Atlas›Domain XVI · Historical, discredited & harmful›Guide 051
Guide XVI-051

Deep sleep therapy (Chelmsford)

Harry Bailey1962Sydney, Australia
A 30 · L 58 · M 1218 interventions in the Trinity explorer
Client cardCompare
[source: …] where a claim comes from[uncertain] not confirmed in a primary source[synthesis] the writer's reconstruction

1. Introduction

Version followed: the findings of the New South Wales Royal Commission into Deep Sleep Therapy (1988–1990) as summarised in the NSW State Archives agency description, with Stephen Garton's Australian Dictionary of Biography entry on Harry Bailey (2007), the Justice and Equity Centre's case record, and the NSW Mental Health Act 2007 (s 83, "Prohibited treatments").

Deep sleep therapy (DST) as practised at Chelmsford Private Hospital, Pennant Hills, in north-west Sydney, was a regime of prolonged drug-induced unconsciousness, often combined with electroconvulsive therapy (ECT), promoted by the psychiatrist Harry Bailey as a treatment for conditions including depression and addiction [source: ADB, Garton 2007; JEC]. Its claimed mechanism was that sustained sleep would "rest" or reset the disturbed mind; no supporting evidence for that claim is documented [uncertain], and few other psychiatrists used it [source: JEC]. At least 24 patients died, many others were left with lasting physical and psychological harm, and a Royal Commission found that informed consent had not been given and that records and death certificates had been illegally altered [source: NSW State Archives description; Dictionary of Sydney]. DST is now a prohibited treatment in New South Wales [source: MHCC Mental Health Rights Manual; Mental Health Act 2007 s 83].

This is a harmful practice. The guide describes what patients went through, never how to carry it out. The guide covers the psychotherapist's own work: understanding the history, recognising its legacy, working with survivors, bereaved families, former staff and descendants, responding to a client drawn to a modern "sleep cure", and acting on safeguarding and reporting duties.

Wider context: prolonged drug-induced sleep ("sleep cure", "prolonged narcosis") was promoted in Europe from the early 1920s, most successfully by the Swiss psychiatrist Jakob Kläsi, was shaped by Pavlovian doctrine in the Soviet Union, and fell out of use as other treatments appeared; a 2020 history notes that sleep cures are not part of conventional treatment but are still offered and requested [source: Stucchi-Portocarrero and Cortez-Vergara 2020, abstract].

2. Framework

Historical phases of the practice (outline only) [source: ADB; NSW State Archives description; Dictionary of Sydney; JEC]

  • Origins (1920s–1950s). European and Soviet prolonged-sleep treatments; declining by mid-century [source: Stucchi-Portocarrero and Cortez-Vergara 2020].
  • Chelmsford (1962 or 1963 to 1979). Bailey and colleagues treated patients at Chelmsford Private Hospital. The NSW State Archives description gives 1962; the ADB and the Dictionary of Sydney give 1963 [uncertain: start year differs between sources]. Five patients died within two years of the treatment starting; a 1967 coronial inquest did not find Bailey culpable [source: ADB]. In 1976 a civil court awarded a former patient damages against Bailey and the hospital for assault and false imprisonment [source: JEC].
  • Exposure (1972–1984). A nurse documented irregularities from 1972 and passed evidence to the Citizens Committee on Human Rights, described by the ADB as a branch of the Church of Scientology; in 1978 the committee wrote to the attorney-general and newspapers reported the allegations; in 1980 the television programme 60 Minutes broadcast on Chelmsford [source: ADB; JEC]. The Dictionary of Sydney credits a Sydney Morning Herald investigation with leading to the Royal Commission [source: Dictionary of Sydney; article dates not verified: uncertain].
  • Legal and disciplinary phase (1980–1980s). Misconduct complaints were made in 1980 and 1982; the then Public Interest Advocacy Centre (now the Justice and Equity Centre) represented complainants from 1983 and in 1984 sued to compel the investigating committee to act; a disciplinary hearing began in June 1986, after Bailey's death in 1985; the Court of Appeal later halted the proceedings against the other doctors on grounds of delay, and a High Court special-leave application failed [source: JEC; names of the judgments: uncertain].
  • Royal Commission (1988–1990). Commissioned on 14 September 1988 to Acting Justice J. P. Slattery after media exposés, inquests, court cases and pressure from the Chelmsford Victims Action Group; 288 hearing days, 297 witnesses; Term 1 report presented 17 December 1990, Term 2 report 21 December 1990 [source: NSW State Archives description].
  • Aftermath. The NSW Parliament banned DST and introduced stricter rules on admitting and treating mental-health patients; coronial practice also changed [source: ADB; Dictionary of Sydney]. DST, insulin coma therapy and psychosurgery are prohibited treatments under the Mental Health Act 2007 (NSW), and performing them can lead to criminal prosecution [source: MHCC]. The year the ban was first enacted is [uncertain].

