Book Review: Not Waving, Drowning is a timely and informative look at Australia’s mental health crisis

Issue 85 of Quarterly trial is timely. The Trauma Cleanser Sarah Krasnostein offers a well-researched and insightful look at Australia’s mental health care systems, and its intersection with other institutions. The trial is based on extensive research and first-hand case studies with vulnerable people who fell through the cracks of the system when they should have received the best care.

Krasnostein holds a doctorate in criminal law and has worked extensively in this area. She attributes the first seeds of her essay to her work in the criminal justice system. Over the years, it has been presented to many people who have received inadequate care from various providers (such as in health care and education), often resulting in devastating consequences such as incarceration.

Drawing inspiration from Australia’s checkered history in mental health, Krasnostein, in approximately 40,000 words, traces mental health issues back to colonization and the massacres of Indigenous populations. She connects the dots between the first purpose-built mental institutions at Tarban Creek in New South Wales and Yarra Bend in Victoria to the newer iterations at Kew and then up to the present day. One thing that is clear throughout history (and regardless of which political party is in power) is how grossly underfunded and underfunded these institutions are.

In his comment, Krasnostein references the various public inquiries that have taken place on mental health over the years. Unfortunately, these surveys offered recommendations that often fell on deaf ears. Hopefully Krasnostein’s essay doesn’t meet the same fate, as it’s another strong voice in this area.

Krasnostein shines a light on a broken system by allowing for deeper debate and discussion. She notes that we are moving towards a more Americanized healthcare system and that this has dire consequences for patients, especially those with many disabilities or comorbidities. These people are particularly vulnerable because they often fall under the purview of many departments, but no one has oversight or clear accountability. This means they can more easily fall through the cracks.

Another issue explored by Krasnostein is mental health stigma. His hope is to try to normalize things to avoid the “otherness” that has gone on for too long. Only then can we truly empathize with people with mental health issues. This is significant as a fifth of Australians are believed to be affected each year, and this has likely been exacerbated by recent events like the pandemic.

Do not agitate, drown is a beautifully written and well constructed essay. It’s disarming, visceral and partly heartbreaking when you read about systemic issues in an environment under intense stress. Krasnostein’s long essay unpacks a lot of the complexity and explores many different themes. She finally made the case for real reform for a system that is long overdue.


Quarterly Essay 85: Don’t Shake, Drown by Sarah Krasnostein is available through Black Inc. Books. Pick up a copy of Booktopia HERE.

Angela C. Hale