Should we be Royal?

Abstract

Objective:

Our college name The Royal Australian and New Zealand College of Psychiatrists (RANZCP) and Crest (Coat of Arms) are echoes of our colonial past, which create a barrier to an inclusive 21st-century Australasian psychiatry. Two hundred and fifty years after European settlement, this article reviews the colonial legacy, the evolution of the college and the process by which the prefix ‘Royal’ came to be attached. This is now an anachronism that symbolically undermines our mission to create a fully inclusive psychiatry for all Australians and New Zealanders, from indigenous people across the spectrum of cultures drawn from recent migrations within our complex multicultural society.

Conclusion:

As psychiatrists, it is time to modernise and reinvent the college name and Crest. We will be a healthier and more inclusive community of practice without the ‘Royal’ prefix, and with a new symbol for our college that embodies our values and vision.

History frames the introduction of the Crown to the people of modern Australasia and the College. We walk forward with our past.

The First Nations’ Peoples of Australia and New Zealand encountered the British Crown of George III via Captain James Cook and party during the 1768–1771 circumnavigation of HMS Endeavour.¹ The first moments in both places were not auspicious. In New Zealand, initial interactions with the crew led to the deaths of Ma¯ori in at least two locations on the North Island by the end of October 1769.² In Australia, first contact is historically symbolised by an Aboriginal shield collected following the British firing of a weapon in Botany Bay, Sydney on 29 April 1770.¹ To this day, the British Museum has refused to return the shield taken in this interaction.^3,4 Australia was declared terra nullius (‘nobody’s land’)⁵ and, from 1788, progressively taken from its occupants.⁶ In New Zealand, the Treaty of Waitangi was drafted by the British and negotiated in haste with the Ma¯ori people in 1840.^7,8 Following this, the New Zealand Settlements Act 1863 and the Public Works Land Act 1865 financed Crown revenue and colonial expansion creating dispossession of land and wealth of the Ma¯ori people.⁹ The business model for Britain was to enjoy the fruits of the Earth, under the aegis of the Crown. Integral to British operations in the Atlantic, the eighteenth-century slave ships anchored in Liverpool exhibited the collateral damage – disrespect of inherent rights of some humans.¹⁰

Two hundred and fifty years since this voyage, the displacement and cultural loss experienced by the indigenous people of both countries is immense. Life expectancy, suicide rates, incarceration and wealth are distinctly unfavourable in these groups (see Table 1).^11–19 What some may perceive to be British accomplishment, others may experience as genocide. Often, the enduring loss so deeply experienced by generations past, present and for the foreseeable future is callously forgiven and forgotten, robbing us all of the opportunity for true advancement.

Table 1.

The ongoing inequalities experienced by the First Nations’ Peoples of Australasia

	Australia		(year)	New Zealand		(year)
	First Nations	Non-First Nations		First Nations	Non-First Nations
Life expectancy (yrs)
Female	75.6	83.4	2017 (AIHW)11	77.1	83.9	2016 (Ministry of Social Development)12
Male	71.6	80.2	2017 (AIHW)11	73.0	80.3	2016 (Ministry of Social Development)12
Suicide rate (per 100,000)
Female	12.6	5.8	2017 (ABS)13	10.4	4.9	2016 (Ministry of Health)14
Male	37.8	18.4	2017 (ABS)13	31.3	14.4	2016 (Ministry of Health)14
Incarceration (per 100,000)
All	2481	164	2017 (ABS)15	710	105	2018 (Department of Corrections)16 2018 (Stats NZ)17
Wealth (median weekly income)
Per person	AUD $441	AUD $670	2016 (AIHW)18	NZ $432	NZ $548 (whole population, includes Maori)	2013 (Stats NZ)19

Our college name

The Australasian Association of Psychiatrists was formed in 1946 to represent psychiatrists across Australia and New Zealand. This was the foundation of our college. We have had three names since.

1946–1963: Australasian Association of Psychiatrists

1963/1964–1978: Australian and New Zealand College of Psychiatrists

1978–present: Royal Australian and New Zealand College of Psychiatrists

The Association transformed into the Australian and New Zealand College of Psychiatrists in 1963–1964 under pressure of training; Queensland would not recognise their Diploma as the Association was not legally constituted.²⁰

Discussion of becoming a Royal College was first mentioned even before this, as documented in the minutes of the Association in 1960.²⁰ This preceded the formation of the United Kingdom Royal College of Psychiatrists in 1972.²⁰

In 1971, the college officially applied to the Australian government for the ‘Royal prefix’ which was granted in 1977.²⁰ During this time, the patrons were the Governor Generals of NZ and Australia.²⁰ However, there is no evidence that New Zealand was included in the discussions or decision to proceed with the application for the prefix.²⁰ The word ‘Royal’ was recognised as evidence of maturity and legitimacy.²⁰

History of the Coat of Arms

Coats of Arms began in medieval times with knights in tournaments recognised by the ‘arms’ on their shields and ‘crests’ on their helmets. In England, the College of Arms continues to grant arms over much of the Commonwealth.²¹

The College Coat of Arms (Figure 1) was designed in the mid-1960s by College Fellow Dr. Eric Cunningham Dax, and granted by the British College of Arms and adopted as the official Australian and New Zealand College of Psychiatrists Coat of Arms in 1969.^20,22

Figure 1.

