Indigenous Australians, like most indigenous peoples, have a long history of engaging with European-style mental health services both in and out of the colonial era. However, their history is poorly documented and largely unexplored. We can’t even say for certain how many indigenous people in Australia used mental health services since first contact, and we know even less about what their experiences were.
Why is this? It may be partly because public mental health records in Australia are under 75- to 100-year restriction, making it challenging to access primary sources. These records don’t always identify Aboriginal people, or identified them by guesswork. Australian mental health records are also a patchwork—each State government runs its own mental health system, with predictable fluctuations in the quality of historical reporting and the types of data gathered.
Thanks to a larger project that provided me with access to restricted patient records, Dr Sophie Davison and I were able to rebuild an outline of indigenous use of public mental health services in Western Australia—the largest and most sparsely-populated of the six Australian states—from 1903 to 1966. Aboriginal people now make up a substantial proportion of mental hospital admissions in Western Australia, but this wasn’t always the case—it turns out that patient numbers were very low before the 1960s, with just 167 people identified as Aboriginal admitted in a 70-year period.
We also tried to provide some account of what their experiences may have been like. We could count admissions from the registers, but to re-create experiences we had to rely entirely on newspaper articles and oral history interviews with white staff. The firsthand voices of Aboriginal people in mental hospitals have been almost completely lost, and the secondary sources are not much better.
So who were these people? On one level, they looked like the white admissions profile: more males than females, many admissions in poor physical health, and a high death rate within a year of admission. But indigenous admissions were much younger than other admissions, and they were far more unwell, both mentally and physically. They were also almost all from very distant regions of the State, usually the far north which is at least 1,000 kilometres away.
And what was it like for them? Through oral history, I was able to record intriguing glimpses of indigenous people in the wards—fighting with staff and failed escapes, mixed with accounts of mutual respect and courtesy. Staff also recollected frustration with senior medical staff who did not always understand the particular needs of Aboriginal people who had come from remote areas, and were frightened and confused.
The firsthand voices of Aboriginal people in mental hospitals have been almost completely lost, and the secondary sources are not much better.
Most of these patients had to be brought long distances to be admitted to hospitals in the metropolitan area, so it’s likely that this was a last resort when they could no longer be managed in their local community. The high death rate is almost certainly linked to their poor physical health, as well as other factors such as separation from their traditional country and local communities. This seems to confirm my earlier research on Aboriginal people in the nineteenth century in Western Australia, where the public mental health system was the last port of call for Aboriginal people with serious mental illness.
Ideas about mental health and illness are culturally shaped, and it’s always challenging to see how a European-style government interacted with indigenous people and diagnosed mental illness among them, knowing comparatively little about their own ideas of mental and emotional well-being. Although Aboriginal people in Western Australia also have a long history of being imprisoned under various laws, it’s unlikely that the mental hospital system was used merely for incarceration—for one thing, it was far too expensive to keep a person in a mental hospital in Western Australia, compared to a prison.
The missing piece of the puzzle is now a study of the admission rate from 1966 onwards. Historically, Aboriginal people were statistically more likely to avoid a mental hospital admission than whites, but they now seem statistically more likely to be admitted than whites. Deinstitutionalisation released hundreds of non-indigenous patients from Western Australia’s mental hospitals, but seems to have left the indigenous ones behind. The reasons why would be well worth exploring: changes in mental health policy and administration, as well as major changes in Aboriginal communities since the 1960s, may well have intersected to produce this effect.
Featured image credit: Travel map by Kevin Hale. CC BY-SA 2.0 via Flickr.