The Point of Our Work - exploring mental health reform in Australia

The Point of Our Work
Growing Our capacity for Change

Dr Simon Duﬀy ￭ The Centre for Welfare Reform ￭ 9th October 2013
￭ Perth, WA ￭ Richmond Fellowship
1

We need humility
and the capacity
to work together
to find a better
way of respecting
each other and
living together
We only have
only just begun
to learn how to
undo the
damage done by
decades of
institutional care
2

At the end of the nineteenth and for
most of the twentieth century it
was common for people to think
that people with intellectual
disabilities and mental illness were
very diﬀerent, hardly human, and
certainly not equal citizens.
3

The powerful eugenic movement
that spread across Europe, America
and the British Empire led
eventually to the murder of over
250,000 people with disabilities or
mental illness in Nazi Germany.

4

The process of de-humanisation
that preceded the Holocaust had
seven steps:

7

Three factors weakened people’s
grasp of their shared humanity:
1. Mass Morality
2. Rootlessness
3. State Power
9

• Utilitarianism - all that matters is happiness
• Relativism - moral rules are just habits
• Communism - what matters is class
• Nazism - what matters is race
11

Francis Galton: Theory of Eugenics - race improvement

12

Powerful ideas which undermine
traditional moral codes, including
respect for the sanctity of life.
Humanity was swept into great
movements, with utopian goals.

13

Graves at Hadamar, an institution that became a
euthanasia centre

14

Without certain fundamental
securities we become weak.
We can be led to do evils that we
would never believe ourselves
capable of.

16

The lack of common interest so characteristic of
modern masses is therefore only another sign of their
homelessness and rootlessness. But it alone accounts
for the curious fact that these modern masses are
formed by the atomisation of society, that the massmen who lack all communal relationships
nevertheless oﬀer the best possible “material” for
movements in which peoples are so closely pressed
together that they seem to have become one.
Hannah Arendt

17

• Nationalism - centrality of the state
• Tax & Welfare - growth in economic power
• Control - growth of law and policing
• Elitism - growth of the ‘professions’
19

The modern state is more powerful,
more organised, more professional
than any previous form of
government.
It is capable of doing great good or
great harm.
20

In the fall of 1941, with the completion of the first
major phase of the euthanasia operation, gas chambers
at psychiatric institutions in southern and eastern
Germany were dismantled and shipped east, where
they were reinstalled at Belzec, Majdanek, Auschwitz,
Treblinka, and Sobibor. The same doctors and
technicians and nurses often followed the equipment.
Germany’s psychiatric hospitals forged the most
practical link between the destruction of the mentally
ill and handicapped and the murder of Germany’s
ethnic and social minorities.
Robert N Proctor
21

Inspired by the ideas of scholars like Binding, Hoche,
and Ploetz, Adolf Hitler came to believe that the future
volkish state should aggressively pursue pro-natalist
policies based upon selective breeding and the
eugenic elimination of the unfit in order to maintain
the racial purity of the German state.
Suzanne E Evans

22

Existing stereotypes and negative
propaganda can be used to prepare
groups to be scapegoats - sacrificial
victims who can be blamed for
problems that nobody knows how
to solve.

23

Even after the victim has been
selected they have to be prepared
for destruction. There are 3 steps:
1. Rightlessness
2. Poverty
3. Segregation
27

