The history of mental health in Australia may be usefully viewed as responses to a succession of cultural and social challenges. The earliest challenge involved development of a colonial psychiatry from the 1800s when psychiatry itself was just emerging in Europe as a branch of medicine. This was the era of public asylums that commenced with optimism but ended with pessimism as they became custodial rather than therapeutic. Basic reform in Australia was delayed until the 1950s when the challenge of developing an independent Australian psychiatry began to be answered. From the 1960s, new factors came into play including effective medications, recognition of patient rights and deinstitutionalisation. A new, cultural and social challenge presented with the massive, post-war inflow of non-British, European immigrants and, later, Asian immigrants. Cross-cultural competence was now essential. From the 1970s, refugees arrived in growing numbers, and from the 1990s, mental health professionals made public the adverse effects of their detention in isolated camps. Another challenge to present in this period was how best to remediate the mental disorders of Indigenous Australians; again cross-cultural competence was necessary. Recently, Indigenous researchers have been developing culture-specific, diagnostic and treatment approaches. The latest challenge is how might Australia best assist in reducing the burden of untreated mental disorders in low- and middle-income countries (LAMIC). This fundamentally cross-cultural enterprise of global dimensions has evoked a vigorous, international, epistemic and policy debate. While the debate has been located mainly in Europe and North America, some Australian psychiatrists have been very active participants.
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