The Art of Psychiatry

Julia Aranui-Faed. Photos: Supplied
Julia Aranui-Faed. Photos: Supplied
Julia was in her fifth year of medical school when this photo was taken (from left) of her with her aunty Nanci Harrison, her grandmother Olive Norman and her mother Anne Baird. Photos: Supplied
Julia was in her fifth year of medical school when this photo was taken (from left) of her with her aunty Nanci Harrison, her grandmother Olive Norman and her mother Anne Baird.
In May, 1988, Julia visited the newly opened Darling Harbour precinct in Sydney, Australia, just before her health broke down.
In May, 1988, Julia visited the newly opened Darling Harbour precinct in Sydney, Australia, just before her health broke down.
Julia Aranui-Faed (nee Baird) grew up in Canterbury and the Wellington region.
Julia Aranui-Faed (nee Baird) grew up in Canterbury and the Wellington region.
Julia was made a Fellow of the Royal Australian and New Zealand College Of Psychiatrists at a conference In Perth in 1982. During this trip she visited Graylands Psychiatric Hospital and saw how the arts were used there.
Julia was made a Fellow of the Royal Australian and New Zealand College Of Psychiatrists at a conference In Perth in 1982. During this trip she visited Graylands Psychiatric Hospital and saw how the arts were used there.
Moa stilt-walkers parade with the taniwha to lay to rest "the mythical beast of mental illness'' at Cherry Farm Hospital on November 5, 1987.
Moa stilt-walkers parade with the taniwha to lay to rest "the mythical beast of mental illness'' at Cherry Farm Hospital on November 5, 1987.

It is 30 years since New Zealand's big psychiatric prisons were closed down. Bruce Munro talks to Julia Aranui-Faed, a significant but largely forgotten figure from that important period in New Zealand history, about her legacy, her mental illness and the freedom to colour her world.

She started dancing as soon as the strains of music reached her ears, her feet, her soul.

Julia Aranui-Faed, former psychiatrist and Medical Superintendent of Cherry Farm Hospital, says she is grateful for the whole of her life, even the rough patches. Photo: Gregor Richardson
Julia Aranui-Faed, former psychiatrist and Medical Superintendent of Cherry Farm Hospital, says she is grateful for the whole of her life, even the rough patches. Photo: Gregor Richardson
No-one noticed at first. All eyes in the 150-strong audience gathered around the first floor Otago Museum atrium were on the Dunedin Rock Choir performing the Everly Brothers' lilting, jilted, melody Bye Bye Love.

Then a nudge, a nod, a smile as the crowd caught sight of her coming into view from the direction of the ground floor entrance.

Red top, woollen cardigan and hat in bright shades of purple, navy trousers patterned with pink roses, tan boots, walking stick. She advanced slowly across the polished marble floor, swaying to the rhythm, moving her feet, tapping her cane in time to the music descending from above.

 

Bye bye love

Bye bye happiness, hello loneliness

I think I'm-a gonna cry-y

 

By the time the choir had uttered its final whispered ''good-bye'' she had made her way across the open space and into the audience's heart. The rousing applause was for the talented singers and the unknown, music-moved, senior citizen.

No-one realised they were clapping Julia Aranui-Faed. Even if they had been told her name, it would have meant little to most. But this was the woman who, three decades ago, took institutionalised psychiatric care and gave it a good shake by the scruff of its neck.

This uninhibited, smiling woman was once a respected, and even feared, senior psychiatrist. Dr Faed, as she was then known, was the Superintendent of Otago's Cherry Farm Psychiatric Hospital. She unlocked psychiatric wards, made the arts part of a nationwide revolution in patient-focused care and established a model for transitioning patients out of hospital that became best practice for the massive close-down of the country's large, psychiatric hospitals in the late-1980s.

And here she is, anonymous, being given belated, unwitting applause by a diverse, surrogate assemblage of the country's citizens as she moves to a tune replete with emotional and mental anguish.

It could be a song about her childhood.

Julia was born on January 8, 1945. Her father was a doctor at Wellington Hospital. But she was still very young when he disappeared from her life.

For a period, she was raised by grandparents and various other relatives throughout Canterbury, before returning to her mother at Naenae, Wellington.

''When I was about 8, we hopped on a bus and Mum said, 'We're going off to see your father','' Julia recalls.

''Well, that was damned funny, because she had said he was dead.''