Phases of the psychotherapist's work [synthesis]

  1. Preparation and historical literacy. Goal: know the documented facts and their sources before a client raises them. Move on when you can state the core findings without overstatement.
  2. Recognition and assessment. Goal: identify a Chelmsford connection (as former patient, bereaved relative, former staff member or descendant) or a present-day draw to prolonged-sedation "cures"; screen risk, cognition and physical health. Move on when risk is assessed and medical needs are routed.
  3. Safety and stabilisation. Goal: suicide-risk management, medical liaison, a consent-centred working frame. Move on when the client can engage with the history without being overwhelmed.
  4. Processing and repair. Goal: grief, institutional betrayal, memory gaps, anger at delayed or denied justice, renewed trust in chosen care. Move on when the client directs the next steps.
  5. Advocacy and follow-up. Goal: records access, complaints, legal advice, commemoration, ongoing care coordination.

Session number and length follow the client's needs and the setting [synthesis].

3. Guiding principles

  • Never provide, supervise, recommend or refer to DST or any prolonged-sedation "cure". Practical meaning: if a client asks about one, you explore and route to medical care; you never help arrange it [source: Mental Health Act 2007 s 83 via MHCC; synthesis].
  • Informed consent is the centre of the work. The Royal Commission found patients were recruited by deliberate deception and did not give informed consent [source: NSW State Archives description]. Practical meaning: make every element of your own work explicit, optional and revisable.
  • Believe the documented record and the client's account together. Practical meaning: treat survivor reports of harm as consistent with official findings unless there is reason to think otherwise; do not ask clients to prove what happened [synthesis].
  • Accuracy over drama. Practical meaning: use source figures ("at least 24 deaths") and attribute them; note where sources differ (24 or 25; 1962 or 1963) [source: NSW State Archives; ADB; Stucchi-Portocarrero and Cortez-Vergara 2020].
  • No replication detail. Practical meaning: do not discuss drugs, quantities or procedures with clients; describe the practice in outline only [synthesis].
  • Medical routing for bodily and cognitive effects. Practical meaning: refer for medical and neuropsychological assessment; never advise starting, stopping or changing a medicine [synthesis].
  • Recognise institutional betrayal. Practical meaning: name that harm came from people and systems meant to help, and that regulators and courts were slow [source: JEC; synthesis].
  • Do not let one history become a verdict on all psychiatric care. Practical meaning: help the client tell a prohibited, abandoned regime apart from current regulated treatments, without pressuring them into any treatment [synthesis].
  • Safe messaging on suicide. Practical meaning: mention deaths by suicide factually, never method, never glamorised; assess risk directly [synthesis].
  • Even-handed about campaigners. Practical meaning: acknowledge, as the ADB and JEC do, that a Scientology-linked committee helped surface the evidence, and support clients to read official findings directly [source: ADB; JEC].
  • Client-directed advocacy. Practical meaning: offer information about records, complaints and legal advice; the client decides whether to pursue any of them [synthesis].
  • Name victims only by role. Practical meaning: in notes, teaching and writing, describe people as "a former patient" or "a bereaved daughter" [synthesis].

4. Intervention inventory

The interventions below are the psychotherapist's own work; steps not drawn from a cited source are marked [synthesis].