7 April 1933 - Law for the Restoration of the Professional Civil Service - dismissal of Jews from government
25 April 1933 - Law against Overcrowding of German Schools - no more than 1.5% of non-Aryans to be
admitted to public schools and universities
14 July 1933 - Law on the Revocation of Naturalisation and Annulment of German Citizenship - withdrawal
of citizenship from ‘undesirable,’ especially East European Jews
15 September 1935 - Nuremberg Laws: Reich Citizenship Law and Law for the Protection of German Blood
and German Honour - the Jew defined and separated legally, socially and politically.
14 November 1935 - First Ordinance on Reich Citizenship Law - Jews denied citizenship
15 October 1936 - Jewish teachers banned from private education of Aryan children
12 June 1937 - Secret directive of Heydrich, head of Security Police that ‘race-violators’ be put in ‘protective
custody’ after serving their sentences.
26 April 1938 - Registration of all Jews with assets exceeding 5,000 RM
14 June 1938 - All Jewish business have to be registered and credit refused by public savings bank
15 June 1938 - June Action sends 1,500 Jews to concentration camps
6 July 1938 - Termination of certain Jewish businesses
23 July 1938 - Special identification cards for Jews
25 July 1938 - Jewish doctors can only treat other Jews
27 September 1938 - Jewish lawyers removed from the bar
12 November 1938 - 1 billion RM fine on the Jews following Reichkristallnacht
15 November 1938 - Jewish children excluded from German schools
28 November 1938 - Movements of Jews restricted
14 December 1938 - Decree replaces the Jewish owner or director
of a firm with an Aryan general manager
1 January 1939 - All Jews have to carry the middle name of Israel or Sara
30 April 1939 - German landlords can evict Jews and other Jews must accept homeless Jews into their
households
1 September 1939 - German attack on Poland, beginning of World War II
28

The Jews had to be stripped of their
rights, their resources and their
place in society.
People with disabilities and mental
illness were already rightless,
impoverished and incarcerated
within the institution
29

Bodies being
cremated at
Hadamar

31

Lennoxcastle Hospital in the 1920s
32

From “Christmas in Purgatory” (1974)
34

In the UK the peak population for
the institutions was in the 1970s.

35

But the journey away from the
institutions has been neither
straight nor fast.

40

This shows spending in one part of England
after the institutions were closed:

42

Often English de-instutitionalisation

was institutions without the park
46

Yet people keep breaking through
the barriers placed in front of them.
Social innovation by people with
disabilities, families and their allies
has changed the lives of many.

47

There is not just one kind of institution

we bring the institution with us
49

The creation of the welfare state
and social rights has helped lift
people from poverty and
increased the capacity for wider
citizenship.
But today the welfare state and
social rights are also under attack.
50

The UK Response to ‘Austerity’
51

In the UK we have seen a very
rapid unravelling of the language
of rights and inclusion - back
towards the language of shame
and stigma.

52

This is in turn
leading to new
more radical
and political
expressions of
the need for
change.

55

Many are questioning the role and
competence of the state.

56

Pruitt–Igoe (St Louis) 1955-1972

57

We need a new appreciation of the
value of community.

59

But he who is unable to live in society, or who has no
need because he is suﬃcient for himself, must be a
beast or a god. He is no part of a state. (Politics 1.2)
Aristotle

60

We must also welcome
human diversity, and yet
treat each other as equals.

61

Aristotle explains that a community is not made out of
equals, but on the contrary of people who are diﬀerent
and unequal. The community comes into being
through equalising, 'isathenai.' [Nich. Ethics 1133 a 14]
Hannah Arendt

62

Q: What’s wrong with Hayley?

A: Absolutely nothing.
65

Three reasons
to be optimistic.

3
66

Reason for
optimism No. 1
The Danes - some
people do resist.

67

Reason for
optimism No. 2
Families - they
just won’t go
away
68

Reason for
Optimism No. 3
People
themselves - the
human spirit is
hard to
exstinguish.
70

I’m a woman who has talent
That they can’t take away.
They tried with drugs
And needles to dope me every day.

They shoved me in a hostel
As a guest of the Salvation Army,
With the company of drunks and punks
It was enough to send a poor lass barmy.

Institutions stink,
They make you want to puke,
The doctors think they’re it
And they’ll read you like a book.

I wonder why it had to be that all my life
No one to love me
No one to care
No one to see
No one to listen properly.

I was kicked around and used
Insulted and abused;
So now my second life begun They messed my mind right from the start A new chance to live life through my son;
Treated me like a dirty tart.
A reason for living I have found
And it’s going to be better second time
But it was them that did that,
round.
It was them that scarred my mind,
It was them that corrupted my innocence, So now I tell you
And left me feeling that no one cared.
I’ve got a voice
I’ve got a right to make a choice.
I’m not a toy for you to abuse
I’m a woman of spirit and now I’ll refuse…
To take that abuse anymore.
72

Citizenship is the right goal

74

Being a citizen is better than being
‘normal’
it brings us together as equals
but also as unique free individuals
Equal and diﬀerent
75