The opening of Artsenta's annual exhibition at the Dunedin Community Gallery last year. Photo: ODT files
The opening of Artsenta's annual exhibition at the Dunedin Community Gallery last year. Photo: ODT files
Up until then, on Anzac Day each year, young Julia had been laying flowers in memory of her father.

''That was very embarrassing. Really embarrassing.''

The bus took them all the way to Kaitaia, in Northland, where Julia followed behind her parents as they walked the beach discussing who would provide the evidence of adultery required to obtain a divorce.

''I later found out that I was the child that caused the marriage.''

Back in Naenae, Julia and her mother were shunned.

''Because all the other married women considered her a danger.

''And I had no friends because I was the daughter of a divorcee.''

It made the young, earnest girl tough.

''After all the crap in Naenae, I thought, I love Jesus and he loves me, but he doesn't expect me to be a doormat.

''I swore, I was aggressive. I don't think they quite knew how to handle me.''

Mother and child moved to Thorndon; a formerly genteel and now slightly rundown suburb that included Parliament and a dozen pubs. Still the days of the six o'clock swill, life there was an education.

Penny Eames, the founding Executive Director of Arts Access Aotearoa, says Dr Julia Aranui-Faed was a "thought leader'' who made a "huge contribution''. Photos: Supplied
Penny Eames, the founding Executive Director of Arts Access Aotearoa, says Dr Julia Aranui-Faed was a "thought leader'' who made a "huge contribution''. Photos: Supplied
''When I was going for fish and chips on a Friday night, I had inbuilt into me, because Mum was a nurse and Dad was a doctor, I had to inspect all the drunken men in the gutters to make sure they were breathing.''

Julia set her sights early on becoming a doctor. She divided her after-school hours, her weekends and even her holidays into allocated blocks that included relaxation, study and helping at home.

In 1962, she was co-dux of Queen Margaret Girls' College. By the end of the next year, she easily won a place in the competitive entry to Otago Medical School. Of 120 trainee doctors, she was one of 20 women and less than a dozen Maori.

''I think my grandmother was of Maori blood - she was always dark - but she would not have wanted that known,'' Julia says of her paternal grandmother, who was a proud descendant of colonial Nelson's moneyed elite.

Julia's fervent aim in becoming a doctor was to go to Africa as a medical missionary. That changed when she worked three summer holidays as an assistant psychiatric nurse at Porirua Hospital.

''What I saw there was just bloody appalling ... I thought, this cannot go on. It is a blot and a sore on our health system. If only New Zealand people knew.

''I can't go to Africa. I will work in the major psychiatric hospitals in New Zealand and I will clean it up.''

 

The Rock Choir's museum recital continues and Julia continues to dance. Voices lift a new song, a new beat. Julia, who is 73, adapts the movements of her feet and cane to the metre, lost in the moment, one with the song.

 

But I would walk 500 miles

And I would walk 500 more

Just to be the man who walks a thousand miles

To fall down at your door

 

Julia worked long and hard to earn her medical degree. Then the real slog began. But she was full of energy, up for the job.

''Usually I was doing five jobs at once,'' she says.

She worked at Wakari Hospital and at Cherry Farm. She gained membership to the Royal Australian and New Zealand College of Psychiatrists.

For three years during the late-1970s and early-1980s, she travelled overseas with her then-husband, haematologist Dr Jim Faed, and their two young sons, working in psychiatry in Australia and Scotland.

In 1981, Julia was made the head of forensic psychiatry at Cherry Farm, dealing with patients who had acted violently.

''We opened those difficult wards.

''It had been keys, keys, keys. Doors going clank, clank, clank. Staff and patients both scared.

''We held meetings with the staff and got them to realise the patients were human.

''It took about six months. Gradually the staff began to feel safe.

''They began to relax ... So, they began to unlock, unlock, unlock, starting with the women's ward.

''Staff and patients began to smile at each other.''

In Perth, Australia, for a conference, in 1982, Julia visited Graylands Psychiatric Hospital and saw how the arts were used there. It was the catalyst for revolutionary Creative Expression Units that spread through New Zealand psychiatric hospitals and in the community.

''I had a strong suspicion that creativity could assist everybody, staff and patients, to access their ... gifts, their wellness, their better selves,'' Julia says.

Penny Eames, the founding executive director of Arts Access Aotearoa, worked with Julia and got to see the idea bud and blossom.

''Julia comes in ... with a mission of change and she doesn't care what anyone thinks. And she's great at it,'' Kapiti-based Eames says.

