History of the School

History of the School of Psychiatry and Clinical Neurosciences (formerly the Department of Psychiatry and Behavioural Science), University of Western Australia – a brief overview by Dr Hans Stampfer.

Laying the Foundations (1964 – 1972)

The Department came into existence in 1964, with the appointment of Ian Oswald to the Chair of Psychiatry. This was seven years after the first medical school in Western Australia had been established. It was to be called ‘Department of Psychological Medicine’ but Oswald preferred ‘Department of Psychiatry’, and so it was. Although advertised as a permanent Chair, Oswald did not make a permanent commitment and negotiated to take up the appointment as ‘visiting professor’ for two-and-a-half years. He had been working in Prof. Carstairs’ prestigious Dept. of Psychiatry in Edinburgh at the time and may have wanted to keep his options open. Here he had to start from scratch. There was no in-patient unit, no curriculum, no infrastructure, not even a designated office or site. With departmental plans still on the drawing board, he had to squat in temporary offices, first at Royal Perth Hospital [RPH] and a little while later in a ‘fibro’ hut at the back of Sir Charles Gairdner Hospital [SCGH]. He formed the nucleus of a department with the appointment of PW Burvill in 1965 and ER Csillag in 1966. Undergraduate teaching was rudimentary and out-patient based. Selected patients were interviewed in a room full of students. Oswald did not extend his visit and returned to Edinburgh after the completion of his contract. Some six months later in 1968, Cecil Kidd, from the University Dept. of Psychiatry in Aberdeen, was appointed as the first permanent chair.

Kidd quickly introduced a more structured undergraduate program of didactic lectures, student/patient contact and small group clinical tutorials. He made Psychiatry ‘accessible’ and was liked as a teacher. He was also a dedicated researcher who expected the same dedication from others. The Department’s only two MD's [Burvill and Zorbas] and first PhD [Finlay-Jones] originated from the time of his headship. A fledgling University Department of Psychiatry in-patient unit [UDP] was established in 1969, with a six bed allocation adjacent to the respiratory medicine unit in ‘A Block’, SCGH. The future location in ‘D Block’ was still at the planning stage and Kidd made a significant contribution to the plans. At this stage however, the Department relied heavily on ‘mental hospitals’ [Heathcoate and Graylands] to provide students with clinical experience.

Staff numbers increased modestly during the 70’s, beginning with the appointments in 1970, of A Zorbas [Lecturer in Psychiatry] and G White [Senior Lecturer in Clinical Psychology]. White was appointed on a 12-month temporary basis to set up a course in behavioral science. This he did and then handed over to D Poole PhD and R Sanson-Fisher, who completed a Ph.D. during his appointment. In 1971, G Dixon was appointed Senior Lecturer in Child Psychiatry and RA Finlay-Jones Tutor/Lecturer in Psychiatry. Finlay-Jones had been awarded a Sobotka scholarship and was the first full time researcher in the Department.

By the beginning of 1971, the foundations had been laid. There was a critical mass of academics, a greatly improved undergraduate teaching program, ongoing research and a Departmental ‘base’. There was justification for optimism about the future when quite unexpectedly, Kidd died in October 1971, after relatively minor elective surgery, while overseas on sabbatical leave. This slowed things down until the appointment of GA German in December 1972. His appointment ushered in the next phase of departmental growth and development.

Building a Department (1973 – 1980)

Development of Under- and Post-graduate Teaching Programs

A graduate from Aberdeen University in Scotland, German trained in Psychiatry in Aberdeen and at the Maudsley Hospital in London. He had occupied the position of Professor of Psychiatry in Uganda for six years. A charismatic personality, gifted teacher and respected clinician, German did much to raise the profile of Psychiatry in the Faculty and in the wider medical community. He had obtained both his Physician and Psychiatry memberships in England and was very much a ‘physician psychiatrist’, with a strong research interest in neuroscience and ‘biological’ psychiatry. German was a very effective ambassador for psychiatry during the next 15 years. He was an excellent speaker with an ability to evoke respect and cooperation at all levels. He did much to give Psychiatry equal standing with other clinical departments and the calibre of his professional standing in the Faculty is reflected in him being elected Dean of Medicine in 1988. German felt strongly that clinical academics should also be practicing clinicians and practiced what he preached. His availability for clinical referrals earned him respect from the wider medical community. Students will no doubt remember him for the clarity of his didactic and clinical teaching.