Coat of Arms.

The crossed bands and central square refers to an intellect that has become disordered and has turned its strength against itself and the body – symbolised by the outer bodily circle, the disorganised inner components of the mind and the enclosed central spirit. Above is the symbol for the chemical compound alum, to which has been attributed special mental healing powers. The symbol incorporates a Roman Cross. Its supraposition is designed to suggest that it is exerting healing influence over the disordered intellect. The snakes entwined about the staffs, which could be caducei, are taken from a coin illustrated by Jung. The snakes can also be related to Ungud, the serpent of the Aboriginal dreamtime.²²

Other colleges

At least four other Colleges provide care without the prefix ‘Royal’: Australasian College of Dermatologists; Australasian College of Anaesthetists; Australasian College of Emergency Physicians; and Australian College for Rural and Remote Medicine.

Discussion

The views raised here cannot reflect all those held by the First Nations’ Peoples of Australasia. Yet, the RANZCP must surely engage with our key partners and consider change if such historic positioning has psychological implications that symbolise ongoing suffering, loss and grief.

The RANZCP Code of Ethics recognises Aboriginal and Torres Strait Islander peoples and Ma¯ori as the traditional owners and custodians of their countries, acknowledging that strong attachment to land and the value of culture, history and traditions is paramount in preserving identity and contributing to mental health (annotation 11.4, RANZCP Code of Ethics, 2018).²³ To identify ourselves via the Coat of Arms as centrepiece erodes the pithy symbolism of local icons from the lands and peoples of Australasia.

The period of the late 1960s and early 1970s when the Coat of Arms was granted and request for the Royal prefix occurred was a different time. The bicentenary of Captain Cook’s voyage to Australia and British endeavour in this region was then generally seen as triumphant. Four members of the Royal family including the Queen attended re-enactment and commemorative ceremonies, as 50 cent coins bearing the Queen and Cook’s image sold out.²⁴ It was a time that often condoned women not being paid equal wages for equal work; most medical practitioners were men; homosexuality was a mental disorder in DSM-II. Yet these reference points were about to change. At the time the college adopted the ‘Royal’ prefix, legal links to Britain were ending. The Privy Council (Appeals from the High Court) Act 1975 terminated the role of the British Privy Council, and the High Court of Australia became the highest court of Australian law.²⁵ The White Australia policy, originally adopted to keep Australia British oriented, also concluded at this time with legislation opening the country to multi-ethnic immigration.²⁶ Yet to this day the austere stature of enquiries, such as Royal Commissions in Australia and New Zealand, continues to serve as reminders of the symbolic power of the term ‘Royal’.

The brand of our college as a professional organisation says much about our vision, mission and values. Would a multicultural and trauma-informed college be Royal? As psychiatrists, we are well-positioned as experts among our other medical peers to address this issue and demonstrate clear leadership as medical specialists. We have particular psychological insights about the dynamics of higher communal authority. Interestingly, the legal profession in Australia and New Zealand has demonstrated a move away from Queen’s Counsel (QC) to Senior Counsel much to the chagrin of some in the profession who claim QC as higher status and independent.²⁷

Is it time to individuate from foreign knights, monarchs and institutions who oversaw slavery and the willing or unwitting displacement of cultures? Many peoples have felt the Royal brand, British policy and the associated legislative framework across the globe for centuries. It is particularly difficult to ignore the impacts still felt by the First Nations’ Peoples today, whom we treat, face-to-face, whom we encourage to enter our profession, while being a standard bearer of that Royal brand. In the work to guide the College forward, change should not be seen to devalue previous acts. Dr Dax was English and brought much vigour post-WWII to Australia in terms of his knowledge of psychiatry and his capacity to hear the voices of patients, both clinically and via their artworks, 16,000 of which are housed under his name.^28,29

Without the ‘Royal prefix’, we will be standing taller and more evolved. Perhaps as diverse multicultural countries, we can walk in partnership with the First Nations’ Peoples of our lands to also develop a symbol for our college that embraces healing that is local, inclusive and not borrowed from a historic British tradition.

We will always have a past, but we can also choose to walk forward to our future.