William Andrew Dibden, AM
Psychiatrist; director of Mental Health Services in South Australia, 1967-78; president, Royal Australian and New Zealand College of Psychiatrists, 1965-66.
Born Sydney, March 22, 1914. Died Adelaide, October 17, aged 79
As a young medical student, Bill Dibden fell ill with pulmonary tuberculosis and for 18 months had to battle this frightening disease in the days before anti-tuberculosis drug therapy. In his later years he was in no doubt that this experiences as a patient during the long haul to recovery had influenced his attitudes as a doctor to those dependent on his clinical skills and understanding, and also on his eventual choice of psychiatry.
This empathy with the weak and dependent, coupled with a great natural energy and warmth, laid the foundations for a social conscience that modernised and reformed the study and practice of psychiatry in this country.
Dibden’s contribution was built on three major pillars. First, he established the South Australian Association of Mental Health; second, as its leader he was largely responsible for raising public money to found a chair of mental health at Adelaide University.
The third element stemmed from his period as director of Mental Health Services in South Australia, during which he rewrote the mental health legislation – a body of work which foreshadowed the reforms of the civil rights movement and that of Brian Burdekin.
Dibden graduated from the University of Adelaide in 1939 and, despite his tuberculosis, persuaded the military authorities to let him serve as a medical officer at an army training base in order to free a fully fit doctor for more active duties.
From this short spell of national service, via a stint in a country general practice, he joined the Parkside Mental Hospital, the principal psychiatric institution in Adelaide. At that time, and with conditions intensified by wartime restrictions, Parkside was the epitome of the closed asylum.
The young Dibden, with his own memories of having been a patient with a potentially lethal illness, was never to forget the grim, antiquated conditions in which patients lived and under-trained staff worked.
In the early 1950s there was still no formal, organised postgraduate training in psychiatry in Australia and, like so many of his more ambitious peers, Dibden spent a couple of years in London at the famous Maudsley Hospital working under Sir Aubrey Lewis, himself an Adelaide graduate and one of Australia’s most distinguished psychiatrists.
On his return Dibden, by now a married man, set up in private practice with a particular interest in the emotional disorders of children. Perhaps in this choice he was already showing his awareness of and his interest in the relatively powerless, weak and defenceless. With his private practice growing and thriving, but urged on by his ever active social conscience, be became the leading promoter of the South Australian Association for Mental Health.
The first attempt to establish this voluntary body in the early 1950s failed, but a second attempt later in the decade was brilliantly successful. In this enterprise, he not only showed his resilience and determination in the face of apparent failure, but considerable administrative skills. At this time, Adelaide University Medical School had the doubtful honour of teaching the shortest undergraduate course in psychiatry of any medical school in the then British Commonwealth – 16 hours of the six-year course.
The South Australian Association for Mental Health, under Dibden’s dynamic drive and with a group of dedicated volunteers, raised by public subscription around $43,000 to found a chair of mental health at the university and finance it for the first three years. In other words, it was the public, rather than the university authorities, who gave the setting up of the chair its priority. This was, by any standards, a remarkable feat and much of the credit must go to Bill Dibden.
At mid-career he made the momentous decision to give up his successful private practice and applied for the position of director of Mental Health Services in South Australia. By this time, in the late 60s, the old closed institutions had been opened up and new, modern training programs had been implemented.
Dibden’s lasting and historical contribution to his time as the State’s senior public psychiatrist was to rewrite the mental health legislation. He saw in the old legislation a paternalism that denied individuality, even though the underlying motives were charitable in intent.
His thinking through of the problem led him to propose a lessening of the powers of the doctor in such matters as involuntary detention of the severely mentally ill and the placing of these powers in the hands of an independent guardianship board, with the further right of appeal for the detained patient to a mental health tribunal.
In all this, Bill Dibden was guided by his concern for the individual, powerless and helpless not only by reason of psychosis, but also by being caught up in an administrative system that did not always operate fairly when the needs to protect the patient and society came into conflict.
Although properly proud, he wore his honours lightly for he was a genuinely modest, unpretentious man without a trace of arrogance in his make-up; he had too great a sense of humour for that. In all his work for his community – and this included being active for many years in Rotary International and in Medic Alert – he was sustained and supported by a very happy marriage, by close family ties and by a circle of friends and colleagues who admired him.
In his quiet, tolerant yet forceful way, his influence for the public good in South Australia and his memory will live long; he was, to use the poet Wordsworth’s description, “a Happy Warrior”.
(1920 - 2004)
Bill Cramond was emeritus professor of psychiatry,