Nursing Care

In the early days of the Colony, untrained convicts were assigned to general nursing roles both in the community and in the prisons. Both male and female convicts acted as nurses, with the male convicts responsible for the male patients and female convict for female patients. They were not paid any wages although were provided their keep.

Prisons often employed the wife of the prison superintendent as the ‘Matron ’; however she was not a trained nurse. Gaols continued to employ prisoners as nurses.

The transfer of control of the Prison Medical Service to the NSW Ministry of Health in 1968 heralded a change in the provision of healthcare in the state’s prison system, including the employment of nursing staff. In 1969 two nurses were engaged to provide healthcare to inmates at the Long Bay Correctional Complex. Thereafter, a nursing presence at each of the correctional centres around NSW was established and today there are over 700 nurses providing health care in NSW prisons. Indeed, the prevailing situation in NSW is now one of nurse-led healthcare, with nurses providing most of the primary healthcare required.

This exhibition is a snapshot of provision of medicine in NSW gaols since colonial times. While the research has yielded much valuable and unique information, there remain some aspects of prison medicine about which we still know very little. The crucial and challenging role of nursing in NSW gaols since establishment of the penal colony is one such area.

Mental Health & History

Tackling mental health through architecture and legislation

Uncertainty over boundaries between mental illness and criminality played out in prisons as much as in psychiatric institutions. Despite the construction of dedicated institutions such as the Tarban Creek Lunatic Asylum in early colonial Sydney, the ‘insane’ were as likely to be imprisoned in Parramatta or Sydney gaols. Early prison architecture often included the ‘Observation Ward’, the place where the level of mental illness of new inmates was assessed.

The desire to control and isolate people deemed unpredictable, or to contain the violence that sometimes accompanied mental illness meant that the social response to ‘madness’ has been incarceration. The first piece of legislation on mental health in NSW for example was passed in 1843. It deemed the most pressing issue to be: “the safe custody of and prevention of crime being committed by persons insane.”

In 1867 the NSW Parliament enacted further legislation requiring judges to commit those brought before them and deemed to be dangerous to what was titled a ‘Lunatic Reception House’. While considered a ‘temporary measure’ between a final committal to either prison or asylum, this legislation for the first time attempted to differentiate the prisoners based on their mental health status.

As the medical specialities of what we now called psychiatry developed during the 19th century, a chronic lack of resourcing remained. Even as beliefs around mental illness changed, the capacity to meet the needs of patients was never sufficient.