4.1 Clinician historical-literacy preparation

  • Purpose and when to use: before working with any client who may have a Chelmsford connection, and before teaching. It prevents both minimising and exaggerating [synthesis].
  • Steps: (1) Read the NSW State Archives description of the Royal Commission and the ADB entry. (2) Note the core findings: deliberate deception in recruiting voluntary patients, no informed consent, illegally altered records and death certificates, restricted drugs routinely given by nurses, poor referral, reporting and aftercare, fraud, obstruction of justice and serious medical negligence [source: NSW State Archives description]. (3) Note the figures and where sources differ (at least 24 deaths, only four investigated by a coroner; 25 in one history) [source: Dictionary of Sydney; Stucchi-Portocarrero and Cortez-Vergara 2020]. (4) Note the current legal status (prohibited in NSW) [source: MHCC]. (5) Keep a one-page reference with sources for use in session.
  • Example language (illustrative): "I've read the Royal Commission's findings, so you won't need to explain the background to me unless you want to."
  • Watch for: your own urge to defend or to condemn the profession; a client's correction of a fact you hold. It is working when you can answer factual questions briefly and return attention to the client.

4.2 Recognising a Chelmsford connection at intake

  • Purpose and when to use: with older clients, especially in New South Wales, who mention a private psychiatric admission between the early 1960s and 1979, unexplained memory gaps from that period, or a relative who died after psychiatric treatment then [synthesis].
  • Steps: (1) Ask an open question about past psychiatric or hospital treatment. (2) If a long sedated admission or a death in hospital is mentioned, ask gently whether the hospital or treatment had a name. (3) Do not suggest Chelmsford; let the client name it. (4) Record the connection factually and by role (former patient, bereaved spouse, former nurse, child of a patient).
  • Example language (illustrative): "Some people who were in private psychiatric hospitals in Sydney in the 1960s and 70s had treatments that were later investigated. Is that part of your history, or your family's?"
  • Watch for: distress on naming; uncertainty about what was done (consistent with the Commission's finding that treatment was not disclosed); the risk of suggesting a history that is not there. Working: the client can say what they know and what they do not.

4.3 Trauma-informed assessment of a former patient

  • Purpose and when to use: once a client identifies as a former DST patient. The ADB records lasting physical and mental harm among survivors, and the JEC records allegations of brain damage and paralysis [source: ADB; JEC].
  • Steps: (1) Agree what will and will not be asked, and that the client may stop at any time. (2) Assess current mood, trauma symptoms, sleep, cognition and memory complaints, physical disability and pain. (3) Ask about present medical care and who coordinates it. (4) Ask about trust in health services and any avoidance of care. (5) Identify supports. (6) Agree a plan together and write it down [synthesis].
  • Example language (illustrative): "I'd like to understand how that time affects you now: your memory, your body, how you feel about doctors and hospitals. You choose how much detail."
  • Watch for: fatigue or confusion during assessment (shorten or pace it); shame about memory gaps; physical complaints that need medical review. Working: the client experiences the assessment as consented and finishes it steadier than at the start.

4.4 Suicide-risk assessment and safety planning

  • Purpose and when to use: with all former patients, bereaved relatives and anyone re-exposed to the history. The ADB records that some former patients later died by suicide [source: ADB].
  • Steps: (1) Ask directly and calmly about suicidal thoughts, intent and plans. (2) Assess protective factors and recent stressors (anniversaries, media coverage, legal news). (3) Build a written safety plan: warning signs, coping steps, people to contact, professional contacts, crisis lines. (4) Do lethal-means counselling as current practice describes it (safe storage and removal; no discussion of method). (5) Review at each contact while risk persists [synthesis].
  • Crisis resources: 988 Suicide & Crisis Lifeline (US); Samaritans 116 123 (UK and Ireland); elsewhere, including Australia, local emergency services or a local crisis line.
  • Example language (illustrative): "When people go back over something this painful, thoughts of not wanting to be alive can come up. Has that happened for you?"
  • Watch for: hopelessness about justice; isolation; anniversary reactions. Working: the client can name their warning signs and the first steps on their plan.

