The mental illness reform movement of the 1960s and 1970s or 'anti-psychiatry' produced a rich critique of institutional responses to mental illness. One consequence of this movement was a powerful commitment from across the political spectrum for the closure of specialist mental hospitals and a move to community care – deinstitutionalisation. This paper briefly explores the reform movement's impact on mental illness services, but it also examines the much less well known and less influential counter critique mounted by archivists, historians, clinicians and philosophers. This counter critique showed that while place was important, no one location guaranteed humane and effective mental illness care. Good, poor and horrific treatment occurred in the community as well as in a range of institutional settings. This paper explores the complexity, interconnectedness and cyclical nature of mental illness services in Victoria, Australia. A regional case study from Gippsland, Victoria, and the story of Cornelia Rau help support the contention that deinstitutionalisation in its most humane and therapeutic sense is an unrealised desire.
This paper defines how out-of-school adolescents from Masaka District in rural southwest Uganda currently receive sexual and reproductive health information and how they would prefer to receive that information. Information adolescents feel they lack falls into three broad categories: sexual and reproductive health issues, the negotiation of sex and sexual relationships, and making the transition to adulthood. The preferred source for information depends on the type of information to be delivered, the overriding principle being that the source must be authoritative in that type of information. Current information sources including family, peers and media are perceived as either flawed or insufficient. Preferable sources fall into three categories based on the type of information provided: accurate sexual and reproductive health information should come from trained community and media-based rather than clinic-based health educators; information about negotiation of good relationships and the negotiation of sex and condom use within relationships should come from an up-skilled traditional source, ssenga (paternal aunt), particularly for young women; and social information about becoming a good adult should come from parents, grandparents, church and community leaders. All information should be positively framed and non-judgemental. Centrally coordinated community health promotions delivered by trained community-based health educators, ssenga and parents, guided and supported by existing radio and print media, are required.
AbstractThis paper explores fifteen residents' perspectives on a supported housing program for people recovering from low prevalence mental health disorders in rural Gippsland, Victoria, Australia. It moves beyond the often unproductive institutional versus community care dichotomy to present a more complex consideration of the residents' perceptions of supported housing as a site for recovery. This paper contributes to the literature on consumers' experiences of mental health care in particular places. The residents' narratives highlight the importance of supported accommodation as an integral part of a recovery focused service system delivered predominantly, but not exclusively, in the community.Keywords: recoveryrural mental healthplacemental health promotioncommunity care
Abstract Objective: This paper provides evidence for the importance of taking an effective history and considering regional differences before formulating national health policies. Design: Qualitative study; the data collection technique included manual searches of rare book collections, a search of the Victorian Public Record Office and Australian Archives files and a local media appeal for information about iodine and iodine supplementation in Gippsland and other regions of Australia. Setting: Regional Victoria and Australia as a whole. Participants: A total of 17 community members from the Gippsland region provided information on taking iodine tablets between the late 1940s and the late 1960s. Main outcome measures: Information from the community members who took iodine tablets, archival material, published papers in journals on iodine deficiency disorder in Gippsland, government reports and meeting minutes regarding distribution of iodine supplementation in Gippsland. Results: Taking an effective history is vital to planning national health interventions. It might not be adequate to just search electronic databases. A thorough search of archival and hard copy material and consultation with members of the population can help find key historical data that can inform better health policy action. Conclusion: There is strong historical evidence of dietary iodine deficiency in the Gippsland region and in a number of other regions across Australia. Government and health authorities should undertake regular iodine status monitoring in these regions. Considering regional difference is important when making national health policy.
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