Not Waving, Drowning: Mental Illness and Vulnerability in Australia – Sarah Krasnostein

Quarterly Essay #85

Mental illness is so prevalent that it’s likely either you or someone you love will have lived experience. If it hasn’t impacted you personally, it probably means that it hasn’t yet, not that it won’t. 

Almost half of all Australian adults will experience mental ill-health during their lives, and almost one in five will meet the criteria in a given year. These numbers have likely risen during the pandemic. 

In this essay, Sarah Krasnostein traces the way mental illness has been managed (or perhaps it would be more accurate to say, poorly managed) over time in Australia. They outline the trauma experienced by convicts and the “increasingly lethal, state-sanctioned attempt to eradicate Aboriginal people” (a minimum of 270 massacres over 140 years, beginning in 1794!!) before exploring our asylum days, beginning with Tarban Creek Lunatic Asylum, Australia’s first purpose built psychiatric facility. 

Krasnostein evaluates our current system, where money buys you care if you’re cis, heterosexual and white, while pretty much everyone else has to fight for the scraps, if they can find any. 

What is known as “the mental health system,” for example, is really just billions of human interactions. And that is where the problems lie. 

We go down the rabbit hole of how people with mental illness are marginalised, looking at the failure of individuals, institutions and society at large. I grew weary hearing about the cascade of inquiries into the mental health system that consistently result in recommendation after recommendation that are not acted on.

We can memorise the stats and read the policies but what really stays with me are peoples’ lived experiences. You can intellectually know that people with mental illness disproportionately experience homelessness and that the ‘service gaps’ are really service chasms, but that doesn’t tell you the whole story. 

Being introduced to Rebecca, who despite being found not fit to stand trial and not guilty because of mental impairment, was imprisoned and kept in solitary confinement for up to 23 hours a day simply because there was nowhere else for her to go? Her story is going to stay with me. So is Daylia’s, a woman with a history of setting fires in order to try to gain control over her life.

The story of lived experience that stood above all others for me, though, was that of Eliza. A young woman who has survived extensive childhood trauma and is living with a diagnosis of borderline personality disorder, Eliza is now a peer worker, working to reform a system that in many ways has failed her. To say that I am impressed by her resilience and courage is an understatement. We need to be listening more to people like Eliza.

Quote I loved whose context I can’t remember but would be appropriate in so many situations

absence of evidence is not evidence of absence 

From the ‘I bet whoever approved this name didn’t give it a lot of thought’ files

The Australian Institute of Health and Welfare have spreadsheets collating cause of death called General Record of Incidence of Mortality (GRIM). 

Because there is no systems change without relational change – and no relational change without personal change – perhaps our best hope lies in a critical mass of those who are privileged by the current economic and social model following the lead of those people with lived experience and making the radical choice to normalise their own vulnerabilities – not just by refusing to participate in the stigmatisation of mental illness, but by calling out Othering in all its pernicious forms. 

There were a couple of quotes from the Correspondence section about Jess Hill’s The Reckoning that I wanted to make note of: 

Adrienne Rich wrote that when a woman tells the truth, she creates “the possibility for more truth around her.” 

Hannah Ryan & Gina Rushton

Silence and withdrawal by the many is what enables crimes by the few. 

Malcolm Knox

Content warnings include alcoholism, bullying, death by suicide, domestic abuse, drug addiction, eating disorders, homophobia, mental health, physical abuse, racism, self harm and sexual assault.

Rating: 4 out of 5.

Once Upon a Blurb

Mental illness is the great isolator – and the great unifier. Almost half of us will suffer from it at some point in our lives; it affects everybody in one way or another. Yet today Australia’s mental health system is under stress and not fit for purpose, and the pandemic is only making things worse. What is to be done?

In this brilliant mix of portraiture and analysis, Sarah Krasnostein tells the stories of three women and their treatment by the state while at their most unwell. What do their experiences tell us about the likelihood of institutional and cultural change? Krasnostein argues that we live in a society that often punishes vulnerability, but shows we have the resources to mend a broken system. But do we have the will to do so, or must the patterns of the past persist into the future?

“In our conception of government, and our willingness to fund it, we are closer to the Nordic countries than to America. However, we’re trending towards the latter with a new story of Australia. The moral of this new story is freedom over equality, and one freedom above all – the freedom to be unbothered by others’ needs. However, as we continue to saw ourselves off our perch, mental health might be the great unifier that climate change and the pandemic aren’t.” —Sarah Krasnostein, Not Waving, Drowning

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