4.5 Medical and neuropsychological routing

  • Purpose and when to use: when a former patient reports memory loss, cognitive change, neurological symptoms or chronic physical problems [source: ADB; JEC; synthesis].
  • Steps: (1) Explain that a psychotherapist cannot assess or treat these and that a doctor or neuropsychologist can. (2) With consent, write to the GP describing the reported history and symptoms. (3) Support the client to prepare for appointments (questions, a support person). (4) Never comment on, start, stop or change any medicine; refer such questions to the prescriber [synthesis].
  • Example language (illustrative): "The memory problems you describe deserve a proper medical assessment. Would you like me to write to your GP so you don't have to tell the whole story again?"
  • Watch for: reluctance rooted in medical mistrust (see 4.11); somatic symptoms being read as purely psychological. Working: an assessment happens and the client feels accompanied rather than handed off.

4.6 Psychoeducation on the official findings

  • Purpose and when to use: when a client wants to know what was found, or doubts their own memory of being harmed [synthesis].
  • Steps: (1) Ask what the client already knows and what they want to know. (2) Summarise, with sources, the Commission's findings (deception in recruitment, absent informed consent, altered records, negligence) and the legal outcome (ban; prohibited treatment) [source: NSW State Archives description; MHCC]. (3) Give no detail of drugs or procedures. (4) Ask how the information lands.
  • Example language (illustrative): "A Royal Commission found that patients weren't properly told what the treatment involved and didn't give informed consent. Not knowing what happened to you fits what it found."
  • Watch for: information overload; re-traumatisation from detail; the client using facts to punish themselves for having agreed to admission. Working: self-blame eases and the client's account feels more coherent.

4.7 Validating institutional betrayal and delayed justice

  • Purpose and when to use: when anger, mistrust or despair centre on how hospitals, regulators and courts responded. The JEC records that complaints were deferred for years and that disciplinary proceedings were halted for delay, a judgment it describes as having placed a heavy burden on private citizens [source: JEC].
  • Steps: (1) Name the betrayal as real and documented. (2) Separate the client's feelings from any duty to forgive. (3) Explore what justice would mean to the client now (acknowledgement, records, commemoration, change). (4) Link to advocacy options (4.10) only if wanted [synthesis].
  • Example language (illustrative): "You were harmed, and then the systems meant to respond took years and in the end stopped. Feeling furious about that makes sense."
  • Watch for: generalised mistrust of all help, including you; rumination. Working: the client can hold anger without it closing off care.

4.8 Grief work with bereaved families

  • Purpose and when to use: with spouses, children and siblings of patients who died. Only four of the 24 deaths were investigated by a coroner, and death certificates were found to have been illegally altered [source: Dictionary of Sydney; NSW State Archives description].
  • Steps: (1) Invite the story of the person who died, not only of the death. (2) Explore complicated grief: a cause of death recorded falsely, no inquest, decades of uncertainty. (3) Address guilt ("I agreed to the admission") with the documented deception in recruitment. (4) Consider rituals of remembrance the family chooses. (5) Screen for prolonged grief and depression and route as needed [synthesis].
  • Example language (illustrative): "For years the official record of how your mother died wasn't true. Grieving someone without a true account is its own kind of loss."
  • Watch for: family conflict about blame; renewed grief on media or archive discoveries. Working: the client can speak of the person with warmth as well as pain.

4.9 Supporting access to records

  • Purpose and when to use: when a client wants their own or a relative's records, or the Commission's public material. NSW State Archives holds the Royal Commission's records, including the report and transcript series [source: NSW State Archives description; Dictionary of Sydney].
  • Steps: (1) Clarify what the client hopes to find and prepare them that records may be incomplete or altered, as the Commission found. (2) Point to NSW State Archives and to the client's own legal or advocacy adviser for access rules. (3) Offer a session to read difficult material together, at the client's pace. (4) Plan self-care afterwards [synthesis; access conditions not verified: uncertain].
  • Example language (illustrative): "Before you request anything, let's think about what you hope it shows and what it would be like if it doesn't."
  • Watch for: disappointment, new shocks, or a sense of being erased. Working: the client experiences the search as their choice and can tolerate gaps.

