades the mental health system.

It can start with entry into the system through a police van or can end with a police shooting.

Force is written into the law and culture of our system, seen most visibly through the use of seclusion, restraint and compulsory treatment. These practices are not ceasing as they should.

Huge parts of the mental health system operate unlawfully. Mental health services routinely operate outside mental health and human rights laws.

When individuals seek justice, courts, tribunals and complaints bodies consistently fail to protect them. Victoria is the only state in Australia that grants compliance powers for a mental health commission to protect human rights. In over 14 000 complaints to the Mental Health Complaints Commissioner, those powers have never been used.

The government and mental health systems have long ignored and devalued self-help, mutual aid and peer support amongst consumers and survivors. This is part of a broader denial of the lived expertise of those with distress and who have used mental health systems.

Caring for a person, including during crisis, is its own set of skills, experience and wisdom. Yet families, carers and supporters are often not acknowledged for their expertise in supporting people. Instead, governments and systems interact with families, carers and supporters in impersonal, transactional and traumatising ways.

Families, carers and supporters are often invisible to the mental health system. Where they are visible to the system, it is as part of a transactional relationship.

Governments and systems have failed young people who are family members, carers (or have caring responsibilities). This often impacts their development, education and life outcomes.

Kinship caring can be common within the families of First Peoples. For many First Peoples, these experiences sit within the context of ongoing systems of racism and shame. There has been a refusal to respond to the concerns and needs of families, despite desperate calls, overwhelming evidence and repeated recommendations.

Families, carers and supporters have been exploited by a system that under-reached in its support. This has shifted people’s life stories as they take on caring relationships that they had not originally expected.