Neo-liberalism, community care and Australian mental health policy.

ABSTRACT

This paper examines key documents from the Australian National Mental Health Strategy and explores the extent to which they reflect neo-liberal ideals. It argues, through discourse analysis of policy documents, that the families of the mentally ill have been reconstructed as a key source of informal care. The development of 'community care' and 'informal care' in Australian policy documents reflect a neo-liberal understanding of the individual and their family, one that views the family as an autonomous unit responsible for its own maintenance. This orientation creates a moral imperative upon the families of the mentally ill to adopt a caring role, conversely allowing for increasing regulation of the family by professional carers through the creation of formal mechanisms for carer involvement in provision of mental health services and the codification of carers' rights and responsibilities in the Mental Health Statement of Rights and Responsibilities.

KEY WORDS

National Mental Health Strategy; neo-liberalism; community care; mental illness; governmentality; discourse analysis

Introduction

This paper examines the Australian National Mental Health Strategy arguing that the documents that comprise it reflect a neo-liberal, governmental rationality. This is evident in the use of the language of economics in framing mental health policy and in the role of market forces in service provision. It is also reflected in a diminishing role for the state in providing mental health services and a growing reliance upon self-governance of health and well-being demonstrated by calls for self-care and community care. This paper will argue that the state, through the National Mental Health Strategy, has distanced itself from service delivery and has established mechanisms for increasing reliance upon non-governmental and private sources of care. It will explore the impact of these changes upon the families of the mentally ill through tracing the construction of 'community care' and 'informal care' in Australian mental health policy documents. This understanding of community care will be juxtaposed against that informing the development of a mental health consumer and carer movement in the late 1970s and the early 1980s. The early consumer movement was an empancipatory movement that sought to challenge medical power. With the advent of neo-liberalism, consumers and carers have been subjected to the language of economics and of the market. The premise of this paper is that this results in the families of the mentally ill being asked to take responsibility for, and to govern, family members.

Neo-liberalism