Psychiatry in Australia and New Zealand: A British Descendant
Like many countries in the Asia-Pacific region, both Australia and New Zealand underwent British colonialism. Their colonization has played a pivotal role in setting the foundation of modern psychiatry in both countries.
Before the arrival of the first European settlers, native people populated Australia and New Zealand: the Aborigines and the Maori. Both groups of people had their own understanding of mental disorders which stemmed from their belief in the supernatural. For the Maori people, there were four spectrums of mental disorders: the insane, the demented, the intellectually disabled, and the spirit-possessed persons. Whanau –or family in the Maori language- were responsible for taking care of the mentally ill.
Around the nineteenth century, the British colonists had made their first arrival in these island nations. The first contact between colonists and the island’s natives was historically disastrous, kickstarting the beginning of centuries of neglect and oppression that left trauma for many indigenous people. Additionally, around the same time, convicted criminals were being “exported” to Australia. Many of them were considered deranged. The exported criminals threatened the precarious social order that the colonial governments had recently inaugurated. Their behavior called for immediate action.
In 1811, the colonial government in Australia issued the first mental asylum at Castle Hill, while the first one in New Zealand appeared around the 1840s. Although their original purpose was to deal with the mental health of the public in the colonies, all of these institutions doubled as prisons for deranged convicts. In both countries, it was clear that the colonial government oversaw the public mental health system without any regard for the native people of these countries.
The first asylums of these respective countries started the first wave of psychiatric hospitals modeled after the Moral Treatment in England. It was accompanied by an increase in the institutionalization of the insane. Researchers attributed the increasing number of patients to the deleterious effect of civilization, or as some would call it, an unfortunate combination of colonialism and industrialism. Many patients suffered from alcoholism, neurosyphilis, and schizophrenia.
The first asylums in Australia and New Zealand followed the British model closely. They were all located in remote areas, far away from the city centers. The location was to encourage community interaction and some agricultural activities. Ideally, patients were encouraged to engage with each other like a small community. In their free time, the caretakers would encourage them to participate in working activities like farming and brewing. These were parts of the Moral Treatment that were popular in England at the time, whose central idea was based on hard work being an essential part of rehabilitation. New interventions, such as new psychotherapeutic techniques like electrical stimulation and chloral hydrate, were quickly adopted in Australia. However, these practices were only seen as time-consuming and impractical in New Zealand and were only developed in the private sector and academic psychology.
Just like the collapse of the Moral Treatment system in England, the Australian and New Zealand asylums soon showed their flaws. Approximately two decades after constructing the first asylums, most psychiatric hospitals in Australia and New Zealand were overcrowded and understaffed. However, this was where the similarities between the British colonizer and the colonized Australia and New Zealand ended.
The first difference lay in the population of patients in the asylums. In England and later the U.S., most patients were women who were institutionalized by their families or doctors. However, in the nineteenth century, a large percentage of the white population in Australia was made up of criminals. This immense percentage of criminals led to the prominence of police in two-thirds of institutionalized cases, most of which were men. The second difference was the lack of funding from the government. Both colonial governments were not financially strong enough to sustain a largely private system like in Britain or the USA. Thus, the state of institutionalization in Australia and New Zealand remained a stalemate until the end of World War II.
From the 1950s and on, the landscape of psychiatry started to change for the better in Australia. Patients were treated in general hospitals and clinical psychiatry, which helped reduce the stigma of mental disorders. From 1960 to 1990, the poor condition of the state-funded and isolated mental asylums, and their abusive treatments were brought to the attention of the public, fueling the fight for patient rights and adequate conditions. New medications and the socialization of patients were now the main focus. The same changes also occurred in New Zealand, but a few decades later. In 1977, New Zealand established its Mental Health Foundation, an organization that later grew to be influential by raising awareness and accessibility of mental health services, especially for the Maori and younger generations.
However, the challenges for Australia and New Zealand persisted. From the mid-twentieth century onward, waves after waves of non-British immigrants started to arrive. Their arrival drew attention back to the mistreatment of the Aborigines and the Maori population by the colonial governments. In 1976, John Cawte reported psychosis as a maladaptive reaction to assimilation for the Aborigines. Cawte also noted that many Aborigines refused mental health services due to the cultural, economic, and educational gap despite its availability. As a result, in 1997, the Mental Health Foundation of New Zealand also drafted the first mental health plan that tended to the needs of the Maori and young individuals.
Despite successful deinstitutionalization in Australia and New Zealand starting in the mid-twentieth century, both countries still face serious problems regarding different cultural backgrounds. Not only do the native populations of these countries require a cross-cultural or culture-specific approach to mental health systems, but so do the non-British immigrants. Their cultural differences mean they cannot fit into one formula of mental health services and resentment can fester if they’re forced. An in-depth understanding of their cultural background would help fine-tune an effective approach for each group and reduce the stigma surrounding mental illness. This is the largest challenge that Australia and New Zealand must solve to improve their population's mental health.
The Aborigines and the Maori had their traditions and explanations of mental illness before the arrival of the British colonists.
From the nineteenth century onwards, mental asylums built by the British colonial governments increased in number in both Australia and New Zealand.
From the mid-twentieth century onwards, attempts to improve the mental health system started in Australia and New Zealand.
Cross-cultural issues arose with waves of non-British immigrants arriving, which drew attention to the native population: The Aborigines and the Maori.
Both the Australian and New Zealand governments have made efforts to improve cross-cultural mental health approaches, especially in regards to the Aborigines and the Maori.