For as long as mental health systems have operated, there has been an uncertain boundary between “helping” people and “harming” them. Many of us have experienced harm in the mental health system, as either consumers or survivors, or as families, carers and supporters.
Victoria’s mental health laws, and Australia’s more broadly, remain incompatible with our human rights obligations. Forced treatment, seclusion and restraint remain lawful despite the harm they cause. People can die on average up to 30 years younger, in part, because of the medications they are forced to take. The harms are broader than this, though, with our mental health institutions and policies – like all institutions and policies – being both a product and producer of colonisation.
Often lost in discussion of harm are families, carers and supporters. Speaking to the Guardian, Lorna Downes, one of the co-authors of a report commissioned by the state’s health department, highlighted the impacts of being rendered invisible to the system. When the system neglects or encroaches on people’s lives, it is often families who bear witness to trauma or bear it themselves. Many live, mourning lives lost.
That is why the recent launch of the Not Before Time: Lived Experience-Led Justice and Repair report has resonated with so many Australians. In fact, we have heard it is resonating with other country members at the UN.
There is unresolved harm that sits at the heart of the mental health system. This harm doesn’t just stem from underfunding, it grows out of systems that were not designed by the people who use them. No wonder it is harmful. Without being clear about these harms, we are bound to repeat them.
In our full report we detail harms, including how people stop being people when they enter the mental health system. We draw on evidence from one person who said: “I can sign a contract. I can run a business. I can have a family. But I am considered incapable of making decisions about my treatment, and I am strapped to a bed.” Another co-author said in the report that the system transforms people into “things”, and that “you can easily do things to things”.
Not Before Time isn’t about vilifying governments or the mental health sector. It is about coming together to acknowledge harm, so that we can provide opportunities for voice and where possible repair.
We recommend that the Victorian government establish a restorative justice process, where those harmed by the mental health system are able to safely share their experiences, and where possible have responses from the government and sector. Often policies, laws and problems become “owned” by professions or bureaucrats. Restorative justice takes “the problem” and brings it back to the community, where it belongs. There, we can solve the problem – in this case harm from the mental health system – together, while centring the focus, decision-making and expertise on those with lived experience.
We recommend this process is undertaken by the forthcoming Mental Health and Wellbeing Commission. It would eventually produce a report that is provided to parliament. But other agencies or states and territories may take the lead; harm is not contained to Victoria. As we note in our report, where governments fail to lead, communities establish their own community-based processes, such as the Morecambe Bay Poverty Truth Commission.
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Our second recommendation is that following the restorative justice process, the Victorian government, with an invitation to the mental health sector, apologises to people with lived experience. This will, for some, provide closure, as well as a commitment to a better future.
We are conscious of the different experiences and types of harm that consumers and survivors, and families, carers and supporters experience. Therefore in both recommendations we recommend that the restorative justice process and apologies are dealt with separately, starting with consumers and survivors. People may identify as being in multiple of these groups, and therefore could participate in both.
In Victoria, we had a royal commission into our mental health system. It articulated where we need to go. But we’re stuck. It’s because we don’t know where we’ve come from and where we are. Governments and the mental health sector committing to restorative justice and apologising will help us find our way, together.
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Chris MacBean, Caroline Lambert, Flick Grey, Simon Katterl, Lorna Downes, Kerry Hawkins, Tim Heffernan and others all contributed to the Not Before Time report
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Crisis support services can be reached 24 hours a day: Lifeline 13 11 14; Suicide Call Back Service 1300 659 467; Kids Helpline 1800 55 1800; MensLine Australia 1300 78 99 78; Beyond Blue 1300 22 4636
