A choice of difficulties : national mental health policy in New Zealand, 1840-1947
Brunton, Warwick Anthony
This thesis describes and analyses the main elements of national mental health policy in New Zealand from the inception of organized government in 1840 until the merger of the Mental Hospitals and Health Departments in 1947. Mental health services, in this context, refer to specialized psychiatric care and treatment. Before 1947 and for many years afterwards, that care was provided almost entirely through a network of public mental hospitals. A "top-down", national view of mental health policy helps to explain why that system evolved, because the national policy was the legal, organizational and regulatory framework within which personal and clinical interventions occurred and specialized care was provided. Governments set out to achieve their policy aims for mental health through regulation, funding, ownership, and occasionally through investigation. Politicians and officials who held particular responsibilities for managing the state's interest in mental health shaped that policy within constitutional arrangements and the machinery of government. Working in a policy field of minor political importance, officials acquired a significant and powerful role in policy-making for they both advised the government on and implemented policy through a virtual monopoly on the provision of specialized services. This thesis examines the part played by ministers, the specialized bureaucracy set up in 1876, and interest groups in the formulation of policy. The primary sources for the thesis have been the archives and published official papers of those government agencies that had responsibility for mental health policy and services. Surviving administrative records of some psychiatric hospitals have also been used. A documentary approach has been complemented by interviews. New Zealand's policy was shaped by the answers to broad policy questions about identifying mentally disordered persons, how they should be dealt with, and how they should be treated. Major elements of the pathway of mental health services in western Europe and the historical interpretations accorded them have been reviewed, because they influenced mental health policy in new Zealand and other countries with a similar colonial background. But "Home" ideas were adapted to colonial circumstances so that, by 1876, three foundational policies of institutional care, separate administration and state responsibility were implemented. Local and national officials faced a choice of difficulties brought about by the intended and unintended effects of these foundational policies. Later policies were built incrementally upon these solid foundations, either in response or reaction to a complex interplay of social, political, and legal factors, therapeutic limitations and developments, or to the growth of the role of government in New Zealand society. These factors made for a pattern of short bursts of high policy activity and the injection of resources followed by troughs of stagnation or quiet incremental adjustments to the core policies.
Advisor: Brookes, Barbara; Olssen, Erik
Degree Name: Doctor of Philosophy
Degree Discipline: History
Publisher: University of Otago
Keywords: Mental health policy New Zealand History; Mental health planning New Zealand History; Mental health services New Zealand History; Psychiatric hospitals New Zealand History
Research Type: Thesis
xi, 517 leaves,  leaves of plates :ill. ; 30 cm. Includes bibliographical references (p. 476-517). "March 2001". Photocopy.