Access and Injustice: An Intersectionality-informed Analysis of Victorian Mental Health Policy in Australia

The use of compulsion and restrictive interventions in mental health care has been linked to social factors including poverty and marginalization. Using an intersectionality-informed analysis of key Victorian mental health policy documents released over the past decade, we identified a consistent lack of attention to the role played by race, socioeconomic status, and other forms of marginalization in the increased likelihood of compulsory treatment. Although policymakers have strived to consider the role of social determinants in catalyzing or mitigating mental distress, this social framework is often displaced by a consistently dominant biomedical approach to mental illness, which emphasizes identifying diagnoses and providing clinical treatment. This paper critically examines the stated intentions of mental health policy in Victoria, Australia, and the recent recommendations of the Royal Commission into Victoria's mental health system. We found that policies and recommendations for reform tend to express an intention to decrease the use of compulsion and restrictive interventions. However, the assumption expressed in reforms is that compulsory treatment is the result of systematic failure to provide treatment through other less intrusive avenues, thus neglecting deliberate discussion and action on the intersecting social factors that directly contribute to compulsory treatment.