4.10 Supporting complaints, legal advice and testimony

  • Purpose and when to use: when a client wants to pursue acknowledgement, compensation or a complaint. Documented routes in the Chelmsford history include a civil claim (a 1976 award of damages for assault and false imprisonment), medical-misconduct complaints, Supreme Court action to compel a regulator, and evidence to the Royal Commission [source: JEC; NSW State Archives description].
  • Steps: (1) Clarify the client's goal. (2) Explain that you are not a lawyer and refer to a legal service or a public-interest law centre such as the Justice and Equity Centre, which represented complainants [source: JEC]. (3) For current complaints about a health practitioner, point to the state health-complaints body and the national practitioner regulator [uncertain: current NSW complaint routes]. (4) Help the client prepare for giving an account (pacing, support person, grounding). (5) Debrief afterwards [synthesis].
  • Example language (illustrative): "I can help you get ready and look after yourself through it. The legal side needs a lawyer; would you like help finding one?"
  • Watch for: re-traumatisation through repeated telling; disappointment with outcomes; time limits on claims (legal advice needed). Working: the client feels in charge of the process.

4.11 Repairing trust: a consent-centred treatment frame

  • Purpose and when to use: throughout work with former patients and families, given the Commission's findings on deception and absent consent [source: NSW State Archives description]. It also models current guidance: NICE describes shared decisions, a choice of recommended treatments, written information on benefits and harms, and the right to decline or change one's mind [source: NICE NG222, sections 1.3.3, 1.5.2].
  • Steps: (1) Explain your approach, its likely benefits and limits, and alternatives. (2) Agree goals in writing. (3) Check consent at each new step and invite the client to say no. (4) Review the work together at intervals. (5) Give copies of plans and letters [synthesis].
  • Example language (illustrative): "Nothing happens here without your agreement, and you can change your mind at any point, including today."
  • Watch for: over-compliance (agreeing to everything) as a trauma response; test it by inviting disagreement. Working: the client starts to decline or amend proposals.

4.12 Working with fear or avoidance of psychiatric treatment

  • Purpose and when to use: when a survivor, relative or descendant avoids needed psychiatric or medical care, or fears ECT because DST was combined with it at Chelmsford [source: ADB; NSW State Archives description; synthesis].
  • Steps: (1) Validate the fear as rooted in real events. (2) Distinguish what was found unacceptable at Chelmsford (deception, no consent, no proper monitoring or aftercare) from current requirements for information and consent [source: NSW State Archives description; NICE NG222]. (3) Help the client prepare questions for any prescriber. (4) Never advise on starting, stopping or changing any medicine or treatment; leave treatment decisions to the client and prescriber [synthesis].
  • Example language (illustrative): "It makes sense that you'd be wary. What would you need to know, and who would you want with you, to feel safe asking your doctor about this?"
  • Watch for: the therapist taking a side for or against a specific treatment; untreated deterioration. Working: the client makes informed decisions with their doctors rather than avoiding contact.

4.13 A client drawn to a present-day "sleep cure"

  • Purpose and when to use: when a client wants to be "put to sleep" until depression, grief, withdrawal or distress passes, or has found a clinic or retreat offering prolonged sedation. Sleep cures are reported as still offered and requested [source: Stucchi-Portocarrero and Cortez-Vergara 2020].
  • Steps: (1) Explore the wish with curiosity: what the client hopes sleep would do (escape, rest, reset). (2) Assess current suicide risk, since a wish to be unconscious can carry passive suicidal ideation (4.4). (3) Share, in outline, that prolonged sedation as a psychiatric treatment caused deaths and lasting harm at Chelmsford, is prohibited in NSW, and has no place in conventional treatment [source: ADB; MHCC; Stucchi-Portocarrero and Cortez-Vergara 2020]. (4) Route to medical care for any sedation, withdrawal or sleep question. (5) Offer supported psychological help for the underlying need [synthesis].
  • Example language (illustrative): "Wanting to sleep through this tells me how exhausted you are. Can we talk about what you'd want to wake up to, and how to get some relief safely?"
  • Watch for: unsupervised use of sedatives; marketing that promises a reset; overseas clinics. Working: the client accepts medical review and engages with alternatives.