An undergraduate course [C Kidd] and post-graduate training program [PW Burvill and WJ Walker] was already in place by the time German arrived. However there was much room for improvement and considerable time and effort was given to the further development of each over the next ten years. By 1980, there was an effective format of undergraduate teaching and a demonstrably successful post-graduate program. Candidates from Western Australia were performing as well as candidates from other states. WA could now generate its own psychiatrists.

Research

The arrival of German and the staff increases during the 70’s led to a diversification of research interest. The two established, ongoing areas of research were epidemiological studies [PW Burvill] and sexual dysfunction studies [ER Csillag]. New areas of research during this period included - staff-patient interaction in ward ‘D20’ (R Sanson-Fisher) - parent-child interaction during the first 6 months of life (C Lawrence) - teaching of empathy and communication to medical undergraduates (R Sanson-Fisher) - behaviour therapy (D. Poole) - collaborative studies of comparative ethnopsychiatry (GA German) – studies of cortical evoked potentials in schizophrenia (HG Stampfer & GA German) – therapeutic effects of luteinizing hormone releasing factor (GA German & HG Stampfer) – speech and thought disorder in psychiatric disorders (E Blackmore). Whilst most of these new investigations produced publications, none progressed to ongoing research.

Steering the Ship Through Tougher Waters (1981 – 1993)

The departmental growth of the 70’s did not continue into the 80’s. This was due largely to a national down turn in the economy. Cutbacks and cost-saving were the order of the day and all academic departments felt the ‘squeeze’ – particularly small departments like the ‘University Department of Psychiatry and Behavioural Sciences’ as it was now called. Even without cutbacks recruitment to University funded clinical academic positions was always a little difficult because of the relatively low salary. Hospital consultants with opportunities for teaching and research were paid more than a full Professor. At the level of salary, a University position was not competitive below Associate Professor and even then there were trade-offs between avocation, status and income. That aside, it became very apparent that the Department would have to rely increasingly on non-University funding for staffing and research initiatives.

Research

Research output was maintained at a satisfactory level thanks largely to a few individuals. PW Burvill was gaining an international reputation for his epidemiological studies and Csillag’s work on sexual dysfunction was building into a solid research enterprise. For the rest, staff members came and went and each tended to ‘do their own thing’. This often meant starting but not finishing or leaving the department to continue work somewhere else. In 1984, the Department lost Bob Csillag. Erudite, broadly educated, sophisticated and charming, he was widely liked and respected by patients, students and peers. He was truly a combination of ‘inspired teacher, original thinker, warm and wise friend’ – as inscribed on the commemorative plague outside the Csillag Lecture Theatre at SCGH. His loss revealed the potential problems of research tied solely to one individual. There was no one to continue what had been a pioneering and very productive area of research. The work was taken over by a collaborator outside the Department and resulted in the development of a practically useful clinical tool.

German effectively left the Department when he was elected Dean of the Faculty of Medicine in 1988, and thereafter, Head of the Division of Dentistry and Medicine. He left an established department whose undergraduate teaching was repeatedly commended by external examiners. There was input into every year of the six year course in medicine – Behavioral Science in years 1-3, didactic and clinical teaching in Psychiatry, years 4-6. The post-graduate program was operating effectively and turning out competitive candidates. The teaching side of things had been developed to a highly satisfactory degree and GA German had made a major contribution. A comparable development in research had to wait until the next phase.