What is wrong with institutions?
1. Devalued lives - the institution defines your place, your role, your
purpose.
2. No freedom or control - the institution strips you of freedom and
personal authority
3. Impoverishment - economic power is nullified
4. Sheltered, but homeless - a home is more than a roof - it’s vital
to control privacy and security
5. ‘Care’ not help - ‘care’ already assumes the passivity and lower
value of the person ‘in care’.
6. Disconnected - the institution cuts you oﬀ and leaves you within
a hierarchical system where abuse can become natural
7. Loveless - relationships have no place in the institution

77

Why citizenship is safer
1. Direction - It’s risky if my life lacks meaning and value
2. Freedom - It’s risky if I cannot direct my life, communicate or
be listened to.
3. Money - It’s risky if I lack money or if I cannot control my own
money.
4. Home - It’s risky if I cannot control who I live with, my home
and my privacy.
5. Help - It’s risky if I’ve no one to help me and if I cannot control
who helps me.
6. Life - It’s risky if I am not a valued member of my community.
7. Love - It’s risky to have no friends or family.
78

Citizenship is
also very
practical. We
can use the idea
of citizenship to
think about
how to help
someone.
79

Citizenship is
possible for
everyone

it just might
take some
extra thought
80

Demanding of man that he assumes his condition and
not till his neighbour's field, he [Rebbe Yaakov-Yitzhak,
The Seer of Lublin] said: "There are many paths leading
to perfection; it is given to each of us to choose our own,
and by following it with great dedication, we can make
it become our truth, our only truth."
Elie Wiesel

82

I used to think that freedom was freedom of speech,
freedom of the press, freedom of conscience. But
freedom needs to include all of the lives of all of the
people. Freedom is the right to sow what you want. It's
the right to make boots of shoes, it's the right to bake
bread from the grain you've sown and to sell it or not to
sell it as you choose. The same goes for a locksmith or
steelworker or an artist - freedom is the right to live and
work as you wish and not as you're ordered to. But these
days there's no freedom for anyone - whether you write
books, whether you sow grain or whether you make
boots.
Vassily Grossman
86

You could no more make a city out of paupers than out
of slaves.
Aristotle
Self-interest is the most powerful engine for individual
and social development, in other words, social progress,
in other words social justice. It is when the most
disadvantaged in society have the opportunity to
improve their lives in their own self-interest that change
will take place.
Noel Pearson
91

Then the old Vainamoinen put this into words:
'Strange food goes down the wrong way
even in good lodging;
in his land a man's better at home loftier.
If only sweet God would grant
the kind creator allow
me to come to my own lands
the lands where I used to live!
Better in your own country
even water oﬀ your sole
than in a foreign country
honey from a golden bowl.'
The Kalevala
96

There are eight degrees of charity, one higher than the
other. The highest degree, exceeded by none, is that of
the person who assists a poor Jew by providing him
with a gift or loan or by accepting him into a business
partnership or by helping him find employment - in a
word, by putting him where he can dispense with other
people's aid. With reference to such aid, it is said, “You
shall strengthen him, be he a stranger or a settler, he
shall live with you” (Lev. 25:35), which means strengthen
him in such manner that his falling into want is
prevented.
Maimonides
101

True love leads a man to fulfilment, not by drawing
things to himself but by forcing him to transcend
himself and to be something greater than himself. True
spiritual love takes the isolated individual, exacts from
him labour, sacrifice, and the gift of himself.
Thomas Merton

106

INFO

Give useful information

Connect to another individual or family

£

Refer to community organisations
Recommend appropriate providers

110

Resources multiply in networks created by intentionally
building relationships that cross boundaries & serve
people's deepest purposes.
Seymour Sarason

112

Citizenship is the full realisation of our
interdependence - the value we bring to each other in
all our diﬀerences.
The lame rides a horse
the maimed drives the herd
the deaf is brave in battle.
A man is better
blind than buried.
A dead man is deft at nothing.
From Viking - Havamal
116

For more information:
Web: www.centreforwelfarereform.org
Twitter: @CforWR and @simonjduffy
Blog: www.simonduffy.info
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© Simon Duffy. Rights Reserved. Full copyright details at www.centreforwelfarereform.org
128

The Point of Our Work - exploring mental health reform in Australia

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