4.14 Working with former nurses and staff

  • Purpose and when to use: with clinicians who worked at Chelmsford or similar settings. The Commission found that nurses routinely gave restricted drugs; one nurse documented irregularities from 1972 [source: NSW State Archives description; ADB].
  • Steps: (1) Assess for moral injury, guilt, shame and fear of exposure. (2) Explore the power structures they worked within, without excusing or condemning. (3) Support reflection on what they knew and when. (4) If they hold information relevant to an inquiry or legal matter, refer them for legal advice [synthesis].
  • Example language (illustrative): "It sounds like you've carried this alone for a long time. We can look at what you did, what you couldn't do, and what you want to do now."
  • Watch for: self-punishment; defensiveness; disclosures with legal implications. Working: the client can describe the past accurately and consider repair.

4.15 Descendants and intergenerational narrative work

  • Purpose and when to use: with children and grandchildren of patients, for whom the history appears as family silences, a parent's changed personality or an unexplained death [synthesis].
  • Steps: (1) Map what is known, suspected and unknown. (2) Look at how the family talked or did not talk about it. (3) Use the documented record to fill gaps, with sources (4.6, 4.9). (4) Work on the client's own relationship to psychiatric care and to the affected relative. (5) Consider a family session if all consent [synthesis].
  • Example language (illustrative): "What did your family say about that time, and what was never said?"
  • Watch for: idealising or demonising the affected parent; anxiety about their own mental-health care. Working: a coherent, compassionate family story emerges.

4.16 Duties when a colleague or institution uses a prohibited or harmful treatment

  • Purpose and when to use: if you learn that a colleague or service is offering prolonged-sedation "sleep cures" or another prohibited treatment. In NSW, performing DST can lead to criminal prosecution [source: MHCC].
  • Steps: (1) Ensure the immediate safety of any client at risk (urgent medical help). (2) Record what you know factually. (3) Consult your professional body's guidance and a senior colleague or supervisor. (4) Report through the regulator or complaints body that applies where you practise; in NSW consider police where a prohibited treatment is being performed [uncertain: current reporting routes]. (5) Never take part in, supervise or refer to the practice. (6) Where you have any personal or professional connection with those involved, consider the APA Ethics Code Standard 3.05 on multiple relationships [source: APA Ethics Code]. Other ethics points here are [synthesis].
  • Example language (illustrative), to a colleague: "I can't be involved in this, and I'm obliged to raise it. I'd rather we talk to the clinical director together."
  • Watch for: pressure to stay silent; your own fear of retaliation (whistleblowers at Chelmsford faced years of delay before a response [source: ADB; JEC]). Working: the concern reaches a body able to act.

4.17 Teaching and supervision on consent and whistleblowing

  • Purpose and when to use: in training, supervision or service development, to make the Chelmsford findings useful for prevention [synthesis].
  • Steps: (1) Present the documented findings with sources. (2) Discuss how deception in recruitment, altered records and slow regulation went unchecked for years. (3) Relate them to current consent and complaint procedures. (4) Refer to people only by role.
  • Example language (illustrative): "What would have needed to be different for a nurse's concerns in 1972 to be acted on that year?"
  • Watch for: sensational retelling; scapegoating one person as if the system were blameless (the Commission condemned all the doctors involved while finding Bailey central) [source: NSW State Archives description]. Working: trainees can name concrete safeguards.

4.18 Navigating campaigners, media and commemoration

  • Purpose and when to use: when a client encounters documentaries, news, survivor groups or anti-psychiatry campaigning about Chelmsford. The ADB and JEC record that the Citizens Committee on Human Rights, which the ADB describes as a Scientology branch, helped bring evidence to light; the Chelmsford Victims Action Group pressed for the Royal Commission [source: ADB; JEC; NSW State Archives description].
  • Steps: (1) Ask what the client has seen and how it affected them. (2) Support them to read official findings directly and to judge each source's purpose. (3) Respect the role campaigners played without endorsing any organisation's wider aims. (4) Explore commemoration the client might want (writing, a memorial gesture, joining others) [synthesis].
  • Example language (illustrative): "Different groups tell this story for different reasons. Would it help to look at what the Royal Commission itself found?"
  • Watch for: media triggering anniversary reactions; pressure from any group to reject all care. Working: the client engages with the history on their own terms.

