Melville Clinic, A Utopian Experiment in Community Mental Health Services: What Was New and What Survived?

Abstract

In 1975 Melville Clinic opened as an experimental community mental health centre in the ethnically-diverse, working-class inner Melbourne suburb of Brunswick. It was established with funding support from the Victorian and Commonwealth governments and was intended to test and refine elements of a community care model that was starting to provide an alternative to entrenched systems of mental hospital care. Developing alongside and extending on European and United States interpretations of the model, Melville Clinic was designed as a force for innovation in the areas of clinical work style, staff roles, organisational structure, and geographic positioning within the community it served. It also aspired to novel types of involvement in community work, multicultural sensitivity, collection of evidence about its performance, and timely self-evaluation. This paper scrutinises the bumpy course of its experimental strategies over the course of seven years during which the clinic retained some of its innovations, divested itself of others, while also changing key aspects of the way it delivered public community-based mental health services. A candid self-evaluation published in 1982 reflected insights gained during the experiment. From a present-day perspective the clinic, now defunct, provides a useful case study of community-based care at an important stage in the evolution of public mental health service formulation and delivery in Australia.