Tag Archives: Joo-Inn Chew

Sarah Krasnostein’s Not Waving, Drowning

Sarah Krasnostein, Not Waving, Drowning: Mental illness and vulnerability in Australia (Quarterly Essay 85, 2022)
– plus correspondence in Quarterly Essay 86

Sarah Krasnostein doesn’t explain the title of this Quarterly Essay. It may be a straightforward inversion of the name of a Melbourne band, but I read it as referring to Stevie Smith’s most famous poem, ‘Not Waving but Drowning’, which begins:

Nobody heard him, the dead man,   
But still he lay moaning:
I was much further out than you thought   
And not waving but drowning.

You can read the whole short poem at this link.

The essay centres around the harrowing stories of three young people whose behaviour no one could have mistaken for cheerful waving, but who received attention from public institutions that left them immeasurably worse off. It’s pretty much a catalogue of horrors, with some glimmering hope to be found in the Victorian government’s commitment to act on the recommendations of the recent Royal Commission into Victoria’s Mental Health System.

Krasnostein avoids defining what she means by mental illness. It’s a bit like what a US supreme court justice said about pornography: ‘I can’t define it but I know it when I see it.’ As well as diagnoses like schizophrenia or – predominantly – various personality disorders, her use of the term comes close to encompassing homelessness, addiction, racism, marginalisation, responses to climate change, and suicide, or even simply vulnerability to the prison and mental health systems. This imprecision may be a feature rather than a bug. The essay is concerned to discuss mental illness from wider perspectives than the purely clinical, and boundaries between it and other forms of oppression are in their nature fluid.

She speaks of the profoundly destructive and destabilising effect of colonisation on the minds of settlers as well as First Nations people. She relies on Erving Goffman’s theory of stigma. She draws on Jung and Freud, and on recent thinking about systems change. She goes into some detail about the interface of criminal law and mental illness diagnoses. And in the middle of it there is the terrible vision of young people’s lives being ruined.

It’s a powerful and timely essay, but I found much of Krasnostein’s argument hard to follow. For example, I didn’t understand the logic by which a diagnosis of borderline personality disorder meant that a person who burned down a lot of buildings wasn’t an arsonist (though I get that punitiveness isn’t a reasonable response). Elsewhere, in an apparent non sequitur, a section begins, ‘I am thinking what it means to remember,’ and goes on to talk about stigmatisation of marginalised groups. Or there’s a beautifully written paragraph about a Trumpian demonstrations in Melbourne that seems to be there because the demo happened while the essay was being written.

More than any other Quarterly Essay, I’m glad of Black Inc’s practice of including correspondence in the following issue. This correspondence helped me understand what the essay was saying.

There are responses from journalists, historians, a psychiatrist, a criminal defence lawyer, and people who have worked in prisons and mental health institutions. Several of them mention their own experience as clients of the mental health system, as Krasnostein does in the essay. Taken as a whole, along with Krasnostein’s generous response, they illuminate the essay beautifully and extend its reach. To finish, here’s a quote from Joo-Inn Chew whose bio tells us she ‘works in general practice and refugee health in Canberra’, that gets to the heart of the essay (I like the way Joo-In Chew writes of wounds, addictions and diagnoses rather than conditions or illnesses):

Behind each wound, each addiction, each diagnosis is a person and a story, and beyond that a web of cultural and economic power which shapes everything, from the start people get in life, to how they express distress and whether they seek help, to how they are treated by front-line services and social institutions. Not everyone knows what it is like to feel safe and free in Australia. Every one of us can take stock of where we are in the web, how we use the power we have and how we recognise the common humanity of people around us. We can normalise our own vulnerabilities and use our power well. I thank Sarah Krasnostein for an essay which invites us to do just that.

(QE 86, Sleepwalk to War, page 123)