5. Handling problems

The problems below are the psychotherapist's own synthesis [synthesis], except where a source is given.

  • The client cannot remember what was done to them. Do not try to recover memories or use suggestive techniques. Validate not knowing, which matches the Commission's finding that treatment was not disclosed [source: NSW State Archives description]. Route memory complaints for medical and neuropsychological assessment (4.5) and work with what is known now.
  • Overwhelm on revisiting the history. Slow down, return to present-focused grounding, shorten sessions, and agree a stop signal. Postpone records or media work (4.9, 4.18) until the client is steadier.
  • Suicidal crisis, including around anniversaries, legal news or archive discoveries. Follow the safety plan (4.4); give 988 (US) or Samaritans 116 123 (UK and Ireland), or local emergency services; involve the client's GP with consent. Discuss suicides in the history factually and without method.
  • Mistrust directed at you. Treat it as reasonable and expected. Name the rupture, ask what you did that felt unsafe, adjust, and reaffirm the client's right to stop or change therapist (NICE describes the right to change clinician) [source: NICE NG222, 1.3.3].
  • The client is stuck in rage at people who were never held to account. Acknowledge that disciplinary proceedings were halted and that the Commission's condemnations came long after the events [source: JEC; NSW State Archives description]. Explore forms of justice still available (acknowledgement, testimony, commemoration) without pushing forgiveness.
  • The client asks you to help them get a "sleep cure" or prolonged sedation. Decline clearly and explain why (prohibited in NSW; documented deaths and harm) [source: MHCC; ADB]. Assess suicide risk, route to medical care, and work on the need underneath (4.13).
  • The client refuses all psychiatric or medical care. Do not argue for or against a specific treatment. Explore the fear, help them prepare questions, and stay connected; if risk is high, follow local emergency procedures.
  • Non-adherence to agreed tasks (records requests, GP letters). Treat it as information about readiness or fear, not resistance; renegotiate smaller steps.
  • Family members disagree about what happened or who is to blame. Hold multiple accounts, return to the documented findings for shared facts, and consider separate sessions before any joint one.
  • A former staff member discloses something with legal implications. Pause, clarify the limits of confidentiality agreed at the start, and refer for legal advice before going further (4.14).
  • A client relies on a single campaigning source. Offer the official findings alongside it and help the client judge sources, without disparaging the group (4.18).
  • The therapist's own reactions. Anger at the profession, or defensiveness on its behalf, can distort the work. Use supervision.

Harm account

What was actually done

From 1962 or 1963 until 1979, at Chelmsford Private Hospital in Pennant Hills, north-west Sydney, the psychiatrist Harry Bailey and colleagues kept patients in prolonged drug-induced unconsciousness, in many cases also giving ECT while patients were comatose; Bailey promoted the regime as a cure for depression and addiction [source: ADB; JEC; NSW State Archives description; start year differs between sources: uncertain]. The Royal Commission found that voluntary patients were recruited by deliberate deception without being told what the treatment involved, that informed consent was not given, that nurses routinely gave restricted drugs, that patient records and death certificates were illegally altered, and that referral, reporting and aftercare were poor [source: NSW State Archives description]. Psychometric testing by a psychologist was examined for its role in justifying the treatment [source: NSW State Archives description]. The Commissioner found evidence of fraud, obstruction of justice and serious medical negligence, condemned all the doctors involved, and found Bailey central: DST at Chelmsford would not have existed without him [source: NSW State Archives description; ADB]. Bailey died in 1985, before the disciplinary hearing began; the JEC records his death as a suicide [source: ADB; JEC].

