Mental Illness Stigma !

Even the enlightenment of the twenty-first century has not entirely eclipsed the shame which some people associate with mental illness.  We use a lot of different terminology to mask it and today people both live and work in the community with what has become a very treatable condition, but it was not always that way.

Our first mental hospital opened in 1838 and was known as the Tarban Creek Lunatic Asylum, situated near the aptly named Bedlam Point in Sydney.  The name was later changed to Gladesville Mental Hospital and before its closure it was home to 1,200 patients.    There are more than three hundred unmarked graves within its grounds because in that era the mentally ill could not be buried in consecrated ground and it was thought unnecessary to conduct a burial service,.

The thinking was that the public needed protection from the mentally ill and hospitals such as these were configured more for containment than for treatment.   They were grim and hostile places and as patients deteriorated they progressed to the far reaches of the building, and eventually to one of those unmarked graves.

The drug industry has developed some very efficient medication to restore mental health and today it  is more likely to be treated from a suburban or regional hospital than a large institution. Even the smaller hospitals have a few mental health beds in a closed ward and evaluation and treatment gets a degree of privacy.  In the majority of cases the patient continues in paid employment.

Unfortunately, this treatment method is based on the patient continuing to take the drugs which control the illness and that is something that is often discontinued, leading to a relapse.  If that involves violent behaviour or becomes unmanageable it involves the police and many of the mentally ill then find themselves serving a prison sentence.  The prison system has become the institution to contain - but not treat - the mentally ill.

Evaluation of the prison population has revealed that at least twenty percent of those behind bars are suffering what can be described as an untreated mental illness.  They are not under care for that illness nor are prescribed drugs reaching them within that system.  When their prison term expires, they will be released untreated.

If the prison system has simply become the replacement for Gladesville then it surely  deserves medical health services to continue behind prison walls.  It guarantee that treatment will be taken for the length of the sentence and the chance of reoffending reduced.  The money spent on providing mental health services within prisons could be counter balanced by a reduction in prisoners passing through such institutions.

We have come a long way in reducing the stigma attached to mental health, but it seems that an opportunity for progress is still being ignored  !