Growth of Research and Department (1993 – 2000)

PW Burvill was promoted to the chair left vacant by Allen German. The second chair at RPH was filled by Assen Jablensky in 1992 and his appointment was a stroke of good fortune for the Department. Widely experienced with an excellent track record of research at the highest international level, he was very much needed at a time when greater emphasis was being given to research-based performance indicators. His arrival was followed by a period of rapid growth in research activity. A previously negotiated research centre at Graylands Hospital became a reality, and in 1994, the Centre for Clinical Research in Neuropsychiatry was opened in grand style. It was a joint initiative between the UWA Department of Psychiatry and Behavioral Science and the Health Department of Western Australia – with collaborative links to the WA Institute for Medical Research, Medical Research Foundation at RPH, Department of Psychology at UWA and Department of Human Biology at Edith Cowan University. With funding from the Health Department, new University positions were created to develop special areas of clinical and research interest. This, in combination with grant funded research staff, led to a rapid increase in staff numbers and research output. By the end of 2000, there was good momentum in research related activity. Publications had increased substantially and areas of ongoing collaborative research had become established. Jablensky took over the headship after Burvill retired in 1998 and no history of the Department would be complete without acknowledgement of the contribution made by Peter Burvill. At the time he retired, he was the longest serving member in the Department and his record-breaking 33 years will probably never be bettered. He remained throughout an exemplary clinical academic who made an outstanding all round contribution as teacher, researcher, clinician and administrator. He maintained a steady stream of publications and never tired of encouraging research at an individual and departmental level. He was often the mentor for individuals writing their first paper. He was held in high professional regard and was widely respected for his integrity as a person.

Into the New Millennium (2001 onwards)

The much discussed formation of schools became a reality and the School of Psychiatry and Clinical Neurosciences was inaugurated in November 2002. Osvaldo Almeida took over the headship from Assen Jablensky in 2002 and was followed in turn by Geoff Riley in 2004 and Sasha Janca in January 2006. From its ‘one-man-show’ start as the Department of Psychiatry in 1964, the School of Psychiatry and Clinical Neurosciences in 2006 has a School Manager (Helen Moran), over 80 staff (including academic, research & clerical staff) and 17 PhD students. It is located at 5 sites - QEII Medical Centre, including West Australian Institute for Medical Research; Royal Perth Hospital including Medical Research Foundation Building & Ainslie House; Fremantle Hospital; Alzheimer Unit, Sir James McCusker Centre, Hollywood Private Hospital; Centre for Clinical Research in Neuropsychiatry, Graylands Hospital – and is well positioned to meet the challenges of the future. It has established areas of productive research and can expect to keep pace with the demands of more competitive circumstances. Devolution into ‘schools’ has not merely decentralized administrative responsibilities. It has increased accountability and competition at all levels and in different domains. ‘Survival’ in the new era means operating a successful academic ‘business’ and the challenge for the School is to maintain and further develop its currently successful business.

Departmental Highlights

• RA Finlay-Jones became Editor of the Journal of the Royal Australian and New Zealand College of Psychiatrists (RANZCP) (1988-91) and was thereafter appointed Professor of Forensic Psychiatry in New South Wales.
• R Sanson-Fisher and D Poole were both appointed to Chairs in Psychology
• GA German was elected Dean, Faculty of Medicine in 1988 and thereafter Head, Division of Dentistry and Medicine. He was awarded the RANZCP Meritorious Service Award in 2001 for outstanding contribution to psychiatry in Western Australia
• The Department was designated a WHO Collaborating Centre for Research and Training in Mental Health in 1996
• A Jablensky was awarded the Organon Senior Research Award (RANZCP), Founders Medal (Australasian Society for Psychiatric Research) in 2000; Honorary Fellowship of the UK Royal College of Psychiatrists in 2001; and Honorary Membership, World Psychiatric Association in 2002
• C Lawrence became the first female Premier of Western Australia from February 1990 until February 1993.