What it looked like to patients, families and staff. Patients were kept unconscious by heavy sedation for days or weeks, lying undressed on beds and fed through tubes, and some were given electroconvulsive shocks while in the coma [source: JEC]. The ADB describes the regime as "extended narcotic induced comas" combined with ECT [source: ADB]. At least one patient received shock treatment against his will [source: JEC]. Voluntary patients were recruited without being told what the treatment involved, and nurses routinely gave the restricted drugs [source: NSW State Archives description]. Pneumonia, infections, dehydration, vomiting and breathing problems were common, and more than a dozen patients died in the coma or shortly after discharge [source: ADB; JEC]. Bailey defended the regime as therapeutically sound and kept asserting that it worked, while other psychiatrists doubted its value and only his small circle used it regularly [source: ADB; JEC]. It came to public attention through a Sydney Morning Herald investigation, which led to the Royal Commission chaired by Justice John Slattery [source: Dictionary of Sydney]. Warning signs today: any offer of a "sleep cure" or prolonged sedation for depression, addiction or stress; a patient who cannot say what treatment they agreed to; and gaps or alterations in a relative's records around a death in hospital [synthesis].

How it caused harm

Patients often developed serious complications, including infections, pneumonia, dehydration and breathing problems [source: ADB]. At least 24 patients died; only four of the deaths were investigated by a coroner [source: ADB; Dictionary of Sydney; one history gives 25: Stucchi-Portocarrero and Cortez-Vergara 2020]. Others later died by suicide, and many survivors had lasting physical and mental harm; former patients alleged brain damage and paralysis [source: ADB; JEC]. Beyond physical injury, the harms included deception, loss of autonomy, falsified records that denied families a true account of deaths, and years of delayed or halted accountability [source: NSW State Archives description; JEC].

Recognising it today

  • DST is a prohibited treatment in New South Wales, alongside insulin coma therapy and psychosurgery; performing it can lead to criminal prosecution [source: MHCC; Mental Health Act 2007 s 83].
  • The Royal Australian and New Zealand College of Psychiatrists issued Position Statement 34 on deep sleep therapy; a 2020 history reports that in 2009 the College judged DST to have no place in treating psychiatric disorders, and the College records the statement as rescinded in June 2023 [source: Stucchi-Portocarrero and Cortez-Vergara 2020; RANZCP; reason for rescission not stated: uncertain].
  • Sleep cures are reported as still offered and requested outside conventional treatment [source: Stucchi-Portocarrero and Cortez-Vergara 2020]. Warning signs [synthesis]: offers to keep a person sedated or asleep for prolonged periods to "reset" the mind or end an addiction; private or overseas settings with little medical oversight; vague information and pressure to consent; promises of rapid cure.
  • Legacy in clients [synthesis]: older former patients with memory gaps, disability or fear of psychiatric care; bereaved families with unresolved questions about deaths; former staff carrying moral injury; descendants with family silences.

What to do instead and how to help those harmed

  • Supported care: treatment chosen through shared decisions, with information on benefits and harms, a choice of recommended options, the least intrusive suitable option, and the right to decline or change one's mind, as NICE describes for depression [source: NICE NG222, 1.3.3, 1.4.2, 1.5.2]. Addiction and sleep problems need medical assessment; never advise on medicines [synthesis].
  • Survivors: trauma-informed assessment, suicide-risk management, medical and neuropsychological routing, records support and repair of trust (sections 4.3–4.12) [synthesis].
  • Families: grief work that acknowledges falsified records and uninvestigated deaths; intergenerational work with descendants (4.8, 4.15) [synthesis].
  • Reporting and legal routes: a prohibited treatment in NSW is a criminal matter [source: MHCC]; complaints about practitioners go to the relevant health-complaints body or regulator [uncertain: current routes not verified]; public-interest legal help has been available through the Justice and Equity Centre (formerly PIAC) [source: JEC].
  • Survivor organisations: the Chelmsford Victims Action Group pressed for the Royal Commission [source: NSW State Archives description]; whether it is still active is [uncertain].
  • Crisis resources: 988 (US); Samaritans 116 123 (UK and Ireland); local emergency services elsewhere.

Sources

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