''I was pretty certain that what she was doing was going to be significant for the rest of the country.''

Patients were given the right to decide for themselves what artistic endeavours they wanted to pursue.

''That was a revolution ... This freedom was really radical in the psychiatric world.''

Photography had been banned. Julia brought in a photographer to stage an exhibition of enormous portraits of patients. It changed staff and patient thinking, Eames says.

''People who always believed they were ugly or that there was something wrong with them ... The works were used to say, you're beautiful ... It was very moving.''

Julia then worked with a group to found a unit for outpatients. It became Artsenta and spawned what was, at one point, about 90 similar arts-based community programmes throughout New Zealand.

By then she was medical superintendent of Cherry Farm. She was also lecturing in the department of psychological medicine at the University of Otago. As a sideline, she was helping found what would become Moana House residential therapeutic community for former prison inmates with addictions. She was also a member of the review panel for the psychiatric maximum security unit at Lake Alice Hospital.

The deinstitutionalisation of psychiatric patients and the closing down of large psychiatric hospitals was under way.

The new community art spaces played an important role in that process, Eames says.

''Julia organised patients to go to this new space, first one day, then two days, then three days a week. Then, she believed, they were ready to live in the community.''

The model was used in the closure of other psychiatric hospitals.

''There was nothing really like these creative spaces anywhere else in the world.

''Her contribution has been huge.''

Then the world came crashing down.

It was May, 1988. Julia was in Sydney to attend a conference. But she never made it. She had a significant mental breakdown, was diagnosed with bipolar affective disorder and thyrotoxicosis. She was put in care at Ashburn Clinic, in Dunedin.

''I was in there for three weeks. But I knew how much it cost and how long it would take. So, I got out of there rather quickly; sooner than I should have,'' Julia says candidly.

''Since then, I have never truly recovered my capacity for very long.''

Her marriage ended about the same time. But in 1993, Julia married Whetu Aranui, at Ratana Pa, near Whanganui. He died six years later.

Her Christian faith has remained important to her.

Julia has worked on and off as a consultant psychiatrist in private practice as well as for district health boards, government departments and Moana House.

Last year, she moved to a rest-home in St Kilda and voluntarily gave up the right to prescribe medicine. She is no longer listed as a psychiatrist with the Medical Council.

''It's a real relief not to have that pressure. But the problem is, I can't stop being a doctor. I can't stop seeing when people are unwell and trying to diagnose what is going on.''

Forensic psychiatry, the care of those whose mental illness has resulted in violence, continues to fire her.

Thirty years on, Julia is still angry about a psychiatrist visiting New Zealand who, she says, swung opinion in favour of putting those who belonged in hospital care in the prison system instead.

''Many of the people in jail have psychiatric disorders, grave ones.

''Really, we should move into the jails and take over a third of them as psychiatric wards.''

She and the Minister of Corrections Kelvin Davis may be thinking along similar lines.

Recently, talking to the Otago Daily Times, Davis praised Corrections' planned 100-bed, top-flight, mental health unit at Waikeria Prison, in the Waikato.

He then added that it was sad that the country's best mental health facility would be inside a prison.

''In my opinion, if we had them in the community - and I know there is cost - then maybe people would get help before they went on to commit crime because of their illness,'' Davis said.

''There are fiscal constraints, but I hope that over time we will get to address many of these issues.''

Julia has moved to a spot on the museum floor where she can see the choir above her. She lifts her head and her hands as they begin a Beatles song that was released the year she graduated.

 

Little darling, it's been a long cold lonely winter

Little darling, it feels like years since it's been here

Here comes the sun

Here comes the sun, and I say

It's all right

 

Julia says she is pleased to be bipolar, despite it giving her ''a lot of very rough patches in life''.

''It's actually been good for me. It's given me an enormous drive, an enormous capacity, humility and an enormous amount of creativity.

''The ability to respond to music is terrific. I get moved to move to music. I think people get envious of my freedom to flow and to colour my world.''

As a psychiatrist, experiencing mental illness also gave her an unusual degree of empathy.

''I have gained the skills to be able to help people through awfulness, because I have had enough experience of it to know there is hope.

''I've had a wonderful, blessed life. I've had so many opportunities, including the opportunity to have a mental illness.

''Every little bit of it has taught me a lot, and I'm really grateful for that.''

Comments

It is dismaying that the private hospital referred to had a 'chequebook' model of practice. You would think care, and the exorbitant fees, would be negotiable in Dr Faed's case.

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