A Short History of Managing Problematic Users of Alcohol in Western Australia by Mental Health Services

Abstract

Abstract. Aims: This paper examines the role that mental health services (MHS) performed in the management and provision of medical care and treatment of problematic users of alcohol in Western Australia (WA) over the period since 1900. Methods: The research involved an examination of legislative enactments and regulations, records of parliamentary debates in Hansard, administrative records in the State Records Office, and other sources of public information, such as departmental annual reports, reviews of services, studies and newspapers. Results: This research identified three eras of policy involving problematic users. The first, from 1900 to the mid 1970s, focussed on controls in inebriates and lunacy legislation to create a regime of civil commitment, designed to confine and compel ‘inebriates’, as well as ‘convicted inebriates,’ to ‘dry out’ and rehabilitate. The second, between 1975 and the late 1990s, involved the creation of a state-wide system of specialist service providers to provide treatment and recovery for problematic users. The system involved a spectrum of services that included a detoxification hospital, outpatient clinics and community-based regional services established and operated by a statutory public health agency, the Alcohol and Drug Authority (ADA). The third era, which commenced in the late 1990s, involved the transfer of all community-based services from the ADA to ‘not-for-profit’ non-government organisations (NGOs). The end result of this devolution was the ADA retained only a limited treatment role, as the operator of the inpatient detoxification facility. The balance of its functions were redefined in relation to the prevention of the use of alcohol and other drugs, primarily through support of mass public education programs, as well as oversight of funded NGO programs. The paper concludes with a consideration of a recent major development which involved administrative and legislative actions in 2015 to abolish the statutory body which had operated since 1975 and transfer administrative responsibility for drug and alcohol services into the Mental Health Commission.