I have now been in Australia for almost 9 weeks. It is definitely becoming a place we know almost as well as the UK. In fact talking to locals we realize we have travelled more extensively around Australia than most Australians. That is also true for us back in the UK , there are not many towns in the UK that either Ron or I haven’t been.
This has given us a fantastic opportunity to network, develop our idea’s on recovery, see how different places are taking forward recovery and unfortunately watch the same mistakes being made as each country strives to take services forward. Some parts of Australian mental health services do not look dissimilar to things that were happening in England 20 years ago. You could also argue the same in some parts of Scotland.
Where psychiatrists hold a substantial part of the power it seems to have been a lot harder to move towards a recovery vision of services. Beds seem to be a power base, as do the number of clients you have on your caseload. The systems tend to be more hierarchical with top down decision making, of course there are exceptions to this rule. In Australia poly pharmacy is regularly practiced & surprisingly instead of drug of last resort, Clozapine is very often given to very young people with only one episode of psychosis.
There are exceptions to the rule, Trieste manages with very few beds & have very developed community services & these developments have been implemented by psychiatrists. In Bethlehem hospital a Croatian psychiatrist Ivona along with the nursing staff are taking recovery forward. In West Cork Dr Pat Braken leads the way. In South London & Maudsley & St Georges an excellent paper has just been published “Recovery is for all-Hope, Agency and opportunity in psychiatry, a position paper by consultant psychiatrists. Dr Richard Warner from Bolder Colerado USA is also vey recovery focused.
What you do find though, is that where the state services are still lagging the voluntary sector is very forward thinking. Here in WA Joe Calleja & his staff at Richmond fellowship have led the way in both backing recovery & funding the Australian hearing voices network.
In Tasmania Anglicare, Aspire, Mission Australia, GROW & RFTAS are developing the recovery agenda with other N.G.O organisations. Although to be fair on the state services they have been heavily investing in training for all staff in taking recovery forward led by many enthusiastic professionals including Ellen Cross from their workforce development unit.
In Scotland SAMH took this role for many years though sadly this no longer seems the case.
England has a strong voluntary sector, Rethink being one of the leaders, St Mungo’s is another example as a homeless charity that has embraced the principles of recovery.
I think the future looks very bright I do not believe that recovery can be buried as another fad, more and more people are seeing the connectedness between trauma & mental distress, my dream is that in the future we will be concentrating on a wellbeing agenda, building resilience in our kids, and actively aware of spotting early on the signs of trauma & dealing with it effectively & early.
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