The evolution and devolution of mental health services in Australia

This article provides a brief historical overview of the development of mental health services in Australia. It commences with the establishment of the first public asylum, Bethlem Royal Hospital, London, in 1247, the arrival of the First Fleet on 24 January 1788 at Botany Bay, New South Wales and the establishment and growth of asylums in Australia. The article identifies some of the major social, historical, medical and political developments that have influenced our understanding and treatment of mental illness and the mentally ill. The article then traces the evolution and development of the five major professions currently represented in public sector mental health services; nursing, occupational therapy, psychiatry, psychology and social work. While there are other allied health disciplines employed in public sector mental health services including art therapists, music therapists, speech therapists, dietitians and exercise physiologists it is occupational therapists, psychologists and social workers who are represented in larger numbers. Tracing the evolution of these five professional groups sheds light on the current concerns within public sector mental health services regarding blurring of boundaries between the professional groups, defining the scope of practice of each professional group and creeping genericism.