Psychiatrists sought to define themselves as the experts in this process. In 1948 the AAP minutes also recorded that 'the question of specialization and protection of the term "psychiatrist" was discussed and the Council resolved that steps should be taken to ensure if possible that only medical men be permitted to use the term "psychiatrist"'. These twin concerns about community education and the professional specialisation of psychiatry characterised the development of mental health services in Victoria over the next fifty years.

The Mental Hygiene Authority (MHA) was established by statute in 1950 as the government body with responsibility for managing the psychiatric hospitals. This body was to replace the Mental Hygiene Department, and it changed its name to the Mental Health Authority in 1959. Despite codifying its administrative responsibility for managing the public psychiatric system, the Mental Hygiene Authority Act 1950 (Vic) also specified that the functions of the MHA included 'provision for the treatment and measures for the prevention of mental defect disorder and disease' (Section 10a). Hence prevention was included within its purview, giving legitimacy to its attempts to influence public policy around the social determinants of mental illness.

The psychiatrist Eric Cunningham Dax was brought out by the Victorian Government from England to chair the MHA after a series of inquiries and press-led campaigns about the impoverished state of Victoria's psychiatric hospitals. Alexander Kennedy of Durham University had conducted an inquiry in 1949 which found that the existing administrative arrangements were no longer effective and that a Mental Hygiene Authority was required that would have six to eight members from diverse professions. When the government decided to have a three-member authority instead, Kennedy wrote to the Minister for Health, CP Gartside, to express his dissatisfaction with this structure and express his view that the chairman should be a lay citizen with 'energy and experience' rather than a psychiatrist.⁸ Nevertheless, the appointment of Dax as chairman of a three-person authority went ahead. Dax was selected from a total of seventeen applicants, eight from the United Kingdom and nine from Australia. The selection panel was constituted of RD Wright, Dean of Medicine at Melbourne University, JG Hayden from the British Medical Association, and John F Williams, representing the AAP.⁹

There was a clear government preference for a psychiatrist to lead the MHA, indicating its trust in the profession to lead the reform of mental health services. Moreover, the MHA would report directly to the Minister for Health, thus bypassing the bureaucratic tangles which Kennedy had identified as interfering with the autonomy of the former Mental Hygiene Department.

Dax himself was quite suited to working in this environment and immediately began to speak freely to the press, something that his predecessor, John Catarinich, had been constrained in doing in his role as a public servant. When he arrived at the airport, Dax declared to the press: 'My first objective is to foster a new attitude to mental illness'.¹⁰ The next year he was appealing to the community: 'The more work there is to be done the better I like it. But please don't think I'm going to do it myself. It will be done by the staff of your mental hospitals, by social workers and by the public. Unless I can get their help, I'll be a failure'.¹¹

Dax was clearly adept at using the concept of mental health as a means of mobilising reforms that would improve social conditions. In July 1952 he wrote to the Minister of Health, WO Fulton, expressing the view that 'the attention of the Mental Hygiene Authority [should] be directed to the emergency housing problem with a request that the Authority approach the appropriate ministers to ... investigate in detail those aspects of emergency housing camps which bear on the Mental Health of the community'.¹² Housing was not a traditional focus for psychiatry, but here Dax made a clear connection between social conditions and mental health. This foreshadowed the growing interest within government in the links between the environment and mental well-being.

While the mental health of the community was of increasing interest to government, the problem remained that individuals with mental illness required care. The rates of patients entering and leaving hospital were an important barometer of how well the community understood mental illness and to what extent sufferers had sought treatment or were able to be supported outside of hospital. Discharge and admission figures were continually commented upon in the Annual Reports of the Mental Hygiene Authority. In 1955, for example, Dax wrote that the discharge rate had risen from 55 per cent to 71 per cent and that the number of 'voluntary boarders' (those who were admitted with the consent of the patient and therefore not needing to be certified by a doctor) had trebled in three years and was running at 40 per cent of all admissions.¹³

In order to improve these figures further, Dax set out to develop prevention programs that targeted individuals at risk of developing an illness. In 1952 he wrote to Fulton requesting funding for a Mental Hygiene Information Bureau 'for emotional, domestic and psychiatric problems'.¹⁴ The Bureau, he wrote, would be staffed by two social workers and a typist and would 'ease psychiatric problems of the community'. This service was to provide information to individuals at risk of developing a mental illness. While this particular project was not funded, a similar service was set up as a 'Personal Emergency Service' in April 1960, which was staffed by volunteers.¹⁵ The year 1960 also saw the MHA propose a training course in public relations for sections of the staff.¹⁶ A Mental Health Education Officer, Rachelle Banchevska, led many of these activities, and a Mental Health Week became a focus for public education, with exhibitions such as 'Mental Health - the People's Wealth' being held in 1958.¹⁷

New legislation made the role of government even more clear with regard to both treatment and the building of mental health literacy. The Mental Health Act 1959 (Vic) led to a separation of the mentally ill from the 'intellectually defective', provided for 'easier admission and discharge', and gave the Authority more power to make arrangements with the Minister for the provision of further community and preventative services.¹⁸ In addition there was to be a greater permeability of the institutions. Admission and discharge would be more streamlined, meaning that the community had to become more literate in mental health in order to recognise when someone should be admitted as well as to be able to receive patients who had been discharged.

Voluntary organisations were critical to this process, both as community educators and in their role providing practical support to patients. The Mental Hospital Auxiliaries, the Melbourne Rotary Club, Victoria's Aid to the Mentally Ill, the Red Cross and the Country Womens' Association all played an active role.¹⁹ But while Dax encouraged the public to become more involved with mental health, he also advocated that the psychiatrist should be closely involved in all of the community efforts. Volunteers and social workers had a role to play in mental health promotion, he noted in his 1961 book Asylum to Community, but 'the psychiatrist should take an active part in community care, the promotion of mental health and the prevention of mental illness' (p. 30). Dax was a strong voice for his profession and sought to increase the status of psychiatrists within the public sector.