Deinstitutionalisation and Managerialism in Queensland's Public Psychiatric Institutions: Challenging "Rhetoric" with Empirical Results

Abstract

This article places the experience of public psychiatric institutions for the long term mentally ill in the context of New Public Management (NPM). This managerialist school of thought has been in widespread ascendancy since the 1970s. Some key characteristics of deinstitutionalisation and NPM are outlined. We then present some historical data about the temporal process of deinstitutionalisation in Queensland's public psychiatric institutions. The time series analysis provided is of a single state since Australia's public health care system is state-based. Although NPM is not a coherent set of principles or doctrines, it is argued that ideology and the reality may be contradicting. Some of NPM's particular emphases are empirically analysed, in particular the view that administration/management expenditures are to be reduced, while emphasising workers 'at the coal face'. The empirical results provide no evidence of a 'parsimonious' approach to management: parsimony occurs only for nursing staff. Relative expenditures on managerial functions have increased.