The University of Newcastle, Australia

Lessons from mental health history

An internationally recognised historian and prolific author, Professor Catharine Coleborne is untangling the secrets of mental health history to ensure that we understand mental illness experiences in our present.

Image of Cathy Coleborne

For more than 20 years, Professor Catharine Coleborne has been exploring the social and cultural histories of mental illness and the institutions created to confine, treat and assist the mentally ill.

More recently, Cathy has sought to break down the way we understand and talk about what she calls “mad history”. Her research argues for the relevance of historical perspectives on mental health, seeking to understand how these histories can—and should—inform debates about mental health services today.

“I am very excited that my research challenges our current modes of understanding and presents new ways of thinking about mental illness experiences with a historical perspective that could reshape our interpretation of mental health in the present.”

Cathy’s findings have made a significant contribution to global research, as well as to museum exhibitions of psychiatric histories. In fact, her widely reviewed insights into colonial institutions, gender and social identity have been applauded as landmark research in the field.

“I want to offer an intervention into new ways of thinking—and talking—about ‘mad’ history. I hope my work inspires people to ask questions such as, what does it mean to study the history of madness? Why is it important to voice these histories? What can they tell us about the challenges and legacies of mental healthcare across the world today?”

Challenging accepted narratives

Cathy is perhaps most well-known for challenging older historical conceptions of institutional care in Australia.

She explains that economic rationalism, and the wider introduction of psychotropic therapies, led to the push to close down institutions in favour of community care. The trend began in the UK in the 1960s and rippled through other Western countries until the end of the 20th century.

Since the widespread closures of mental hospitals, institutionalised care has been viewed with mixed feelings.

“Some people felt really sad at the closure of institutions because they found them places of care and respite, often in lovely settings in the countryside.

“But other people found institutions to be very repressive, very dark, very violent places, where abuses occurred. Both stories are true, and multiple stories need to be told.”

Cathy has sought to challenge accepted narratives of institutional care by examining how institutions operated and reviewing patients’ first-hand accounts of their experiences of care. Her work revealed some thought-provoking insights.

“My book, Madness in the Family, showed that families were involved in admission, discharge and institutional visits, as well as becoming proactive in post-institutional care or ‘aftercare’ in the very early 20th century.

“My historical work is internationally known and regarded for this insight, as well as for the reflection on patient and family emotions, and the way that the historical archive of cases and sources in the histories of mental illness can be understood. It has given some expression to those people seeking to understand the histories of mental illness in new ways.”

While there’s no doubt that institutions had both positive and negative attributes, Cathy says that their closure left a gaping hole in mental healthcare across Australia—one that she asserts has not yet been adequately filled.

“We still see many people struggling with mental illness, and services in our wider communities tend to be fragmented, meaning that the aims of community psychiatry following the closures of large psychiatric hospitals have left many families and individuals without adequate support.”

Let’s talk about madness

Along with multiple edited collections, journal articles and book chapters, the University of Newcastle’s Head of School of Humanities and Social Science has published four sole-authored books on the concept of ‘madness’ throughout history—and its compelling relevance in our modern world.

Her newest book, Why Talk about Madness? Bringing history into the conversation provides a fascinating summary on the history and relevance of first-person accounts of mental breakdown. It also looks at how psychiatric ‘patients’, ‘survivors’ or ‘consumers’ have been represented over time, and the significance of this representation.

Cathy says her book aims to escape from dominant modes of writing about the asylum.

“My new book, Why Talk about Madness? will provoke and stimulate debate in public life about the meanings of madness, allowing new forms of thinking and writing about mental illness as well as voicing concerns about the early modes of representing mental illness in our society—these often did not account for sufferers.”

Learning from our past

Cathy is currently second Chief Investigator on two Australian Research Council Discovery Projects focused on the histories of mental health and psychiatry in Australia spanning the 19th and 20th centuries.

Her work is investigating how the history of the mad movement, self-help and mental health consumer advocacy from the 1960s have had an impact on modern society, as well as how they are discussed and reflected within modern literature.

Her next book, Narrating Madness in the Twentieth Century, focuses on the overarching histories of consumer networks, advocacy, policy changes, shared histories and points of difference across Australia, New Zealand, the United Kingdom and Canada. With Dr Elizabeth Roberts-Pedersen, she is also writing a book about the global history of mental health: Making Mental Health: A Global History (Routledge Critical Approaches to Health).

Cathy hopes that by critically analysing mental health history, and its influence on current discourse, her research will help to build a more accurate picture of the strengths and weaknesses of current mental healthcare policies and practices. It will help us see how current practice ideologies fit within a historical context—and perhaps point towards better ways of supporting people’s mental health in the future.

“Current mental health policy, practice and research face many challenges. For example, biomedical approaches to mental illness can make it harder to obtain the perspectives of people living with mental illness conditions, or who find it hard to be heard.

“Placing all of these challenges into a historical perspective is an important and valuable endeavour that can be overlooked in the rush to promote medical solutions to mental health problems, rather than understanding service provision, experiences and multiple narratives of mental illness, health and wellbeing”.

Transferring knowledge through generations

Catharine has held the post of President of the Australia and New Zealand Law and History Society, has been a member of the Royal Society of New Zealand’s Marsden Panel (Humanities), including in 2019, and was a Specialist Adviser to New Zealand’s Tertiary Education Commission. She also has vast experience in course design, digital delivery of content and team teaching.

Describing her students as ‘fantastic’ and ‘talented’, Catharine has supervised more than 40 pieces of postgraduate research, including doctorates, masters and honours dissertations to completion, and supervises higher research degree students with the University of Newcastle.

As an educator, Cathy is committed to fostering and transferring knowledge to the next generation, helping to guide the future of the humanities and social science fields of inquiry. As a Head of School, she launched the new podcast series, The Human Experience, in 2019.

Currently the Chair of The Educator Network, Cathy is a keen advocate for growing educational leadership and talent, and innovation across different modes of delivery for students at the University of Newcastle.