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Failing the mentally ill

Australia seems to have an inability to find the middle ground, to settle on a point midway between the extremes, and consequently we seem to be forever at one end or the other. A sorry illustration of that is the Richmond Scheme introduced in the 1980s to, as the government liked to say, de-institutionalise the mentally ill. The purpose was to move mentally ill people from institutions to community-based care, and while that was a godsend for many it was a terrible end for others. So many of them moved from the institution to the street, where they were murdered, or committed murder, or died of exposure and malnutrition, or were left to deteriorate physically and mentally.

A man who shuffles along inner Newcastle's streets day and night is a tragic example of the new right of mentally ill people to be independent of care. He's known as Richard, and in my column in The Herald today I tell of the many attempts to help him and his persistent, silent rejections of those good intentions. He is dressed in rags, with no crotch in his trousers at the moment; his hair is a solid wad of dirt; and he is not known to take food or shelter directly from anyone. This has been the case for a decade or more. I'm told that Richard, who may be in his 50s, has been assaulted a number of times, and he has the habit of walking straight onto our busiest roads without looking.

I know that the public's capacity to impose assistance on the mentally ill has been reduced by both the re-arrangements of the Richmond Scheme and the 2007 Mental Health Act, but should not our mental health authorities have a closer look at this case?

The act does allow for taking a person into care involuntarily if the person's behaviour "for the time being is so irrational as to justify a conclusion on reasonable grounds that temporary care, treatment or control of the person is necessary for the person's own protection from serious physical harm". The act says that "the continuing condition of the person, including any likely deterioration in the person's condition and the likely effects of any such deterioration, are to be taken into account".

I fear we will be shocked when it is too late that we did not help Richard. Do you share my concern? Or do you believe that the mentally ill have the right to be as mentally ill as they wish?

