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doi: 10.3109/10398569309081339pmid: N/A
The relative emphasis on “biological” or “psychological” formulations in our understanding of “mental” disorders has varied at different periods in history. The early traditions of Western medicine, as represented by ancient Greek and Roman physicians, recognised that mental disturbance could be produced by physical disorders. The famous 17th century neurologist Thomas Willis, who coined the term “neurology”, believed in a neurological basis of psychiatric disorder. This opinion was explicitly stated in the mid-19th century text on mental disorders by Griesinger [1]. In fact, in die latter half of the 19th century, neuropsychiatry was synonymous with general psychiatry. A number of developments led to this situation. The study of aphasia had resulted in a burgeoning interest in brain structure-function relationships. The recognition of general paresis as an acquired disease with an identifiable aetiology had resulted in therapeutic optimism. Further, neurologists of this period were interested in retaining the territory of mental disorder as a source of patients.
doi: 10.3109/10398569309081340pmid: N/A
There are approximately 155,000 Vietnamese born people in Australia, with 46,000 in Victoria. The majority came to Australia as refugees. Many were subjected to the reality or threat of war, persecution, imprisonment, discrimination, economic deprivation, violence, the loss of family or other major stressors. These stressors have included the hazards of the escape, lengthy stays in refugee camps and, on arrival in Australia, lack of familiarity with English and with the culture. The Vietnamese Community in Australia was expected to have a high prevalence of mental illness, especially when newly arrived from refugee camps. In a study published in 1986 as “The Price of Freedom” [1] 32% of the young Vietnamese adult group was found to suffer from psychiatric disorder. At follow-up two years later, the prevalence of psychiatric disorder, without any major intervention, had dropped to 5–6%, a prevalence lower than that in the Australian-born community. In addition, the Vietnamese community's use of mental health services (inpatient and community-based) is lower than that of any other ethnic group.
doi: 10.3109/10398569309081341pmid: N/A
With increasing numbers of people in western society engaging in deliberate self-harm behaviours, psychiatric practitioners should reconsider some of the implications.1. Psychiatry as a branch of medicine has a medical bias in assessing people who have engaged in deliberate self-harm behaviours and tends to view these behaviours as symptoms of psychiatric illness rather than sociological disorder.2. The increasing number of these distressed people is causing an increasing psychiatric workload to the disadvantage of other patients, research activity and teaching.3. The psychiatric profession should focus its attention on patients with formal psychiatric illness and encourage the involvement and participation of professionals from other agencies and services who are now trained and willing to become involved.Psychiatry cannot replace the enfeebled phenomena of collective sentiment or the regulatory function of a simpler, more cohesive society (as described by Durkheim) but many of the established self-help groups can help and links could be established with these agencies. To do this will require changes to established professional role boundaries and the loosening of medico-legal constraints which currently prevent relinquishing of responsibility when there is an obvious absence of psychiatric illness.
doi: 10.3109/10398569309081342pmid: N/A
In February 1988 an outpatient service began at the Mercy Hospital for women with psychiatric disorders in the postpartum period. A year later an inpatient service, now eight beds, was opened.
doi: 10.3109/10398569309081344pmid: N/A
Remarkably little is recorded to suggest that lunacy was regarded as a problem in the transports, by the reported suicides or the reactions to starvation, privation and cruelty in the early years of settlement [1].Nevertheless, in 1787, Phillip, the first Governor of New South Wales, was specifically directed to exercise powers regarding the insane. Part of these orders were: “Wee have thought fit to entrust you with the care and commitment of the said ideots and lunaticks and their estates” [2]. From then onwards nothing is heard of “the lunaticks” until after Samuel Marsden was given official duties in this field.
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