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TRANSCRIPT
The Consumer Perspective in Mental Health Policy
PHOTO: “Larissa” by Alexandra Crosby is licensed under CC BY-NC-SA 2.0
Dr. Peri O’Shea
Acknowledgements
• The Traditional Owners of the land on which we meet
• People with a lived experience of mental illness and the people who love us
Who am I
Academic and advocate
Lived experience of mental ill health
Childhood & Intergenerational Trauma
Lover, Mother, Nana, Sister, Daughter, Boss, Colleague
and Friend
A ‘carer’
CEO of consumer peak
NSW Consumer Advisory Group – Mental Health Inc. trading as
BEING is the independent, state-wide organisation for people
with a lived experience of mental illness (consumers).
We work with consumers to achieve and support systemic
change.
Vision
For all people with a lived experience of mental illness to
participate as valued citizens in the communities they
choose.
BEING’s ValuesThe lived experience of people is fundamental to all that we do and our work is underpinned by a commitment to upholding international human rights.
We hold the following values:
• Respect and dignity for all to enable inclusion
• Valuing the worth of each individual without judgement
• Social justice and equity to ensure participation
• Promoting equity of access and opportunity in all areas of life
• Belief in recovery to make it possible for every individual to recover
• Integrity to ensure transparency and accountability
• Fidelity to ensure the legitimate representation of the views of consumers
• to ‘drive’ own recovery • people to work with them; not for or on them
• choice – informed, supported and fair
• to feel safe
• being related to as a person
• belief in recovery, belief in them
• recovery orientated services
• environments conducive to recovery
• access to assistance when required
What people want
to facilitate their recovery
Participation
Participation is a fundamental human right as enshrined in Article 25
of the International Covenant on Civil and Political Rights
(ICCPR)
Participation of mental health consumers results in more effective
public policy and facilitates individual recovery
Levels of Participation
• Participation at all levels
• “Nothing about us without us”
• Consumers should be supported to effectively participate in all
decisions that affect them.
• Participation in our their Recovery
• Participation in Service Quality Improvement
• Participation in Service Planning & Governance
• Participation in Social & Legislative Systems change
Consumer Representation
• Improves the quality of peoples’ lives
• Improves service delivery
• Increases the satisfaction of consumers using mental health and other services
• Creates more equity in the relationships between mental health services and consumers
• Improves public policy, guidelines, laws and community attitudes
Being treated as a person
• Holistic services
• Equity of access to all health services
• Wellbeing
• Inclusion
• Understanding – not discrimination
• Whole of health
• Whole of life
• Services not just treatments
The Mental Health Consumer Movement
• Is a social justice movement,
• Founded upon principles of social justice
• Made up of people with a lived experience of mental illness.
• Exists around the world
• Is known in different countries as:
• the Survivor Movement (USA),
• the User Movement (UK), or
• the Consumer Movement (Australia)
• The people within the movement reflect the diversity of the peoples
around the world
Origins
The consumer movement is thought to have its beginnings at
Bethlem Royal Hospital in London UK which is also known as
Bedlam.
History of MH Reform
• Broader historical and social context – liberal, humanistic, less paternalistic
• Backlash from institutionalisation, loss of basic rights, mistreatment
• 1993 National Inquiry into the Human Rights of People with Mental Illness (Burdekin Report)
• 1994 Creation of CAGs in all States and Territories
• First National and State MH policies and plans
• First National Mental Health Standards
National Recovery Framework
Principles of Recovery
1. Promoting a culture and language of hope and
optimism
2. Person first and holistic
3. Supporting personal recovery
4. Organisational commitment and workforce development
5. Action on social inclusion and the social determinants
of health, mental health and wellbeing
Participation and Policy
The National Standards for Mental Health Services (2010, p. 11) …
Standard 3 – Consumer and Carer Participation
Consumers and carers are actively involved in the
development, planning, delivery and evaluation of
services.
Mental Health Statement of Rights• Examples of access rights mentioned include the following equal
opportunities to access and maintain:
• Health and mental health care
• Housing
• Education and training
• Work and employment
• Legal services
• Income maintenance
• Insurance
• Mental Health consumers have the right to social inclusion and
participation in social life on an equal basis with others without
discrimination of any kind
“Contributing Life” framework
National MH Commission
**Recognition that society generally is not mentally healthy
The Implementation Challenge
• Culture change at the top does not necessarily translate to change at the frontline
• Must have a plan and resources for implementation
• Mental Health Policy is so far ahead of implementation that the challenge of implementation is perpetuated
• Policies are often seen as rhetoric only
Hospital Culture
Hospitals are machines
Not very human Moving people through
Emptying beds
Keeping order
Not set up to be holistic Wards segregated by illness
Medical specialisations
Will more Choice = Less Choices?
• Policy reform such as ABF and NDIS could potentially
jeopardise good services, programs and practice
• Impact on NGOs
• Limited rural services
Activity Based Funding (ABF)
• Important not to price out:
• Consumer focus
• Flexibility
• Diversity and complexity of needs
• Non-traditional practices that might just work
• Difficulty putting Mental Health services in neat
boxes
Opportunities and Threats
• Recognition that mental illness can be disabling
• Consumer Choice (maybe)
• Self driven (maybe)
• Potential to access non-traditional services
• Issues designing for complexities of mental illness
• Criteria could undermine Recovery
• Potential discontinuity of services
Why we like it and why it just might work
Holistic
Prevention focused
Community focused
Values lived experience
Has buy-in / ownership
Ongoing collaboration - “Champions for Change”
Role of Peer Workers
Engender hope
‘Fast forward’ relations of trust and recognition
Roles include:
• peer support and mentoring
• individual and systemic advocacy
• service delivery
• participation in service evaluation, research
• input into education and training programs
Informing cultural and structural change in service delivery and
workforce development
Consumer’s are people
We all have our bad days
Cleveland Clinic Empathy Projecthttps://www.youtube.com/watch?v=cDDWvj_q-o8
THANK YOU
Dr Peri O’Shea
Phone: 02 9332 0200
Website: www.being.org.au
Being receives core and project funding from the Mental Health Commission of NSW