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The Robinson Report cleared the way for a lot of these water viewed Institutions to be closed, such as Callen Park, Hawksbury and now Watt Street, staff retrenched and properties sold off as surplus to requirments. Patients were either placed on the streets to fend the best they could or placed in the midst of a community in an attempt to intergrate them. Of course a lot of patients could not intergrate and became violent street people committing all sorts of crime and ending in jail many for crimes of violence such as murder, wounding bashing etc. due to their frustrations and failure to medicate. A very sad indictment on uncaring persons placing some of the most vulnerable people in our society at risk. Unfortunately Richard falls into some of these categories.
Posted by MijzJasper, 7/09/2009 10:11:57 AM, on The Herald
its a bit much to have a whole column devoted to the life of directeur sportiff.
Posted by packdrill, 7/09/2009 10:19:18 AM, on The Herald
I believe we should do what we can for these individuals...regardless of which city or what country they are living in. It is always a sad thing to see these people wandering around. I don't know what the solution is, apart from give as much support or help as possible...maybe a lock up type hospital can help in certain cases, if it saves their life?
Posted by suzhousid, 7/09/2009 10:19:20 AM, on The Herald
I think the Australian Health System is failing alot of people, and the most disadvantaged are the mentally ill. I'm not a fan of locking people up in mental institutions but sometimes, to rehabilitate them, to get them on the right medications, there should be a rehabilitation centre where they are kept, be it volintary or involintary so they can be assisted. From there they should be integrated into society with regular (daily) carers delivering their medications and spending time with them. This can be scaled back to every other day as improvement is shown. But i would not want them locked up indefinately but assistance must be accepted by the mentally ill, even if forced upon them. And for poor old Richard, If it is the gentleman i am thinking you are talking about, i have witnessed him being egged by youths, and kicked, which is so unfortunate. He just keeps to him self for the most part and should have assistance forced upon him. We wouldn't accept that kind of life for one of our children, so why accept it for someone else's child. Its just not right.
Posted by Nafe, 7/09/2009 10:49:56 AM, on The Herald
I agree, Nafe, that there must be value for everyone in a short-term arrangement to sort out medication and restore, hopefully, an appreciation of the need for hygiene and such. Still, some people question whether it's better to be insane and happy or sane and unhappy. This issue, raised more often than you may believe, founders on the rock of choice. Some people on the street have an illness that precludes such a choice.
Posted by Jeff Corbett on 7/09/2009 11:06:58 AM
Mental health, like all health issues, is complex and there is no “one size fits” all solution. Cases such as the gentleman “Richard” are those that fall through the cracks – neither suitable for management in the community and unwilling to be institutionalised. I suspect his problems are multiple and refractory. Judging from your story, it sounds like there may be grounds to have him detained against his will, as his wandering into traffic clearly constitutes a danger to the public and himself. That said, his freedom to live his life as he chooses is his only tangible asset. Do we take away that freedom to protect our sensibilities, and perhaps “help” him (although he may see it as anything but help) or do we respect his right to live his life as he sees fit, no matter how distasteful/distressing/disturbing we find it. No easy answers I'm afraid.
Posted by Directeur Sportif, 7/09/2009 11:14:52 AM, on The Herald
i wonder what happened to the waterfront real estate that used to be the refuge for such people . Also how were they cared for in such circumstances? JC has to get full marks for the humanity he is revealing and i remember two instances where i have enquired randomly about the wellness of two I seperately encountered on the street. The first a young bloke in sydney out one night was sitting in the gutter with his head drooped into his hands - i just said "are you alright mate?" he looked up and said that was now but was not before i asked. I took that as a thanks mate for asking. The next was a person in dissarray on a back street in the sydney cbd in th eday - i just quipped a short g'day mate hows it going. He said that he had just got over a week of alcoholic stupor internment and was now travelling ok - i gave him a really heartfelt "good for you". funny what strangers can say when you ask about their wellbeing. Sad that richard seems to be somewhere else other than here and now with us all? Good for you for trying JC .
Posted by notashrink, 7/09/2009 11:42:21 AM, on The Herald
Thank you for your article on Richard. For years I have seen him shuffling around town in his filthy clothes and matted hair. Often I was having lunch with visitors to our City when he walked past the restaurant window and I have to say it made me very embarassed and very angry. Embarrased when asked by visitors why he was allowed to be on a Newcastle street looking like that - and angry at the Police for not picking him up and at least making him shower and change his clothes. I knew that he would have been offered help by one of our wonderful volunteer groups. I now have a better understanding of his plight thanks to your article. YES I am concerned for his welfare. We are all failing this man - regardless of the fact he may want it that way. If we mistreated an animal and left it in the same condition as Richard we would be prosecuted!
Posted by Annette, 7/09/2009 12:04:56 PM, on The Herald
Packdrill @lias @lias @lias @lias It does advance your honour and dredibility not one scrap to submit a spurious comment in an attempt to denigrate some other person at the expense of these poor and disadvantaged persons who need all our charity and help.
Posted by MijzJasper, 7/09/2009 12:26:01 PM, on The Herald
Jeff is that the old man that walks around town with his clothes ripping into pieces? If that is the person you are talking about that is very sad. When he originally move here after tragic family issues & beaten by thugs on numerous occasions & has only gotten worse over the years & refuses charity off anyone. When he first came to town, he was approachable & one could have a yarn with him, but over the years he has copped it the bad way & they only grab him when he starts getting delusional. If some actually had a chat with him in his time in Newcastle you will find that he is a highly intelligent man & for once on these blogs I agree with sporty about this one distasteful/distressing/disturbing we find it, there is no easy answers to mental health at all. I have personally worked in this industry from a distance & it is one of the saddest things anyone will see in their lives, because no matter what you say or do, sometimes it's just not enough to help them. Good story Jeff, & anyone that uses mental health issues to give people crap on these blogs need to have a real look at themselves, they are the ones bringing up a mental issues about themselves in public full stop. Sporty?
Posted by The Real Richard Tough Titties Walters, 7/09/2009 12:51:18 PM, on The Herald
Jeff, I have made enquires about this gentleman. The Police have tried to help him and still do keep an eye on him when possible. Enquiries have been made by Police with JFH and it is understood that they have had him in their care some years ago and got him cleaned up. He has in the past been on their outreach workers list. Police tell me that he is a danger to himself by his own neglect and they have brought this to the approapriate authorities. The authorities disagree. Police can schedule him and take him to JFH but the authorites would only release him. The Police are not to blame in this matter, and it disturbs them probably more than you to drive past him knowing there is not much more they can do. Do you think he should be forced to do what others want, because we deem him to be mentally ill and dirty? As for Nafe, what did you do when you saw him egged and kicked? I personally could not stand by and watch that doing nothing. Jeff, I guess you already know this, his name is not Richard.
Posted by Buell, 7/09/2009 1:18:09 PM, on The Herald
Hello Buell. I'm sure that the police are disturbed about his vulnerability and his deteriorating condition. The Mental Health Act seems to give clear grounds for having him admitted involuntarily to a hospital for help, so I can't understand the reluctance. Scheduling, if that's what it is still called, requires the authorisation of a doctor, and I wonder if individual doctors who work in the field are reluctant to bear that responsibility. By the way, I don't know his real name. He is, though, referred to often as Richard.
Posted by Jeff Corbett on 7/09/2009 1:46:21 PM
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Jeff Corbett
Bend the online ear of the Hunter's most provocative columnist.

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